- Centene Corporation (Raleigh, NC)
- …team to ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks UM resources to ensure adherence ... to performance, compliance, quality, and efficiency standards + Collaborates with utilization management team to resolve complex care member issues + Maintains… more
- ERP International (Tinker AFB, OK)
- **Overview** ERP International, LLC is seeking a **Registered Nurse - Utilization Managment** for a full-time position supporting **Medical Managment** in support of ... Tasks: Duties may include but are not limited to** : Provides Utilization Management activities and functions by using MTF-specific Quality Improvement processes to… more
- Beth Israel Lahey Health (Boston, MA)
- …America) Position Summary: In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission status ... of care being billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records to ensure criteria for… more
- Beth Israel Lahey Health (Burlington, MA)
- …Center is now offering up to a $3,500 in signing bonuses for our Utilization Review positions. Important Details: * Signing Bonuses are paid out in three payments. ... **Job Description:** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission status… more
- Trinity Health (Boise, ID)
- …years' experience in hospital based medicine with exposure to utilization management and documentation initiatives. 3. Demonstrated teamwork, performance analysis, ... with Trinity Health experts in managing and developing medical utilization programs and documentation initiatives. **Work Experience** **Job Description:** Saint… more
- UNC Health Care (Chapel Hill, NC)
- …improve the health and well-being of the unique communities we serve. Utilization Manager Psych Team completes clinical reviews for all areas: Inpatient, Observation ... episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to… more
- Colorado State University (Fort Collins, CO)
- Posting Detail Information Working TitleWood Utilization and Marketing Program Specialist Position LocationFort Collins, CO Work LocationPosition is fully remote ... the benefit of present and future generations". The Wood Utilization and Marketing Program Specialist is a sub-staff of...supervision of the Manager of Program Delivery, the Wood Utilization and Marketing Program Specialist is responsible for the… more
- Corewell Health (Southfield, MI)
- …Together, we are Corewell Health. Scope of work The Clinical Utilization Management (UM) Supervisor is responsible for monitoring, supervising, and performing ... daily Utilization Management functions, which includes but is not limited...but is not limited to pre-admission, admission, and concurrent utilization reviews. The Clinical UM Supervisor will provide daily,… more
- Beth Israel Lahey Health (Burlington, MA)
- …Advisor will play an active role in optimizing healthcare resource utilization , ensuring quality, patient care, and managing valuable organizational resources. The ... the director of care transitions to assess and guide the appropriate utilization of medical services while maintaining compliance with all regulatory requirements.… more
- Centene Corporation (Sacramento, CA)
- …Clinical Review team to ensure appropriate care to members. Manages utilization management issues related to member care, provider interactions, and facilitates ... operations within utilization management. + Manages prior authorization, concurrent review, and...applicable guidelines, policies, and procedures + Reviews and analyzes utilization management activities, operations, costs, and forecasted data to… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE SUPERVISOR ... direction, administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one of the… more
- Sharp HealthCare (San Diego, CA)
- …the System Integrated Care Management (ICM) team the Transfer and Admissions Utilization Manager (UM) partners with the Centralized Patient Placement Center (CPPC) ... internal transfer requests and direct admission requests. This position supports utilization review functions to ensure appropriate patient status and assists with… more
- Children's Mercy Kansas City (Kansas City, MO)
- …of children beyond the walls of our hospital. Overview The Manager of Utilization Review will provide leadership to integrated inpatient teams and assist the ... as training/oversight of programs and services. Responsible for effective utilization review and proper resource management, including patient statusing processes,… more
- Providence (Seattle, WA)
- **Description** **THE ROLE** The Senior Director Utilization Management & Denials - Administration is 100% remote. The role requires a broad knowledge and focus on ... Utilization Management and Denials principles such as performance improvement, healthcare finance (including contractual arrangements, utilization /quality… more
- EM Key Solutions, Inc. (Eglin AFB, FL)
- Eglin AFB, FL, USA | Full Time Registered Nurse - Utilization Manager Onsite Position EM Key Solutions is seeking Registered Nurse (RN) for a full-time ... Utilization Review / Management position supporting the Medical Maintenance...to the following: + Develops and implements a comprehensive Utilization Management plan/program in accordance with the facility's goals… more
- EM Key Solutions, Inc. (Eglin AFB, FL)
- Eglin AFB, FL, USA | Hourly | Full Time Registered Nurse - Utilization Manager Location: Eglin Hospital at Eglin AFB, Fort Walton Beach, FL. Position Type- Onsite EM ... Key Solutions is seeking a Registered Nurse (RN) for a full-time Utilization Review / Management position supporting the Medical Maintenance Team at Eglin Hospital,… more
- Ventura County (Ventura, CA)
- …Diem Registered Nurse III - Hospital Case Management/ Utilization Review Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4396275) Apply Per Diem ... Registered Nurse III - Hospital Case Management/ Utilization Review Salary $119,061.54 - $151,803.47 Annually Location Ventura, CA Job Type Per-Diem Job Number… more
- Beth Israel Lahey Health (Burlington, MA)
- …Shift:** Day (United States of America) Joint role of Case Manager and Utilization Review Nurse Hospital at Home Full Time Days 8:00am-4:30pm potential for weekends, ... Nurse (RN) Case Manager for Hospital at Home Care Transitions coordinates utilization review, discharge planning and monitors quality assurance for Lahey Clinic… more
- Universal Health Services (Riverside, CA)
- …or in writing). 1. Responsible for the collection of accurate data from utilization of services within the Utilization management Department. Prepare useful ... this data. 2. Prepare monthly reports and analyze miscellaneous utilization data (ie percentage of Csections, mental health ...utilization data (ie percentage of Csections, mental health utilization , home health/ DME utilization , and number… more
- The Arora Group (Bethesda, MD)
- Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/LVN) - Utilization Review in Bethesda, Maryland to ... on Federal holidays. DUTIES OF THE LICENSED PRACTICAL NURSE (LPN/LVN) - UTILIZATION REVIEW: + Initiate, perform and complete assigned duties in providing care… more
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