- Boston Childrens Hospital (Boston, MA)
- …Experience as a Case Manager (Discharge Planning and or Utilization Management ) preferred. Licensure/ Certifications: Current Massachusetts license as a ... Job Posting Description Department Summary: The UM Case Managers at Boston Children's review documentation within 1 business day of patient admission to assess for… more
- MedPro Healthcare Staffing (Greensboro, NC)
- …Contract Nurse, Agency Nurse, Travel Contract, Travel Nursing, Case Manager , Case Management , Utilization Review , Case Manager RN *Weekly payment ... 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
- Alameda Health System (Oakland, CA)
- SUMMARY: The System Utilization Management [SUM] Utilization Review RN is responsible for ensuring the appropriate use of healthcare resources while ... in orientation of fresh staff as requested by the Manager of Utilization Management . 17....and changes in healthcare delivery as it pertains to utilization review (eg, medical necessity, level of… 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
- EvergreenHealth (Kirkland, WA)
- …arrange for equipment, and arrange for additional services in the community. Utilization Management /Case Management Nurses provide clinical information to ... provides intervention to facilitate patient care in an optimal timeline. Oversees utilization review process including education, support, and training of team… more
- Kaiser Permanente (Los Angeles, CA)
- …utilize/apply the general and specialized principles, practices, techniques and methods of Utilization review / management , discharge planning or case ... the interdisciplinary approach to providing continuity of care, including Utilization management , Transfer coordination, Discharge planning, and obtaining… more
- HEALTH FIRST CAREERS (Melbourne, FL)
- Job Requirements POSITION SUMMARY The Utilization Review (UR) nurse performs medical necessity reviews on all payer admissions to determine appropriate admission ... reimbursement analysts as necessary. Is an active member of the Utilization Management Committee. Work Experience MINIMUM QUALIFICATIONS Education: Associate's… more
- Valley Health System (Paramus, NJ)
- POSITION SUMMARY: Performs concurrent utilization review activities on all patients within the assigned caseload. Collaborates and educates the medical staff on ... appropriate utilization review guidelines and documentation in accordance...Commercial payors guidelines. Monitors and intervenes on LOS, resource utilization and denial management / prevention within the… more
- AmeriHealth Caritas Health Plan (Philadelphia, PA)
- …collaboration. Lead with Clinical Insight. Whether you're an experienced utilization review nurse, a sharp case manager , or a behavioral health clinician ... services. Discover more about us at www.amerihealthcaritas.com. Join a mission-driven Utilization Management team where your clinical expertise helps shape… 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
- 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 ... quality control and process improvement activities as related to Utilization Management . Supports the facility by ensuring.... Supports the facility by ensuring effective and efficient utilization review and discharge planning services to… 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… more
- Elevance Health (Waynesville, NC)
- Anticipated End Date: 2025-09-07 Position Title: Manager I Care Management (Haywood Co.) Healthy Blue Care Together CFSP Job Description: ... responsiveness to client needs, and direct, hands-on engagement. The Manager Care Management , Foster Care ( Manager...may include, but are not limited to: Manages resource utilization to ensure appropriate delivery of care to members,… more
- UNC HEALTH (Raleigh, NC)
- …through the integrating and functions of case management , utilization review and discharge planning. The Care Manager must be highly organized ... processing) to Care Management Assistant. Consult Social Worker and/or Utilization Manager per established departmental protocol. Maintain knowledge of… more
- Novo Nordisk Inc. (Boston, MA)
- …collateral development Achieve or exceed assigned sales objectives through effective utilization of all available resources, strategies and tactics Collaborates with ... by not exceeding the Novo Nordisk points threshold assigned based on review of Motor Vehicle Records. Qualifications A bachelors degree required Minimum five… more
- AdventHealth (Altamonte Springs, FL)
- …documents avoidable days, and facilitates progression of care. Collaborates with Utilization Management staff for collaboration on patient status changes ... Bachelor's degree in Nursing Health-related master's degree or MSN Prior Care Management / Utilization Management experience Professional Certification more
- Highmark Health (Erie, PA)
- …including but not limited to: appropriateness of care, documentation requirements, utilization review principles and criteria, insurance benefits and ... utilization . Serves as key team members in the management of readmissions, length of stay, ED utilization...or CERTIFICATIONS Required None Preferred ACM Certification (Accredited Case Manager ) - American Case Management Association -… more
- Tufts University (Somerville, MA)
- …*Must have at least 7 to 10 years relevant experience/expertise in contract review , drafting and negotiation, strategic sourcing, vendor management in one or ... Overview The Procurement Contract Manager is responsible for working with the Procurement...*Bachelor's Degree in business, economics, operations, or supply chain management . *Expertise in review , editing, and negotiation… more
- AdventHealth (Hinsdale, IL)
- …documents avoidable days, and facilitates progression of care. *Collaborates with Utilization Management staff for collaboration on patient status changes ... Worker is under the general supervision of the Care Management Supervisor or Manager and is responsible...AND EXPERIENCE PREFERRED: *Current working knowledge of discharge planning, utilization management , care management , performance… more
- Valley Presbyterian (Los Angeles, CA)
- …level of customer satisfaction in the most cost-effective manner. Responsible for Utilization Management , Case Management , and Discharge planning activities ... Job Summary: As a Registered Nurse/Case Manager , Case Management Unit, you will...with Critical Care experience desirable. Previous experience in Case Management , Utilization Management , or Discharge… more
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