• Maris Grove by Erickson Senior Living (Glen Mills, PA)
    …practice with a focus on utilizing master scheduling template and review of patient scheduling reportsCollaborates and communicates with Medical Director relative ... for maximizing reimbursement for the practice by coordinating Centricity and Medical Manager Workflow processes to capture all provider services. Works directly with… more
    JobGet (06/01/24)
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  • Case Manager with Utilization

    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 weekend ... 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
    Beth Israel Lahey Health (04/19/24)
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  • Case Manager II - Utilization

    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
    Lucile Packard Children's Hospital Stanford (06/01/24)
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  • Utilization Review RN

    Catholic Health Initiatives (Omaha, NE)
    …discharge for appropriate status determination. 2. Ensures compliance with principles of utilization review , hospital policies and external regulatory ... Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. **Preferred** Certified Case Manager (CCM), Accredited Case … more
    Catholic Health Initiatives (04/12/24)
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  • Registered Nurse - Utilization

    Glens Falls Hospital (Glens Falls, NY)
    …can be foundhere. **Job:** **Nursing - Case Management* **Title:** *Registered Nurse - Utilization Review Nurse - Care Management (Sign-On Bonus for Full-Time & ... timely and accurate information to payers. The role integrates and coordinates utilization management and denial prevention by focusing on identifying and removing… more
    Glens Falls Hospital (04/26/24)
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  • Utilization Review RN

    Virginia Mason Franciscan Health (Bremerton, WA)
    …discharge for appropriate status determination. + Ensures compliance with principles of utilization review , hospital policies and external regulatory ... Duties: + Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is warranted… more
    Virginia Mason Franciscan Health (05/25/24)
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  • Utilization Review Manager

    Universal Health Services (Panama City, FL)
    Responsibilities Utilization Review Manager Opportunity Emerald Coast Behavioral Hospital provides inpatient treatment services to children, adolescents ... TMS therapy for chronic depression. Visit us on-line at: https://emeraldcoastbehavioral.com/ The Utilization Review Manager is responsible for oversight of… more
    Universal Health Services (05/03/24)
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  • RN Care Manager Utilization

    Catholic Health (Lockport, NY)
    …and Holiday Rotation Hours: 8:00a-4:00p, 9:00a-5:00p, 10:00a-6:00p, 11:00a-7:00p Summary: The RN Care Manager , Utilization Review / Transitions of Care, as an ... the Care Management and interdisciplinary care team, provides comprehensive Utilization Review and transitions of care services...review experience in the role of a Care Manager or Disease Manager , Population Health ,… more
    Catholic Health (05/30/24)
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  • System Manager - Utilization

    Baptist Memorial (Memphis, TN)
    …Case Management Preferred-RN with 7 years of clinical experience with Utilization Review or Case Management experience in a hospital or payer setting ... education + Employee referral program Job Summary: Position: 18373 - System Manager - Utilization Review Facility: BMHCC Corporate Office Department: HS… more
    Baptist Memorial (05/18/24)
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  • Interim Nurse Manager , Utilization

    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 (03/20/24)
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  • Utilization Review Manager

    The Mount Sinai Health System (New York, NY)
    The Utilization Review Manager for the Selikoff Centers for Occupational Health is responsible for the management of program operations within a particular ... medical records, and internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with multiple professionals to… more
    The Mount Sinai Health System (05/02/24)
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  • Utilization /Case Manager RN

    Mountains Community Hospital (Lake Arrowhead, CA)
    …admissions at MCH by collecting and recording all information and data needed for utilization review as requested and required by third party payers. Monitors ... Full Time - Exempt position SUMMARY The Case Manager is responsible for utilization management and case management of patient… more
    Mountains Community Hospital (03/27/24)
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  • Utilization Review RN

    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
    Billings Clinic (03/13/24)
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  • Sr Utilization Review Spec-…

    Hackensack Meridian Health (Hackensack, NJ)
    …patient population and HackensackUMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, ... **Overview** The Senior Utilization Review Physician Specialist collaborates with...vs. Inpatient c. Liaison to the Medical Staff supporting Utilization Management Committee processes d. Hospital Based… more
    Hackensack Meridian Health (05/07/24)
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  • Mgr - Utilization Review / Mgmt

    Universal Health Services (Auburn Hills, MI)
    …of post-graduate related experience in psychiatric or substance abuse treatment required. Hospital utilization review / utilization management experience ... Hospital is seeking a dynamic and talented licensed Utilization Management Case Manager to join our...medical terminology, experience in case management, discharge planning, and/or utilization review preferred. + Employees must be… more
    Universal Health Services (05/29/24)
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  • RN Utilization Manager - Care…

    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
    UNC Health Care (05/18/24)
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  • Utilization Manager UM II - Transfer…

    Sharp HealthCare (San Diego, CA)
    …of the System Integrated Care Management (ICM) team the Transfer and Admissions Utilization Manager (UM) partners with the Centralized Patient Placement Center ... transfer requests and direct admission requests. This position supports utilization review functions to ensure appropriate patient...Degree in a health related field + 3 Years Utilization Management or case management within a hospital more
    Sharp HealthCare (03/30/24)
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  • Utilization Manager II - UM System…

    Sharp HealthCare (San Diego, CA)
    …(ICM) team the Utilization Manager (UM) II position supports utilization review functions to ensure appropriate patient status before the patient is ... compliance with all local, state and federal regulations governing utilization review activities and/or care management. Expected...in Healthcare or a related field + 3 Years Utilization Management or case management within a hospital more
    Sharp HealthCare (05/16/24)
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  • Utilization Management Plan Oversight…

    AmeriHealth Caritas (Newark, DE)
    ** Utilization Management Plan Oversight Manager , Registered Nurse (must reside in DE)** Location: Newark, DE Primary Job Function: Medical Management ID**: 34207 ... + Assist in preparation, coordination, and participation in and follow up of Utilization Management audits, such as readiness review , Data Validation, CMS… more
    AmeriHealth Caritas (05/08/24)
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  • Utilization Management Case Manager

    Universal Health Services (Dearborn, MI)
    …of post-graduate related experience in psychiatric or substance abuse treatment required. Hospital utilization review / utilization management experience ... Responsibilities Utilization Management Case Manager Beaumont Behavioral...medical terminology, experience in case management, discharge planning, and/or utilization review preferred. + Familiarity with EPIC/EMR,… more
    Universal Health Services (05/22/24)
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