- Commonwealth Care Alliance (Boston, MA)
- …Knowledge, Skills & Abilities (must have): - Expertise in managing utilization review processes including prior authorization, concurrent and retrospective ... facilities under the provisions of CCA's benefits plan. The Manager , Utilization Management is responsible for overseeing...for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff… more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer ... review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring...RN **Desired Licensing (nice to have):** + CCM (Certified Case Manager ) **Required Experience (must have):** +… more
- Stanford Health Care (Palo Alto, CA)
- …responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient ... improvement activities that lead to optimal patient outcomes. A Case Manager differs from other roles in...team members; arranges follow up care as appropriate. + Utilization Review -- Reviews prospectively, concurrently and… more
- Providence Little Company of Mary Medical Center San Pedro-… (San Pedro, CA)
- …discharge planning, and utilization review skills Description: The RN Case Manager coordinates patient care plans and services across the continuum of ... Center San Pedro- Case Management Job Type Travel Offering Nursing Profession RN Specialty Case Manager Job ID 33531148 Job Title RN - Case Manager… more
- Providence Little Company of Mary Medical Center - San Pedro (San Pedro, CA)
- …of Mary Medical Center - San Pedro Job Type Travel Offering Nursing Profession RN Specialty Case Manager Job ID 33531206 Job Title Registered Nurse - Case ... Date 09/08/2025 End Date 12/08/2025 Duration 13 Week(s) Job Description Job Title: Case Manager Profession: Registered Nurse Specialty: Case Management… more
- University Health (San Antonio, TX)
- …nursing experience required (as a Staff nurse II or above). Work experience in case management, utilization review or hospital quality is preferred. ... POSITION SUMMARY/RESPONSIBILITIES The nurse case manager coordinates, in collaboration with the patient and interdisciplinary team, the treatment/plan of care… more
- University Health (San Antonio, TX)
- …highly preferred. Three to five years nursing experience required. Work experience in case management, utilization review or hospital quality is preferred. ... POSITION SUMMARY/RESPONSIBILITIES The nurse case manager coordinates, in collaboration with the patient and interdisciplinary team, the treatment/ plan of care… more
- ERP International (Luke AFB, AZ)
- …and 5:00pm, including a one hour lunch **Core Duties:** - Participate in Utilization Management/ Case Management meetings to review and identify opportunities ... **Overview** ERP International is seeking a **Licensed Clinical Social Worker/ Case Manager ** for a Full-Time position in support of the **56th Medical Group,… more
- Stony Brook University (Stony Brook, NY)
- RN Case Manager **Position Summary** At Stony Brook Medicine, a **RN Case Manager ** is a valuable member of our team, who provides clinical services to ... our high standard of excellence. **Duties of a RN Case Manager in the Care Management Department...the following but are not limited to:** + Completes Utilization review screen for inpatient and observation… more
- MVP Health Care (Schenectady, NY)
- …capability through the coordination of quality cost effective care. The Case Manager will also monitor and review cases with the Medical Director to ... continuous improvement. To achieve this, we're looking for a Case Manager , Medicaid Long Term Support Program...Your key responsibilities: Utilize the essentials of an integrated utilization management and case management model that… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …from home opportunity! Please note this position aligns to PST business hours.** The ** Manager , Case Management** Team is a Supervisor for Case Managers. ... job functions, which may include preauthorization, outpatient and inpatient management, case management, retrospective claim review , and delegated management… more
- Alameda Health System (San Leandro, CA)
- SLH Case Manager RN + San Leandro, CA + San Leandro Hospital + SLH Social Services + Part Time - Day + Care Management + $58.74 - $97.91 per hour + Req ... + FTE:0.7 + Posted:Today **Summary** **JOB SUMMARY** The SLH Case Manager RN is responsible for providing...Experience: Two years related in acute care facility and/or utilization review training. Minimum Experience: Varied clinical… more
- Luke Staffing (Agana Heights, GU)
- …Government and professional clinical standards and clinical protocols. . Participate in Utilization Management/ Case Management meetings to review and ... **INDEPENDENT LICENSED SOCIAL WORKER CASE MANAGER ** **SITE OF SERVICE:** ....of newly assigned unit personnel. . Collaborate in the review of unit standing operating procedures. . If directed,… more
- Amherst College (Amherst, MA)
- …supports the selection, training, and utilization of the Community Standards Review Board. Enters case information and stewards case completion ... Office Manager for Care and Accountability Amherst Campus Full...and dissemination of training materials for the Community Standards Review Board and Advisors. Responds to inquiries regarding law… more
- Commonwealth Care Alliance (Boston, MA)
- …support consistency and quality across BH and Health Home providers. - Participate in case review meetings and rounds as needed to enhance coordination and care ... Position Summary: The Behavioral Health (BH) Provider Engagement Program Manager is responsible for cultivating strong, collaborative relationships with behavioral… more
- Home Depot (Richmond, VA)
- **Position Purpose:** The District Asset Protection Manager (DAPM) is responsible for teaching, coaching, and training associates to ensure the effective execution ... be able to multi-task across stores and gain the partnership of the District Manager , Store Manager , Store Leadership Team, APS and other store associates to… more
- Teleflex (Minneapolis, MN)
- Clinical Affairs Manager , Interventional Access (REMOTE) **Date:** Oct 11, 2025 **Location:** Minneapolis, MN, US **Company:** Teleflex **Expected Travel** : Up to ... REQUIRED: 50% (Domestic and International; overnight required)** The Clinical Affairs Manager will provide clinical expertise, insight, and support to clinical… more
- Alameda Health System (San Leandro, CA)
- …3 years, experience in Case Management in an acute setting or utilization review at a medical group or health plan. Required Licenses/Certifications: Active ... necessarily performed by each individual in the classification. + Coordinates all utilization review functions, including response to payor requests for… more
- University Health (San Antonio, TX)
- …preferred. Three years recent, full time hospital experience preferred. Work experience in case management, utilization review , or hospital quality assurance ... a registered nurse is required. National certification in related field is desirable. Case Manager Certification (CCM, CPHQ, or ANCC) or Certified Diabetes Nurse… more
- Thornton Construction Company (Opa Locka, FL)
- …Tool Box Talks. Issue subcontractor safety violations and submit weekly to Project Manager . Implement Thornton's Hurricane Preparedness Plan in case of an ... subcontracts, contract drawings, specifications and addenda, and to assist the Project Manager in the development of the on-site procedures. Examine the contract… more
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