- Broward Health (Fort Lauderdale, FL)
- …Point Shift: Shift 1 FTE: 1.000000 Summary: Performs and monitors integrated, concurrent utilization review and case referrals on patients, consistent with ... the approved Utilization Review Plans. Works with medical and professional staff to...Care and other third party payors to ensure appropriate case management. Education: Essential: * Associate Education specialization: Essential:… more
- Coffeyville Regional Medical Center (Coffeyville, KS)
- …providers to establish the most suitable course of action. The RN Case Manager assures appropriate utilization review and may interact with insurance ... pride in our friendly and caring staff. The Infusion RN/Infusion Services Case Manager focuses on assuring proper care of outpatient infusion patients while… more
- Baptist Memorial Health Care Corporation (Jackson, MS)
- …Healthcare/Medical- Case Manager Preferred, or Healthcare/Medical - Utilization Review Preferred. Education Minimum Required Graduate of School ... to complete an initial review . Collaborate with physicians, Manager of Case Management and physician advisors to resolve conflicts. Coordinate with bed… more
- American Traveler (Philadelphia, PA)
- American Traveler is seeking an experienced RN Case Manager with at least three years of hospital case management experience and a valid PA or Compact RN ... *Position is based in a hospital setting within the case management unit, *Day shifts from 8:00 am to...certification required, *Minimum of three years of recent hospital case management experience required, *PA fingerprints and PA Childline… more
- Contra Costa County, CA (Martinez, CA)
- …Health Services? The Contra Costa Health Department is seeking to fill one (1) Utilization Review Manager position in Contra Costa Health Plan, located ... business. We are seeking a strategic, experienced, and collaborative Utilization Review Manager to lead...must have included experience as a Utilization Review Nurse, Discharge Planner, or Case Management… more
- Baton Rouge General (Baton Rouge, LA)
- …employers in the state. Check out our employee perks here! What You Will Do: As Manager of Utilization Review , you'll be responsible for overseeing the daily ... team that shapes the future of patient care through resourceful and compassionate utilization review ? What We're Looking For: Strong leadership and advocacy… more
- UHS (San Antonio, TX)
- …Joint Commission, CMS, Tricare standards. Computer skills and knowledge of basic case management/ utilization review principles. EDUCATION: Bachelor's degree ... care team and will provide ongoing and systematic utilizaton review . The Care Manager advocates for patients...experience in mental health setting with previous experience in Case Management/ Utilization Review and discharge… more
- Tenet Health (Delray Beach, FL)
- …years acute hospital or Behavioral Health patient care experience Certification: Accredited Case Manager (ACM) preferred. #LI-RS1 Tenet complies with federal, ... by case basis. This position integrates national standards for case management scope of services including: - Utilization Management services supporting… more
- Fort Duncan Regional Medical Center (Eagle Pass, TX)
- …rounds. Manage department budget, staffing, and training needs. Function as Utilization Review /Denials Manager as required. Qualifications Registered ... (CCM, ACM, CCM-RN) preferred. Proven leadership experience in acute care, utilization review , case management. Strong working knowledge of hospital billing,… more
- Molina Healthcare (Long Beach, CA)
- …(such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services ... (such as, therapeutic drug monitoring, drug regimen review , patient education, and medical staff interaction), and oversight (establishing and measuring performance… more
- Optum (New Berlin, WI)
- …Health Care and discover the meaning behind Caring. Connecting. Growing together . The Case Manager RN is responsible and accountable for coordination of patient ... Must have strong analytical, critical thinking and organizational skills Knowledge of Utilization Review , Medicare Requirements processes as well as State and… more
- Methodist Hospitals (Merrillville, IN)
- Overview Under the guidance of the Case Manager , the Lead Utilization Specialist is responsible for serving as a resource for internal and external customers ... verbal and written communication. Coordinates responses to the Peer Review Organization as it relates to both medical and...(DRG) coding to serve as a consultant to the Utilization Specialist. Excellent communication skills both verbally and in… more
- Encompass Health (Tustin, CA)
- …Participate in utilization review process: data collection, trend review , and resolution actions. Participate in case management on-call schedule as ... This is a per diem Case Manager position. After orientation and...Maintain knowledge of regulations/standards, company policies/procedures, and department operations. Review /analyze case management reports, including Key Care… more
- Veterans Health Administration (Memphis, TN)
- Summary The Utilization Management (UM) Inpatient Care Coordinator is a professional registered nurse who is responsible and accountable for indirect patient care by ... employees of Memphis VA Medical Center only Videos Duties Registered Nurse- Utilization Management Inpatient Care Coordinator (UMICC) facilitates patient care and… more
- Highmark Health (Monroeville, PA)
- …including but not limited to: appropriateness of care, documentation requirements, utilization review principles and criteria, insurance benefits and ... techniques BSN LICENSES or CERTIFICATIONS Required None Preferred ACM Certification (Accredited Case Manager ) - American Case Management Association -… more
- WellPower - All Jobs (Denver, CO)
- Clinical Case Manager - HITT Team Wellpower...hiring salary ranges. We ask all applicants to carefully review the hiring salary range for each posted job ... recovery. Responsible for all clinical documentation of consumer interaction. As a Clinical Case Manager , you will be providing transportation the people we… more
- KBR, Inc. (Arlington, VA)
- Title: Special Operations Case Manager Part-Time (National Capital Region) Belong. Connect. Grow. with KBR! KBR is a company of innovators, thinkers, creators, ... meeting care goals. Knowledge and skill in using pre-established utilization review criteria recognize and report actual... management experience and must be certified as a case manager by a recognized certifying organization,… more
- Tranquil Care Hospice (Los Angeles, CA)
- Are You Ready to lead in Healthcare? We are currently seeking a LVN Case Manager (LVN CM) to join our outstanding healthcare team! Salary Range: $83,200-$99,840 ... you will contribute to the team: As a LVN Case Manager (LVN CM) , you will...patients and their families receive appropriate care coordination and utilization of services to ensure the highest quality care.… more
- Trinity Health (Ann Arbor, MI)
- …Part time Shift: Day Shift Description: POSITION PORPOSE The Registered Nurse Case Manager assumes overall accountability for patients' discharge plans while ... leadership role in achieving desired clinical, financial and resource utilization outcomes. This is achieved by coordinating care and...Friday. WHAT YOU WILL DO The RN Registered Nurse Case manager is responsible for conducting a… more
- The Salvation Army Central Territory (Davenport, IA)
- …Army business. Certificates, Licenses, Registrations: Successfully completes The Salvation Army's Case Manager Certification within 90-days of hire. Physical ... human needs in His name without discrimination. Summary/Primary Purpose: Provide case management services for individuals and families receiving housing services… more
