- Aequor (New York, NY)
- …experience as an occupational nursing professional Minimum experience of 1-3 years in case management, utilization review and/or quality assurance Experience ... services to employees within regulated scope of practice and disability case management. Experience/Education: MS/NP in nursing degree and current NP license… more
- Merck & Co. (Durham, NC)
- …several years; currently Durham employs 1,000+ people. This role as a Manager , Operations will be an energetic, leader with strong interpersonal, leadership, and ... culture by reducing waste and constantly driving continuous improvement. -Responsible to review and approve compliance documents, as per procedures or need.Supply -… more
- Merck & Co. (Rahway, NJ)
- Job DescriptionPosition Description: HVAC Operations Manager Reporting to the Associate Director in HVAC, the HVAC Operations Manager will be part of the 24-hour ... operations team for the site.- The Manager will direct a team of hourly personnel who...Accountable for establishing a Safe by Choice.- Accountable to review and approve compliance documents, as per procedures or… more
- CHRISTUS Health (Alamogordo, NM)
- …status and assists him/her in ensuring proper placement of patient. Conducts utilization review using nationally recognized medical necessity criteria and ... there are actual or potential sources of under- or over- utilization . Collaborates with providers, nurses, patients, families, and other...documents the review . Refers cases for second level reviews when medical… more
- Cedars-Sinai (Los Angeles, CA)
- **Job Description** **Job Summary: Key Job Responsibilities** The Utilization Review Case Manager validates the patient's placement to be at the most ... **Req ID** : 1072 **Working Title** : CSMC 8750000 Utilization Management Utilization Review Case Manager FR 48010 Allen 429 1.00 **Department** :… more
- Trinity Health (Mason City, IA)
- …its goals **Hours:** Monday-Friday 0630-1430; no weekends or holidays **About The Job** The Utilization Review Case Manager responsibilities include ... 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
- University of Miami (Miami, FL)
- …. The University of Miami is currently seeking Utilization Review Case Manager ... and retrospective chart reviews for clinical utilization and authorization. The Utilization Review Case Manager coordinates with the healthcare team… more
- Beth Israel Lahey Health (Burlington, MA)
- …Hours:** 40 **Work Shift:** Day (United States of America) Joint role of Case Manager and Utilization Review Nurse Hospital at Home Full Time Days ... Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality...Case Manager experience as well as Utilization Review experience ( review medical… more
- Henry Ford Health System (Wyandotte, MI)
- …therapy experience, safety planning, psychiatric assessment, COPE and DWIHN knowledge, utilization review . GENERAL SUMMARY: The Case Manager is a member ... meet an individual's and family's health care needs. The goals of the case manager are to promote patient safety, quality of care and cost-effective outcomes.… more
- Baptist Memorial (Memphis, TN)
- …program Job Summary: Position: 18373 - System Manager - Utilization Review Facility: BMHCC Corporate Office Department: HS Case Mgmt Administration ... with 5 years of clinical experience at least 2 of which involve Utilization Review or Case Management Preferred-RN with 7 years of clinical experience… more
- Providence (Medford, OR)
- …based on population focus. Duties also include complex discharge planning and utilization review . The Nurse Case Manager must be competent to analyze ... **Description** The RN Case Manager is an expert professional...year home health, mental health, substance use, hospice, and/or utilization review . + Progressive nursing leadership experience,… more
- LA Care Health Plan (Los Angeles, CA)
- …current and unrestricted California License Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Certified Professional ... Manager , Delegation Oversight Clinical Audit Job Category: Clinical...with the Director, Delegation Oversight Audit on clinical issues/clinical review and interfacing with external agencies including other Local… more
- Catholic Health Initiatives (Omaha, NE)
- …reliability test for Utilization Review product(s) used. **Preferred** Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or ... **Overview** Utilization Review RN is responsible for...effectively with multiple stakeholders Professional communication skills. Understand how utilization management and case management programs integrate.… 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 ... the District of Columbia required 2-3 years of recent acute care experience Case Management Certification preferred Nursing at GWUH: Nurses at GWUH identify as… more
- LA Care Health Plan (Los Angeles, CA)
- …California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required ... Manager , Enhanced Care Management (RN or LCSW) Job...ECM services to medically and behaviorally complex members. + Review systems and processes, making recommendations for improvement to… more
- LA Care Health Plan (Los Angeles, CA)
- …California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required ... Information Preferred: Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or… more
- Mayo Clinic (Rochester, MN)
- …physicians and multi-disciplinary teams. Major Functions of the RN Case Manager include: Utilization Review , including concurrent admission status and ... the resources you need to succeed. **Responsibilities** The RN CASE MANAGER provides ongoing support to Mayo...within a creative and challenging work environment. Experience in utilization review , ability to navigate medical records,… more
- CVS Health (Charleston, WV)
- …+ Foster care experience + Crisis intervention skills + Managed care/ utilization review experience + Certified Case Manager (CCM) certification + ... Fayette, Gilmer, Kanawha, Nicholas, Roane, Or Webster County. The Case Manager RN (CM RN) is responsible...face member visits + Using clinical tools and information/data review , conducts an evaluation of member's needs and benefit… more
- UNC Health Care (Raleigh, NC)
- …care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management ... and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and...of patient data and treatments. Communicates daily with the Case Manager to manage level of care… more
- 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… more
