• Utilization Management

    LA Care Health Plan (Los Angeles, CA)
    Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II is primarily responsible for receiving/reviewing… more
    LA Care Health Plan (09/10/25)
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  • Associate Director, Admissions

    University of Pennsylvania (Philadelphia, PA)
    …resources, and ensure compliance with institutional privacy policies. As the school's liaison for Graduate Admissions User Groups and the Provost Office, ... required. Qualifications: A Bachelor's degree with 3-5 years of experience in admissions operations, enrollment management , or higher education recruitment is… more
    University of Pennsylvania (09/09/25)
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  • Hospital Admissions Rep IV

    University of Rochester (Rochester, NY)
    …Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500016 Admissions Center-SMH Work Shift: UR - Rotating (United States of America) Range: ... **Responsibilities:** GENERAL SUMMARY Coordinates or manages inpatient and outpatient admissions , including bed assignments and the completion of preliminary… more
    University of Rochester (08/07/25)
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  • Hospital Admissions Rep IV

    University of Rochester (Rochester, NY)
    …Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500016 Admissions Center-SMH Work Shift: UR - Rotating (United States of America) Range: ... financial eligibility, secures account for billing and coordinates account management through discharge Completes appropriate forms to complete Death Certificate… more
    University of Rochester (08/07/25)
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  • RN Admissions Case Manager - OLGMC (7a-7p…

    Ochsner Health (Lafayette, LA)
    …(CCM), Certified Professional Utilization Review (CPUR), Certified Professional in Utilization Management (CPUM) or Certified Professional in Healthcare ... in the delivery of patient care. Preferred - Experience in case management or utilization review. **Certifications** Required - Current Registered Nurse… more
    Ochsner Health (08/14/25)
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  • Registered Nurse - Community Care…

    Veterans Affairs, Veterans Health Administration (Ann Arbor, MI)
    …knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ... seeking a Full-Time Registered Nurse (RN) - Community Care Admissions /Transfers Office, aligned under Chief of Staff. Responsibilities The...in the community. The CC RN serves as a liaison to both internal and community providers and is… more
    Veterans Affairs, Veterans Health Administration (09/10/25)
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  • Administrator of Admissions , Outreach…

    Calvary Hospital (Bronx, NY)
    …pertinent data. 8. Knowledge of and experience in Quality Assessment and Improvement, Utilization Review. 9. Ability to develop management systems to track data ... Outreach, Admitting and Intake implementing changes when appropriate. Acts as liaison between Calvary Hospital and referring institutions and providers. Actively… more
    Calvary Hospital (08/20/25)
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  • Utilization Management Nurse - 20…

    Omaha Children's Hospital (Omaha, NE)
    …equal opportunity employer including veterans and people with disabilities. **A Brief Overview** Utilization Management (UM) is a specialty area of Nursing Case ... physician advisor, and NCM in various aspects of denial management . UM will serve as a liaison ...settings. + Skills in negotiation and problem solving with utilization management . + Should be a creative,… more
    Omaha Children's Hospital (09/05/25)
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  • Utilization Management Nurse…

    Omaha Children's Hospital (Omaha, NE)
    …equal opportunity employer including veterans and people with disabilities. **A Brief Overview** Utilization Management (UM) is a specialty area of Nursing Case ... physician advisor, and NCM in various aspects of denial management . UM will serve as a liaison ...settings. + Skills in negotiation and problem solving with utilization management . + Should be a creative,… more
    Omaha Children's Hospital (09/05/25)
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  • Director Utilization Mgmt (Do Or MD…

    Wellpath (Lemoyne, PA)
    utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners and stakeholders, and ... care support. **About this role** The Medical Director of Utilization Management leads and oversees utilization...to reduce length of inpatient stays and decrease ED admissions . + Evaluate and recommend policy improvement related to… more
    Wellpath (08/08/25)
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  • Hospital Liaison - Patient Health Advocate

