• Case Manager II, Acute - Inpatient…

    Sutter Health (San Mateo, CA)
    …Overview:** This position coordinates the utilization management , resource management , discharge planning, post - acute care referrals and care ... interview patient/family and determine preferences for post - acute care services. Utilization Management . * Completes initial InterQual review screening… more
    Sutter Health (04/13/24)
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  • Care Manager II, Acute (RN)

    Sutter Health (San Francisco, CA)
    …oversees the Case Management Assistants to determine preferences for post - acute care services. Utilization Management . * Reviews medical record to ... communicates to patient/family prior to transition. * Assures necessary paperwork for post - acute transfers to comply with state and federal regulatory… more
    Sutter Health (04/26/24)
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  • Cardiologist

    ChenMed (Chicago, IL)
    …Coordinates as needed with the transitional care team, hospital, skilled nursing facility, post - acute , utilization management , and home-based services ... PCP requests for external cardiology referrals and participates in delegated utilization authorizations; determines level of urgency of follow-up, referral /… more
    ChenMed (04/27/24)
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  • Cardiologist

    ChenMed (Houston, TX)
    …Assists and coordinates, in conjunction with the transitional care team; hospital, SNF, post - acute , delegated utilization management and home-based ... Director/Manager, Center Managers, external sub-specialists and providers in hospitals and post - acute care facilities. **KNOWLEDGE, SKILLS AND ABILITIES:** +… more
    ChenMed (04/27/24)
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  • VP Care Management Post

    Kaleida Health (Buffalo, NY)
    …equity, and any applicable collective bargaining agreement.* **Grade:** 600 **Position:** VP Care Management Post - Acute Care Transition **Union Code:** 00 - ... executive leadership and guidance for critical areas of Care Management (CM), Discharge Planning and Post - Acute...related or Business field preferred. 10 years of care management / utilization management experience required in… more
    Kaleida Health (04/18/24)
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  • National Solution Medical Director - Post

    Elevance Health (Columbus, OH)
    …with Managed Care, Utilization Management , Prior Auth, and Benefits Management decision support in the Post - Acute Domain, DME, Home Health, ... as part of consideration for employment. **National Solution Medical Director - Post Acute Services** + Job Family: MED > Licensed Physician/Doctor/Dentist… more
    Elevance Health (04/30/24)
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  • Per Diem Registered Nurse III - Hospital Case…

    Ventura County (Ventura, CA)
    …the interdisciplinary approach to providing continuity of care, including Utilization management , Transfer coordination, Discharge planning, and obtaining ... health care facilities; responsible for complying with AB 1203, Post Stabilization notification; and complies with other duties as...No 03 Please detail your nursing experience with Case Management , Utilization Management , and discharge… more
    Ventura County (04/22/24)
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  • Senior Director Utilization

    Providence (Seattle, WA)
    …Medicare 5-Star, NCQU and/or URAC (preferred) + Knowledge of principles and practice of acute utilization management + Knowledge of evidence-based practice + ... **Description** **THE ROLE** The Senior Director Utilization Management & Denials - Administration is 100% remote. The role requires a broad knowledge and focus… more
    Providence (02/16/24)
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  • Utilization Management Admissions…

    LA Care Health Plan (Los Angeles, CA)
    …in the acute setting. Works with UM leadership, including the Utilization Management Medical Director, on requests where determination requires extended ... Utilization Management Admissions Liaison RN II...Provides the primary clinical point of contact for inpatient acute care hospitals requesting Inpatient care/ post -stabilization admission… more
    LA Care Health Plan (03/02/24)
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  • RN Supervisor Utilization Management

    Corewell Health (Southfield, MI)
    …everyone.​ 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...services in 22 hospitals, 300+ outpatient locations and several post - acute facilities-and Priority Health, a provider-sponsored health… more
    Corewell Health (04/10/24)
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  • Utilization Manager UM II - Transfer…

