- Phoenix House (Wainscott, NY)
- ** Utilization Review Manager ** **Job Details** **Job Location** East Hampton Residential - Wainscott, NY **Position Type** Full Time **Education Level** ... Shift** Morning **Job Category** Nonprofit - Social Services **Description** **SUMMARY** The Utilization Review (UR) Manager coordinates commercial, and… 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 ... Our Team of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff performance… more
- Beth Israel Lahey Health (Burlington, MA)
- …a job, 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...staffs. -Case Manager experience as well as Utilization Review experience ( review medical… more
- Ascension Health (Baltimore, MD)
- …Manage activities, workflow and resources of assigned nursing travelers. + Ensure compliance with regulatory and accreditation requirements for their assigned team. + ... **Details** + up to $5,062 gross full weekly travel rate + **Department:** Ascension Travel Program & Interim Leadership + **Schedule:** Full-time + **Hospital:** St. Agnes + **Location:** Baltimore, MD * Rates may vary by location and specialty. Stipends… 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 ... reporting, quality, and Lean process improvements, and facilitating the quarterly Utilization Review Committee meetings. Provides evidence based and outcome… more
- Intermountain Health (Murray, UT)
- …help successfully manage the daily operations of a specific care management or utilization review program. This role is responsible for communicating and ... and self-funded Commercial Employer plans. The Healthy Connections Program Manager reports to a line of business leader or...return on investment. **Skills** + Leadership + Communication + Utilization review or care management + Performance… more
- Ascension Health (Appleton, WI)
- …salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes ... quality review programs and key performance indicators for all utilization review activities. + Interact with medical, nursing, and executive leadership to… more
- Ascension Health (Pensacola, FL)
- **Details** + **Department: Utilization Review ** + **Schedule: Full time days** + **Hospital: Ascension Sacred Heart Pensacola** + **Location: Pensacola, ... salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes… more
- Ochsner Health (Lafayette, LA)
- …+ Determines appropriate staffing levels and the interviewing, hiring, performance review , and termination of employees within practice unit(s); maintains employee ... schedules to assure appropriate coverage. + Develops departmental specific systems to assure an environment that emphasizes patient courtesy and responsive service delivery. + Performs other related duties as required. The above statements describe the general… more
- Children's Hospital Boston (Boston, MA)
- …Posting Title:Per Diem RN Case Manager , Utilization Management/ReviewDepartment:Patient Services-Patient Care OperationsAutoReqId:80451BRStatus:Part-TimeStandard ... experience required, pediatric experience preferred. + Experience as a Case Manager (Discharge Planning and or Utilization Management) preferred. Licensure/… more
- Prime Healthcare (Lynwood, CA)
- …Shift Days Connect With Us! (https://careers-primehealthcare.icims.com/jobs/212260/case- manager %2c-rn utilization - review ... effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service… more
- Amergis (Stanford, CA)
- Salary: $4388 / Week Care Coordination Manager - Utilization Review RN | Palo Alto, CA | Contract-to-Perm Opportunity We're seeking a highly experienced RN ... pivotal Care Coordination Manager role, overseeing case management and utilization review functions in a dynamic, patient-centered environment. Position… more
- CVS Health (Charleston, WV)
- …Foster care experience * Crisis intervention skills * Managed care/ utilization review experience * Certified Cas Manager (CCM) certification * Case ... following counties: Wood, Wirt, Jackson, Mason, Putnam, Cabell, Lincoln, Wayne. The Case Manager RN (CM RN) is responsible for telephonically and/or face to face… more
- Mayo Clinic (Rochester, MN)
- …workers, physicians and multi-disciplinary teams. Major Functions of the RN Case Manager include: Utilization Review , including concurrent admission status ... to work well within a creative and challenging work environment. Experience in utilization review , ability to navigate medical records, value based purchasing… more
- Mount Sinai Health System (New York, NY)
- …+ Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager ... **Job Description** **RN/Case Manager MSH Case Management PT Days** The Case...a. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management… more
- Houston Methodist (The Woodlands, 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,...prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members, as well as… more
- Actalent (Sunrise, FL)
- …+ Prepare and present reports on department activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management + ... Working under the general supervision of the Director and/or Manager /Supervisor of Medical Management, and in collaboration with an...or LPN License. + Minimum of one year of utilization review experience and discharge planning in… more
- Alameda Health System (Oakland, CA)
- System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Services As Needed / Per ... FTE:0.01 + Posted:May 15, 2025 **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review ...in orientation of fresh staff as requested by the Manager of Utilization Management. 17. Maintains knowledge… 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. + Manager ... **Job Description** The Case Manager (CM) will be responsible for all aspects...1. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent ... prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members, as well as...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more