- Covenant Health (Nashua, NH)
- …policies and procedures. + Maintains/enhances professional development/skills required to function as a Utilization Review Case Manager + Completes all ... health care team. + Annual goals are achieved. + Attends pertinent case management/ utilization review programs to maintain current knowledge of UR practices.… more
- Holzer Health System (Gallipolis, OH)
- …organizational and financial outcomes. Serves as a clinical expert and resource in Utilization Review and Case Management. Partners with Social Workers ... field will be taken into consideration. . Professional experience with case management, utilization review , or discharge planning highly desirable. .… more
- Beth Israel Lahey Health (Burlington, MA)
- …you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient Registered ... Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality...Case Manager experience as well as Utilization Review experience ( review medical… more
- Mount Sinai Health System (New York, NY)
- …Requirements** + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + ... **Job Description** **RN/ Case Manager MSH Case ...a Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case… more
- Mount Sinai Health System (New York, NY)
- …preferred. + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + ... **Job Description** **RN/ Case Manager Inpatient Mount Sinai West...1. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case… more
- Children's Hospital Boston (Boston, MA)
- 80451BRJob Posting Title:Per Diem RN Case Manager , Utilization Management/ReviewDepartment:Patient Services-Patient Care ... required, pediatric experience preferred. + Experience as a Case Manager (Discharge Planning and or Utilization Management) preferred. Licensure/… more
- Prime Healthcare (Lynwood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/212260/ case - manager %2c-rn ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care… more
- AdventHealth (Orlando, FL)
- …Obtains pre-authorization and provides information to the Utilization Review Specialist, Utilization Review Case Manager and the Clinical Support ... to the transfer and placement of all patients. Proactively initiates steps, including utilization of the hospital and physician chain of command, to prevent EMTALA… more
- LA Care Health Plan (Los Angeles, CA)
- …California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required ... Information Preferred: Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or… more
- Mayo Clinic (Rochester, MN)
- …physicians and multi-disciplinary teams. Major Functions of the RN Case Manager include: Utilization Review , including concurrent admission status and ... resource utilization , and clinical documentation. The RN Case Manager will function within the Mayo...within a creative and challenging work environment. Experience in utilization review , ability to navigate medical records,… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) PRN position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... ensures prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members,...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
- Helio Health Inc. (Syracuse, NY)
- …to track, review , and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our ... issues. To support the mission of Helio Health, theUtilization Case Manager will enhance the program's efforts...Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care,… more
- Alight (NJ)
- …+ 5+ years medical advisory experience in occupational health, worker compensation, disability, health case management, or utilization review . + 2+ years as ... Additionally, demonstrate excellent problem-solving skills when questioned on your case management plans. + Consulting on medical, behavioral health,...a Clinical Case Manager . Additionally, possess a working knowledge of disability, client… more
- Trinity Health (Silver Spring, MD)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Job Title:** RN Case Manager - Utilization Management **Employment Type:** Full Time ... **Location** : Holy Cross Hospital **Position Purpose:** As a Case Manager in Utilization Management,...coordinate care and address clinical documentation needs for accurate case review and status determination. + Oversee… more
- Prime Healthcare (Montclair, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/215040/ case - manager -%28rn%29 ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care… more
- Prime Healthcare (San Dimas, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/214914/ case - manager -%28rn%29 ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care… more
- Children's Mercy Kansas City (Kansas City, MO)
- …of, and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including patient ... quality, and Lean process improvements, and facilitating the quarterly Utilization Review Committee meetings. Provides evidence based...days of hire + One of the following: American Case Management, Certified Case Manager … more
- Beth Israel Lahey Health (Plymouth, MA)
- …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who ... and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager...administration or related field preferred or commensurate experience and Case Management Certification required + Minimum of 3 years… more
- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... this position is able to cover a multitude of utilization review functions through point of entry,...ensures prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members,… more
- Tenet Healthcare (Detroit, MI)
- RN Utilization Review Full Time Days - 2506001796 Description : The Detroit Medical Center (DMC) is a nationally recognized health care system that serves ... care and appropriate level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as needed. (5% daily,… more
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