    Sharp HealthCare (San Diego, CA)
    …the episode of care and supports other members of the System Centralized Utilization Management team to ensure final status reconciliation. This position ensures ... ensure appropriate patient status and assists with repatriation and post -stabilization reviews for patients before the patient is bedded,...Degree in a health related field + 3 Years Utilization Management or case management more
    Sharp HealthCare (03/30/24)
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  • RN Utilization Manager - Rex Case…

    UNC Health Care (Raleigh, NC)
    …stay, and discharge reviews in accordance with federal regulations & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is ... and payors), and assesses the patient care progression from acute care episode through post discharge for...management referrals. Initiates appropriate social work referrals. 3. Utilization Management Process - Performs utilization more
    UNC Health Care (04/04/24)
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  • RN Manager Utilization Management

    Corewell Health (Grand Rapids, MI)
    …Health. Scope of Work Manages and coordinates the clinical functions of the Utilization Management Department. Oversees the efficiency and effectiveness of the ... utilization management teams, made up of ...services in 22 hospitals, 300+ outpatient locations and several post - acute facilities-and Priority Health, a provider-sponsored health… more
    Corewell Health (04/09/24)
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  • Utilization Review RN

    Actalent (San Bernardino, CA)
    …of patient care as it relates to acute inpatient stay and post - acute facility stay. The Utilization Review RN Coordinates continuing care/outside ... Description: As a part of the Utilization Management team the Utilization...RN License BLS AHA Must be experienced with Care Management Prior Authorizations Acute Outpatient experience -… more
    Actalent (04/20/24)
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  • Case Manager with Utilization Review…

    Beth Israel Lahey Health (Burlington, MA)
    …the healthcare team to coordinate and facilitate patient discharge. 14) Works with the Post Acute Care Coordinator to facilitate timely patient access to post ... . 7) Works with patients and families to facilitate post hospital care and develop plans to meet short...of medical/surgical nursing care experience. -Two years of Case Management or Utilization Management experience… more
    Beth Israel Lahey Health (04/19/24)
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  • Utilization Review Specialist

    Munson Healthcare (Traverse City, MI)
    …of resources. + Assists in developing and revising policies to support utilization management activities, including criteria and guidelines for appropriate use ... colleagues and hospital associates at information meetings. + May represent Utilization Management on various committees, professional organizations, physician… more
    Munson Healthcare (04/20/24)
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  • Utilization Management Nurse…

    LA Care Health Plan (Los Angeles, CA)
    …varied clinical experience in an acute hospital setting. At least 2 years Utilization Management /Case Management experience in a hospital or HMO setting ... Utilization Management Nurse Specialist RN II...and Physician Advisor on case reviews for pre-service, concurrent, post -service and retrospective claims medical review. Monitors and oversees… more
    LA Care Health Plan (04/09/24)
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  • Utilization Management Nurse…

    CVS Health (Trenton, NJ)
    …systems and keyboardingPreferred Qualifications- Knowledge or clinical practice experience in a post acute facility ( Skilled nursing, Rehabilitation, Long Term ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and knowledge in… more
    CVS Health (04/30/24)
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  • Utilization Management Case Manager

    Universal Health Services (Dearborn, MI)
    Responsibilities Utilization Management Case Manager Beaumont Behavioral Health (a UHS Facility) A growing 144-bed behavioral health facility - Beaumont ... For more information, please visit our website: https://beaumontbh.com/ PositionSummary The Utilization Management Case Manager is primarily responsible for… more
    Universal Health Services (04/10/24)
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  • RN Utilization Review Specialist

    Corewell Health (Grand Rapids, MI)
    …and continued stay. Educates medical staff/other health care professionals regarding utilization management and quality requirements. Makes recommendations and ... provides financial and utilization management (UM) information to other members...experience Skills/knowledge/abilities typically gained through at least five years, post licensure, related experience in acute care,… more
    Corewell Health (05/01/24)
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