- Kaiser Permanente (Denver, CO)
- Job Summary: SNF Post - Acute Utilization Management ( UM ) Care Coordinators are health care professionals who receive incoming referrals for patients ... if there is a need for admission to a post - acute level of care . The...consistent use of the clinical support system (approved guidelines, UM physician, MCG, and other tools) is expected. Review… more
- Wellstar Health System (Hiram, GA)
- …documents barriers for timely disposition. Responds to referrals for patients post ‐ acute needs from physicians and the care team. Participates in ... transition at discharge. Ensures/maintains discharge plan consensus with patient/family, physicians, care teams and payers. Initiates/facilitates post ‐ acute … more
- Wellstar Health System (Roswell, GA)
- …documents barriers for timely disposition.Responds to referrals for patients post - acute needs from physicians and the care team.Participates in ... transition at discharge.Ensures/maintains discharge plan consensus with patient/family, physicians, care teams and payers.Initiates/facilitates post - acute … more
- Wellstar Health System (Marietta, GA)
- … care teams and payers. * Responds to referrals for patients post ‐ acute needs from physicians and the care team. * Participates in Interdisciplinary ... for best level of care transition at discharge. * Initiates/facilitates post ‐ acute referrals through departmental processes for timely transition to the next… more
- Wellstar Health System (Marietta, GA)
- … care teams and payers. Responds to referrals for patients post ‐ acute needs from physicians and the care team. Participates in Interdisciplinary Rounds ... estimated date of discharge and make recommendations for best level of care transition at discharge. Initiates/facilitates post ‐ acute referrals through… more
- Kaiser Permanente (Atlanta, GA)
- …continuum of care through the hospital course and into post - acute settings, including monitoring, coaching, intervening, creative problem solving, removing ... years of experience in utilization management, case management, discharge planning in an acute care setting. Minimum two (2) years of current clinical nursing… more
- Alameda Health System (Oakland, CA)
- …Required Experience : Three years of utilization review experience. Health insurance company and/or acute care hospital, post - acute and psych; three ... trends, and optimizing resource utilization. This role supports patient care coordination, fosters physician collaboration, and aligns with organizational objectives… more
- ERP International (Luke AFB, AZ)
- …Establish mechanisms to ensure proper implementation of patient treatment plan and follow-up post discharge in ambulatory and community health care settings. - ... **Be the Best!** Join our team of exceptional health care professionals across the nation. Come discover the immense...Military Veterans! **ERP International has been named a Washington Post 2025 Top Workplace! We are thrilled to be… more
- ERP International (Tinker AFB, OK)
- …Establish mechanisms to ensure proper implementation of patient treatment plan and follow-up post discharge in ambulatory and community health care settings. - ... **Be the Best!** Join our team of exceptional health care professionals across the nation. Come discover the immense...Military Veterans! **ERP International has been named a Washington Post 2025 Top Workplace! We are thrilled to be… more
- MVP Health Care (Tarrytown, NY)
- …guidelines. + Support and assess discharge planning efforts to ensure continuity of care and appropriate post - acute services. + Collaborate with providers, ... with Medicare guidelines and documentation standards preferred + Strong knowledge of sub- acute care , rehabilitation, and skilled nursing services + Proficiency… more
- Sharp HealthCare (San Diego, CA)
- …an accredited Licensed Vocational Nurse (LVN) program + 3 Years experience in the acute patient care and/or SNF setting. + California Licensed Vocational Nurse ... + Demonstrates knowledge of department policies and proceduresAuthorizes appropriate care levels, ie sub- acute , short term SNF...authorization as needed for DME or other services for post skilled nursing facility placement or home care… more
- Humana (Little Rock, AR)
- … care management. The clinical scenarios predominantly arise from inpatient or post - acute care environments. Has discussions with external physicians by ... Sun, Mon)** + 5+ years of direct clinical patient care experience post residency or fellowship, which...management, case management, discharge planning and/or home health or post acute services such as inpatient rehabilitation.… more
- CenterWell (Boston, MA)
- … facilitation with hospitals. The clinical scenarios predominantly arise from inpatient or post - acute care environments. There are discussions with external ... Qualifications** + MD or DO degree. + 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience… more
- LA Care Health Plan (Los Angeles, CA)
- …Provides the primary clinical point of contact for inpatient acute care hospitals requesting Inpatient care / post -stabilization admission requests, Higher ... within regular timelines. Reviews clinical data in real-time and post admission to issue a determination based on clinical... care (inpatient vs. observation) admission in the acute setting. Works with UM leadership, including… more
- Sutter Health (Oakland, CA)
- …Processing Service (PPS),Centers for Medicare and Medicaid Services (GR) Grouper (CMS) preferred. + Post - acute levels of care such as Home Health, Hospice, ... medical staff, including house staff, and all utilization management ( UM ) personnel, Care Management (CM) personnel to... Care . Skilled Nursing Facility (SNF), Long Term Acute Care (LTAC), B&C, Sub- acute ,… more
- University of Michigan (Ann Arbor, MI)
- …**Organizational Relationships** + Reports to the Associate Chief Nursing Officer (ACNO) for Primary Care and Post Acute + Partners with the Medical Director ... of care management and social work across adult and pediatric inpatient, ambulatory, post - acute care settings and emergency room. + Implement and sustain… more
- Integra Partners (Troy, MI)
- Integra is looking for a LPN/LVN experienced in the managed care payor environment to perform pre-service and post -service utilization reviews and appeals for ... but are not limited to: + Perform pre-service and post service UM authorization reviews utilizing federal...or outpatient setting + Minimum of 2 years of UM experience in a managed care , payor… more
- Dignity Health (Gilbert, AZ)
- …plan, engaging other relevant health team members, the patient and/or patient representative and post acute care providers in accordance with the patients ... nursing, physicians, ancillary departments, insurers and post acute service providers to progress the care ...Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification Training: + Knowledge of managed care… more
- Virginia Mason Franciscan Health (Silverdale, WA)
- …plan, engaging other relevant health team members, the patient and/or patient representative and post acute care providers in accordance with the patients ... utilization management, nursing, physicians, ancillary departments, insurers and post acute service providers to progress the care toward optimal outcomes… more
- Nuvance Health (Danbury, CT)
- …progress, verifying continued need for services, and facilitating timely discharge planning. * * Post - Acute Care Coordination:* Collaborate with post - ... ensure CMS and regulatory compliance.* *Develop and maintain a UM plan to guide the team with detailed processes...connect patients with appropriate community resources, support services, and post - acute care options. Address barriers… more
