- UNC Health (Chapel Hill, NC)
- …effectiveness through the integrating and functions of case management, utilization review and discharge planning. The Care Manager must be highly organized ... guidelines and policies.Responsibilities:1. Identify Cases & Prioritize Day - Review work list to prioritize patients and identify new...from CAPP as appropriate. As necessary meet with the Utilization Manager (UM) and SW after the… more
- Baptist Memorial (Memphis, TN)
- …assistance/continuing education + Employee referral program Job Summary: Position: 18373 - System Manager - Utilization Review Facility: BMHCC Corporate ... Summary Responsible for the Utilization Review Program across the system . In collaboration with system care coordination leadership ensures the strategic… more
- Trinity Health (Fresno, CA)
- **Employment Type:** Full time **Shift:** **Description:** **Are you an experience RN Manager , Utilization Review of Acute Care seeking your next ... adventure?** **Duration:** 13-week Assignment The Interim Utilization Management , RN Manager is responsible...Utilization Management will ensure the timely delivery of utilization review , discharge planning and support case… more
- Trinity Health (Mason City, IA)
- …**Hours:** Monday-Friday 0630-1430; no weekends or holidays **About The Job** The Utilization Review Case Manager responsibilities include case screening, ... in the state of Iowa. + Bachelor's Degree required. BSN preferred + Utilization management focused certifications that are recognized in the state of Iowa preferred… more
- The Mount Sinai Health System (New York, NY)
- The Utilization Review Manager for the Selikoff... System is one of the largest academic medical systems in the New York metro area, with more than ... medical records, and internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with multiple professionals to… more
- Sharp HealthCare (San Diego, CA)
- …intervention to UR Manager , Physician Advisor, as appropriate. Participate in system or site-level utilization review activities and projects as ... System Integrated Care Management (ICM) team the Utilization Manager (UM) II position supports ...Utilization Manager (UM) II position supports utilization review functions to ensure appropriate patient… 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
- Universal Health Services (WA)
- Responsibilities Case Manager / Utilization Review / Discharge Planning Registered Nurse - GW Hospital Full Time / Part Time (Weekend ONLY/both days every ... Referral Bonus Challenging and rewarding work environment with advanced technological systems , processes, and practice Commitment to Wellness sponsored by the… more
- Mayo Clinic (Phoenix, AZ)
- …managers and social workers in the inpatient and ambulatory settings. The RN Manager effectively resolves utilization review and denial management issues, ... Five years of hospital-based case management, including discharge planning and utilization review experience. **Additional Qualifications:** + Knowledge of… more
- Trinity Health (Fresno, CA)
- …at the time patients access the hospital in the emergency room. The case manager is responsible for utilization review , collaboration with physicians to ... of clinical nursing experience in an acute care medical center is required. 3. Utilization review , discharge planning or case management experience and BSN is… more
- Henry Ford Health System (Detroit, MI)
- …equipment. + Innovative Team Structure: Benefit from our new dyad Social Work/RN Case Manager model and remote utilization review setup, designed to let ... **NEWLY ENHANCED PAY RATES** RN Case Manager - Emergency Department Work Schedule: Three 12-hour...Emergency Department team as a Registered Nurse (RN) Case Manager ! Who We're Looking For: Passionate, compassionate, and dedicated… more
- Henry Ford Health System (Detroit, MI)
- …provided equipment. + Innovative Team Structure:Benefit from our new dyad Social Work/RN Case Manager model and remote utilization review setup, allowing you ... and dynamic environment? Join our team as a Registered Nurse (RN) Case Manager ! Who We're Looking For: Passionate, compassionate, and dedicated individuals who are… more
- Sharp HealthCare (San Diego, CA)
- …immediate intervention to UR Manager , Physician Advisor, as appropriate.Participate in system or site-level utilization review activities and projects as ... System Integrated Care Management (ICM) team the Transfer and Admissions Utilization Manager (UM) partners with the Centralized Patient Placement Center… more
- BayCare Health System (Cotton Plant, AR)
- …and clinical excellence. **BayCare Health System ** is currently seeking a ** Utilization Review Specialist Senior** to join our outstanding and compassionate ... team. **The Utilization Review Specialist Senior responsibilities include:** +...in Critical Care or Emergency Service **Facility:** BayCare Health System , Utilization and Denials Mgmt-MPH **Location:** **Morton… more
- Billings Clinic (Billings, MT)
- …starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Utilization Review RN CARE MANAGEMENT ... loan reimbursement Under the direction of department leadership, the Utilization Review / Management RN. This position is...*Priority 5: Escalation *Refers cases that require second level review to Physician Advisor, Manager , and Director… more
- Sharp HealthCare (San Diego, CA)
- …necessity reviews and authorizes medical services that meet medical criteria. The review of care is region specific and consists of outpatient healthcare services ... to case management or quality management as appropriate for utilization or quality issues while maintaining department processes in...preferred. + Experience and knowledge of IDX modules and systems , proficient in use of ICD-10, CPT and HCPC… more
- University of Utah Health (Salt Lake City, UT)
- …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** + ... of InterQual Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of CMS Regulations. **Working… more
- UNC Health Care (Chapel Hill, NC)
- …to improve the health and well-being of the unique communities we serve. RN Utilization Manager position specifically for a Utilization Manager /Clinical ... care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management… more
- Lucile Packard Children's Hospital Stanford (Palo Alto, CA)
- …responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient ... to provide requested clinical and psychosocial information to assure reimbursement. UTILIZATION REVIEW + Reviews prospectively, concurrently and retrospectively… more
- AmeriHealth Caritas (Newark, DE)
- …the business. This position will solicit ideas for systems improvements, review and present new system enhancements/features, and engage in continuous ... ** Utilization Management Plan Oversight Manager , Registered...preparation, coordination, and participation in and follow up of Utilization Management audits, such as readiness review ,… more
