- Boston Childrens Hospital (Boston, MA)
- …Experience as a Case Manager (Discharge Planning and or Utilization Management ) preferred. Licensure/ Certifications: Current Massachusetts license as a ... of payer denials. They identify and implement initiatives to manage utilization trends, collaborating with the hospital's discharge planning case managers,… more
- Alameda Health System (Oakland, CA)
- …requirements. 16. Participate in orientation of fresh staff as requested by the Manager of Utilization Management . 17. Maintains knowledge of current ... SUMMARY: The System Utilization Management [SUM] Utilization ...Nurse in the State of California Preferred Licenses/Certifications: Certified Case Manager (CCM) or Accredited Case Manager … more
- MedPro Healthcare Staffing (Greensboro, NC)
- …RN Travel, Travel Nurse, Contract Nurse, Agency Nurse, Travel Contract, Travel Nursing, Case Manager , Case Management , Utilization Review, Case Manager ... Joint Commission-certified staffing agency, is seeking a quality Case Manager Registered Nurse (RN) for a travel assignment with...to $1,000 Duties Responsibilities The role of the case management nurse (RN) is to coordinate continuity of care… more
- Reef Systems (Montgomery, AL)
- …briefings and Professional Staff (ProStaff) meetings. Identify and notify the Government MTF case manager , Utilization Management (UM) nurse or Primary Care ... Air Force medical Service (AFMS) mission at the Referral Management Center (RMC) located at Maxwell AFB, AL. This...Each referral is coordinated through a process called Referral Management (RM). When specialty care is referred, the Referral… more
- Amergis Healthcare Staffing (Orange, CA)
- …Case Manager to help support a health insurance agency! The Medical Case Manager (BHI Utilization Management ) will be responsible for reviewing and ... as those listed above may also be qualifying. Preferred Qualifications: Utilization management reviewer experience. Managed care experience. Behavioral health… more
- Kaiser Permanente (Los Angeles, CA)
- …the interdisciplinary approach to providing continuity of care, including Utilization management , Transfer coordination, Discharge planning, and obtaining ... B21|AFSCME|SCNSC Job Level: Individual Contributor Department: Sunset Medical Center - Utilization Management - 0801 Pay Range: $60.79 - $74.4 / hour Travel:… more
- Valley Health System (Paramus, NJ)
- …and Commercial payors guidelines. Monitors and intervenes on LOS, resource utilization and denial management / prevention within the assigned caseload. ... cents experience in clinical nursing, minimum of 3 years in case management / utilization . SPECIAL SKILLS: Registered Nurse, Licensed in State of New Jersey,… more
- AmeriHealth Caritas Health Plan (Philadelphia, PA)
- …services. Discover more about us at www.amerihealthcaritas.com. Join a mission-driven Utilization Management team where your clinical expertise helps shape ... experience in ICU, ED, Med-Surg, pediatrics, behavioral health, or similar. Prior Utilization Management or managed care experience preferred. Strong analytical,… more
- American Traveler (Salem, MA)
- …*BLS certification through AHA required, *ACLS certification through AHA required, *Case Management , Utilization Management , and Discharge Planning skill set ... American Traveler is hiring an experienced RN Case Manager with strong case management and...*Collaboration with multidisciplinary teams to coordinate care and resource utilization , *Parking may not be validated and public parking… more
- HEALTH FIRST CAREERS (Melbourne, FL)
- …reimbursement analysts as necessary. Is an active member of the Utilization Management Committee. Work Experience MINIMUM QUALIFICATIONS Education: Associate's ... Emergency Department Nursing Knowledge/Skills/Abilities: Current working knowledge of care transitions, utilization management , case management and managed… more
- EvergreenHealth (Kirkland, WA)
- …arrange for equipment, and arrange for additional services in the community. Utilization Management /Case Management Nurses provide clinical information to ... payer conditions are met. Primary Duties: Under the direction of the department Director/ Manager of Care Management , supervises the day-to-day activities of the… more
- Bodycote (Wichita, KS)
- Account Manager Our people are the heart of our business. As the world's largest provider of thermal processing services, Bodycote employs thousands of highly ... Summary: Based in the Central ADE Region and reporting to the Regional Sales Manager , you will drive business growth. You will be responsible for prospecting new… more
- Day Kimball Healthcare (Putnam, CT)
- …Registered Nurse, Case Manager Job Responsibilities: Manages the Case Management Department functions and activities to include Utilization Review/Case ... Kimball Health is hiring for a Registered Nurse, Case Manager for Case Management Department as a...preferred. Knowledge of regulatory issues that direct healthcare, compliant utilization management , compliant care management … 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 Nurse (RN) ... certification (CCM, ACM, CCM-RN) preferred. Proven leadership experience in acute care, utilization review, case management . Strong working knowledge of hospital… more
- WellSpan Health (York, PA)
- …Responsibilities Essential Functions: Reviews assigned patients for medical necessity, utilization management , and appropriateness of setting for continued ... resources to support continuous quality and cost of care efforts. Liaisons between utilization management team, third party payers, and the treatment team… more
- NursingPro Staffing (Orange Park, FL)
- About the job Case Management Manager RN Normal Business hours role Monday to Friday- no weekends You may work extended hours if needed max 46hr per week. No ... payer regulations, quality control and process improvement activities as related to Utilization Management . Supports the facility by ensuring effective and… more
- Guidehealth (Rockford, IL)
- …inside and outside the exam room for all patients. Job Description The Manager , Clinical Care is primarily responsible for the day-to-day operations of an integrated ... Based clinical initiatives. This includes but is not limited to case management , transitions of care, care coordination and continuity, provider/staff education on… more
- HEALTH FIRST CAREERS (Palm Bay, FL)
- …in a acute care hospital. Knowledge/Skills/Abilities: Knowledge of care transitions, utilization management , case management , performance improvement and ... Job Requirements POSITION SUMMARY: The RN Case Manager is fully engaged in providing quality/no harm,...support personnel to achieve optimal clinical outcomes through effective utilization of resources and discharge planning for all hospital… more
- Seattle Children's Hospital (Seattle, WA)
- …experience caring for children with medical complexity Current or previous hospital case management or utilization review experience Current or previous case ... Using Seattle Children's leadership qualities and values-based behaviors the manager is accountable for achieving goals and key performance...management or utilization review leadership experience Compensation Range $115,277.00 - $172,915.00… more
- DeWolff, Boberg & Associates (Houston, TX)
- Description With over 38 years of cross-industry management consulting experience, DeWolff, Boberg & Associates has successfully provided services to a variety of ... clients worldwide and has conducted over 700 projects in 20 countries. Management Consultants gain exposure to Fortune 500 companies in various industries and work… more
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