- American Traveler (Roseville, CA)
- …must be disclosed prior to consideration, Additional Information *Responsible for comprehensive case management , utilization review , and coordination ... current CA RN license. Job Details *Work in a Case Management unit within a managed care...*Must have a broad knowledge base of healthcare delivery, utilization review , observation status, and post-acute levels… more
- Ascension (Wichita, KS)
- …of the offer. Responsibilities Provide health care services regarding admissions, case management , discharge planning and utilization review . Review ... at time of hire. Additional Preferences Prior experience in case management or utilization review strongly preferred. Why Join Our Team Ascension Via… more
- Fort Duncan Regional Medical Center (Eagle Pass, TX)
- …relevant certification (CCM, ACM, CCM-RN) preferred. Proven leadership experience in acute care, utilization review , case management . Strong working ... Position Summary Lead and oversee the hospital's case management department, ensuring patients receive...and transitions to prevent readmissions. Liaise with medical staff, utilization review , social services, payors, and community… more
- American Traveler (Salem, MA)
- …is required, *BLS certification through AHA required, *ACLS certification through AHA required, * Case Management , Utilization Management , and Discharge ... an experienced RN Case Manager with strong case management and discharge planning skills for...*Collaboration with multidisciplinary teams to coordinate care and resource utilization , *Parking may not be validated and public parking… more
- American Traveler (Madison, WI)
- …Traveler is seeking an experienced RN Case Manager for a daytime rehab utilization review position requiring an active RN license and two years of ... based in a rehabilitation hospital setting, *Role is within the Utilization Review department, *Day shift schedule from 08:00 to 16:30, Job Requirements… more
- Medical Solutions (Omaha, NE)
- …in Port Charlotte, FL is seeking its next amazing RN (Registered Nurse) to work in Case Management ( Utilization Review ). Read on if this sounds like ... your perfect fit! Nurses and allied healthcare professionals are in high demand nationwide, and our team of industry-leading, traveler-favorite recruiters can get you where you want to go - personally and professionally. Wherever you may roam, travel… more
- Cottage Health (Goleta, CA)
- …Years of Related Work Experience: Minimum: 3 years of experience working with utilization review or case management in an acute care facility or health ... their Clinical Denials and Appeals department responsible for the overall management of utilization review processes and clinical denials between Cottage… more
- Loma Linda University Health (Loma Linda, CA)
- …perspective and objectivity when managing and facilitating the prioritization of care coordination, utilization review , case management and discharge ... judgment and critical thinking skills to ensure efficient and effective age-specific case and utilization management and social work services at Loma Linda… more
- WNS Global Services (Houston, TX)
- …two (2) years of clinical experience and/or in an administrative role *Experience in utilization review , case management , or clinical quality ... or an alternative application process by emailing ###@healthhelp.com Job Description *Performs utilization review of cases to determine if the request meets… more
- Baptist Health (Louisville, KY)
- …experience in acute care nursing required. BSN preferred. B. Utilization review /discharge planning, case management experience preferred. C. Current RN ... licensure to practice professional nursing in the Commonwealth of Kentucky. CCM preferred. If you would like to be part of a growing family focused on supporting clinical excellence, teamwork and innovation, we urge you to apply now! Baptist Health is an Equal… more
- Valley Health System (Paramus, NJ)
- … certification preferred. EXPERIENCE: Minimum five years experience in utilization review management and/or case management preferred. Minimum ... critical thinking and clinical reasoning skills effectively problem-solve and provide case management services. Job Location The Valley Hospital-Paramus Shift… more
- Novo Nordisk Inc. (San Francisco, CA)
- …policies, legal, regulatory, and compliance requirements Ensures effective administrative management of regional business as well as operational budgets Maintains ... budget expenditures as directed Records all activities within a customer response management system (eg VEEVA) and all expenses within Concur in accordance with… more
- Optum (Minnetonka, MN)
- …a clinical and psychosocial approach through the continuum of care. Through concurrent case management , patients will be assessed to determine appropriateness of ... inpatient medical/surgical unit 3+ years of experience working with inpatient hospital case management 3+ years of experience with/knowledge of community… more
- MedPro Healthcare Staffing (Bel Air, MD)
- …Travel Nurse, Contract Nurse, Agency Nurse, Travel Contract, Travel Nursing, Case Manager, Case Management , Utilization Review , Case Manager RN ... Unlimited Referral Bonuses up to $1,000 Duties Responsibilities The role of the case management nurse (RN) is to coordinate continuity of care for patients often… more
- NORTH EAST MEDICAL SERVICES (Burlingame, CA)
- …clinical providers to solve the complex issues. Collaborates with MSO Case Management team and PCPs to ensure resource utilization is appropriate; plans and ... $128752.00 - $165048.00 Salary Description SUMMARY OF POSITION: The Utilization Management (UM) Nurse is a licensed...for the inpatient UM process, including initial and concurrent case reviews, review of inpatient skilled nursing… more
- Riverside Health System (Hampton, VA)
- …Communicates effectively and professionally regarding modality. Provides education regarding utilization management to patients, families, and other members ... team members based upon a thorough medical record review and knowledge of federal and evidence-based guidelines, including...or Accredited Case Manager (ACM) - American Case Management Association (ACMA) (Preferred) Other Requirements… more
- Conway Behavioral Health (Conway, AR)
- …stay with third party payers in a professional manner. Gather data to support case management activities, including presentation of gathered data and case ... PURPOSE STATEMENT: Provide administrative support to the Utilization department. ESSENTIAL FUNCTIONS: Perform pre-certification and negotiate continued… more
- Optum (Hot Springs National Park, AR)
- …address barriers to care. Primary Responsibilities: Care management , case management and utilization review of behavioral health services This ... Caring. Connecting. Growing together. Qualified Behavioral Health Providers are case managers in the State of Arkansas that work...of appropriate levels of care to members Provides care management services through review and evaluation of… more
- HCA Healthcare (Miami, FL)
- …Experience or 2 years of critical care experience Certification in case management or utilization review preferred InterQual experience preferred HCA ... patient. The CM collaborates with the Rehab Program Director and Facility Case Management Director regarding departmental functions. The CM coordinates efforts… more
- EvergreenHealth (Kirkland, WA)
- …hospice, arrange for equipment, and arrange for additional services in the community. Utilization Management / Case Management Nurses provide clinical ... to facilitate patient care in an optimal timeline. Oversees utilization review process including education, support, and...Science degree in Nursing 2 years acute care or case management experience Current State of Washington… more