    Somatus (Atlanta, GA)
    …accessing resources to adhering to a physician's treatment plan upon discharge. The Hospital Liaison will work with the RNCM, case management and care givers to ... leadership and/or provider engagement to build relationships with case management teams at strategic facilities in assigned area as...ongoing conversations and plans to address areas to reduce admissions and cost utilization + Other duties… more
    Somatus (08/28/25)
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  • Associate Director of Outreach

    The Arc Erie County NY (Williamsville, NY)
    …the Intake and Admissions team, including supervision, coaching, and performance management . + Serve as a liaison between intake staff, program leadership, ... program utilization . Compliance & Quality Assurance + Ensure all admissions processes are compliant with federal, state, and local regulations, including OPWDD… more
    The Arc Erie County NY (08/23/25)
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  • ED RN Case Manager - UR & Discharge Planning

    Beth Israel Lahey Health (Plymouth, MA)
    …unit cost, 4) reducing readmissions. **Duties/Responsibilities:** **A. Utilization Management ** Performs review of anticipated admissions utilizing InterQual ... This role is structured around four major functions + Utilization Management + Care Coordination + Discharge...satisfaction with the discharge from the ED Prevents unnecessary admissions for social reasons Functions as a liaison more
    Beth Israel Lahey Health (08/10/25)
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  • Physician Advisor

    Virginia Mason Franciscan Health (Tacoma, WA)
    management committee, in defining operational strategic objectives for the Utilization Management Program and serves as the liaison to other medical staff ... * Act as physician liaison between case management / utilization management and providers to...* Review and report on PEPPER metrics; (LOS, CMI, Re- admissions , OBS rates, and governmental audit measures) to Hospital… more
    Virginia Mason Franciscan Health (09/06/25)
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  • Logistics RN Bed Management

    Bassett Healthcare (Cooperstown, NY)
    …do The Logistics C3 RN is responsible for appropriate placement for patient admissions , coordinating and expediting admissions and transfers as well as ... Bassett Medical Center and throughout the network. Acts as a primary liaison between all service locations, support departments, other healthcare facilities, and in… more
    Bassett Healthcare (09/09/25)
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  • RN/Case Manager-MSH-Case Management

    Mount Sinai Health System (New York, NY)
    …limited to: a. Reviews all new admissions to identify patients where utilization review, discharge planning, and/or case management will be needed using ... **Job Description** **RN/Case Manager MSH Case Management FT Days** The Case Manager (CM) will...length of stay (LOS), improved efficiency, quality and resource utilization . Assignment will be by units/clinical areas of practice… more
    Mount Sinai Health System (08/28/25)
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  • Case Management Coordinator - Inpatient…

    Cedars-Sinai (Beverly Hills, CA)
    …review process. The coordinator works collaboratively with all team members of Utilization Management , Patient and Provider Services, Claims Department and other ... with community resources and social supports required. One (1) year of utilization management or managed care experience preferred. **About Us** Cedars-Sinai… more
    Cedars-Sinai (08/08/25)
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  • Mental Health Therapist (LCSW, LMFT or LCPC)…

    Logan Health (Kalispell, MT)
    Logan Health Wellness & Pain Management is proud to offer some of the most comprehensive pain and wellness care in the United States. Job Description Summary Logan ... Health Wellness and Pain Management is looking for an LCSW, LCPC or LMFT...Duties: + Triages referrals from providers and ensures on-going liaison occurs with stakeholders as applicable to assigned area(s).… more
    Logan Health (07/08/25)
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  • Senior Denials Mgmt Specialist

    Houston Methodist (Sugar Land, TX)
    …with clinical team partners. This position uses sound clinical judgement in the Utilization Management process and knowledge of regulatory requirements to make ... Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical denial management and… more
    Houston Methodist (07/31/25)
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  • Licensed Practical/Vocational Nurse - Referral…

    Luke Staffing (GU)
    …of clinical nursing experience is required. One year of previous experience in Utilization Management is required. Full time employment in a nursing field ... requirements of this position, it must be directly related to referral/ utilization management . + **Licensure:** Current, full, active, and unrestricted… more
    Luke Staffing (08/07/25)
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