- Boston Childrens Hospital (Boston, MA)
- …nursing experience required, pediatric experience preferred. Experience as a Case Manager (Discharge Planning and or Utilization Management) preferred. ... 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)
- …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...months of recent experience in an Acute Care Case Manager setting Active RN License BLS Certifications Degree from… 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 ... review , and transitions to prevent readmissions. Liaise with medical staff, utilization review , social services, payors, and community providers. Track and… more
- EvergreenHealth (Kirkland, WA)
- …provides intervention to facilitate patient care in an optimal timeline. Oversees utilization review process including education, support, and training of team ... for equipment, and arrange for additional services in the community. Utilization Management/Case Management Nurses provide clinical information to our payers and… more
- Kaiser Permanente (Los Angeles, CA)
- …the general and specialized principles, practices, techniques and methods of Utilization review /management, discharge planning or case management. Working ... during case review or other activities. Reviews, analyses and identifies utilization patterns and trends, problems or inappropriate utilization of resources… 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. Maintains knowledge...and changes in healthcare delivery as it pertains to utilization review (eg, medical necessity, level of… 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 with CMS regulations and Commercial payors guidelines. Monitors and intervenes on LOS,… more
- American Traveler (Salem, MA)
- American Traveler is hiring an experienced RN Case Manager with strong case management and discharge planning skills for a dayshift inpatient role. Job Details *Work ... through AHA required, *ACLS certification through AHA required, *Case Management, Utilization Management, and Discharge Planning skill set required, *Certified Case … 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 ... care including the appropriate length of stay, patient status management, resource utilization and discharge planning for all hospital admissions. The UR Nurse… more
- Rogers Behavioral Health (Oconomowoc, WI)
- …Supervisor will have involvement with managed care companies as needed and coordinate with the utilization review manager or lead. Monitor the safety of the ... aftercare providers to ensure continuity of care, if warranted. Communicate with the Utilization Review department to provide information necessary to assist in… more
- Mad River Community Hospital (Arcata, CA)
- …Profession RN Specialty Case Manager RN Job ID 16149898 Job Title RN - Utilization Review RN Weekly Pay $2205.3 Shift Details Shift Days 3x12 Scheduled Hours ... 36 Job Order Details Start Date 03/05/2025 End Date 06/04/2025 Duration 13 Week(s) Client Details City Arcata State CA Zip Code 95518 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 better… more
- VIBRANTCARE REHABILITATION, Inc. (Sacramento, CA)
- …all times. Attend and/or participate in facility meetings as directed by Center Manager (may include utilization review , infection control, disaster ... practice under the direction and supervision of a licensed Physical Therapist. Review the VibrantCare Clinical Operations Policies & Procedures Manual on a yearly… more
- TERRACON (Wichita, KS)
- …daily operations of drilling staff, including training, development, and performance review , utilization of equipment, personnel workload, safety oversight, ... preparation of proposals and cost estimates. With support from the Department/Office Manager and Regional Exploration Manager perform business and client… more
- Northwell Health (Riverhead, NY)
- …case management and clinical pathways, variance analysis and trending, quality management/ utilization review and home care/discharge planning, preferred. Keeps ... another level of care according to regulatory standards. * Performs concurrent utilization management Conducts chart review for appropriateness of admission and… 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 ... exceeding the Novo Nordisk points threshold assigned based on review of Motor Vehicle Records. Qualifications A bachelors degree...this job family are as follows: Rare Endocrine Therapy Manager $ 96,670 to $ 178,840 Sr Rare Endocrine… more
- UNC HEALTH (Raleigh, NC)
- …effectiveness through the integrating and functions of case management, utilization review and discharge planning. The Care Manager must be highly organized ... policies. Responsibilities: 1. Identify Cases & Prioritize Day - Review work list to prioritize patients and identify new...from CAPP as appropriate. As necessary meet with the Utilization Manager (UM) and SW after the… more
- AdventHealth (Altamonte Springs, FL)
- …and world-class resource The role you'll contribute : The RN Care Manager in collaboration with the patient/family, social workers, nurses, physicians and the ... and progression through the continuum of care. The RN Care Manager ensures efficient and cost-effective care through appropriate resources monitoring, and… more
- LHC Group, Inc. (Lafayette, LA)
- …Care Manager , and/or home health clinicians regarding identified OASIS, utilization , or plan of care inconsistencies. Utilizes available tools and develops ... Job Description Responsible for the timely review of plan of care and OASIS time...record to ensure accuracy of OASIS items, documentation, and utilization for quality and outcome management through clinician collaboration… more
- Highmark Health (Erie, PA)
- …including but not limited to: appropriateness of care, documentation requirements, utilization review principles and criteria, insurance benefits and ... outcomes, engages patients/caregivers in their healthcare, and supports effective resource utilization . Serves as key team members in the management of readmissions,… more
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