- Genesis Healthcare (Hanover, NH)
- …recent clinical experience is required. Must have a valid driver's license. Utilization review, case management , and discharge planning experience is preferred ... Experience in business development preferred. Certifications: CCM, CRRN or CIRS preferred. To protect the health and safety of our patients, residents, employees, family members, and the communities we serve, Genesis has implemented a universal COVID-19… more
- Guthrie (Sayre, PA)
- Position Summary: The Utilization Management (UM) Reviewer, in collaboration with other internal and external offices, payors, and providers and staff, is ... responsible for the coordinates Utilization Management (UM) processes and requirements for...the level of care or service for hospital inpatient admissions and short procedures by translating clinical information to… more
- Sharp HealthCare (San Diego, CA)
- …+ Knowledge of medical terminology, healthcare finances, alternative care options, utilization management , health plan criteria, established criteria such as ... UM Department. Prepares referral requests for outpatient services, elective inpatient admissions , skilled nursing facility admissions , durable medical equipment… more
- Sharp HealthCare (San Diego, CA)
- …time for routine, urgent and expedited referrals as outlined in SCMG's Utilization Management Plan.Decisions will be communicated to the appropriate persons ... + Knowledge of medical terminology, healthcare finances, alternative care options, utilization management , health plan criteria, established criteria such as… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... net required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison...the acute setting. Works with UM leadership, including the Utilization Management Medical Director , on… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …of solutions.** + **Collaborates with the Patient Financial Services and Utilization Management Directors to assure that accurate insurance information ... Carrier Clinic inpatient treatment and Blake Recovery Center. The Director of Admissions has 24 hour/7 days...an APN.** + **Minimum of 2 years of 24/7 management experience in Admissions Centers, Emergency Department… more
- Chatham Hills Subacute Care Center (Chatham, NJ)
- Admissions Director The Director ...seven years of recent clinical experience. + Preferred case management experience + Must read, write and speak the ... language + Experience in business/development preferred. + Prior experience in utilization review or discharge planning preferred. The salary for this position… more
- Virginia Mason Franciscan Health (Bremerton, WA)
- …annual bonus eligibility, and more! **Responsibilities** **Job Summary / Purpose** The Utilization Management (UM) Director is responsible for the ... market(s) development, implementation, evaluation and direction of the Utilization Management Program and staff in support of the CommonSpirit Health Care… more
- Acacia Network (Bronx, NY)
- …concurrent review package. + . Submitting concurrent review package and follow up with Utilization Management team at the Managed Care Plan for status. + . ... of referrals. + . Circulate current medical reports for Medical Director to review and approve for admissions . + . Ensure signatures are in consent forms for new… more
- Universal Health Services (San Antonio, TX)
- …to the next shift of patients still in process and reports regularly to the Director of Care Management / Admissions on matters of departmental and personnel ... and uses this information to improve the delivery and utilization of care to best meet the clinical and...requests and coordinates care with referral sources. + Milieu management in admissions : keeps staff members and… more
- Universal Health Services (Fort Washington, PA)
- …collects pre-admission data and ascertains insurance coverage via Business Office and Utilization Review. + Completes the admissions process by entering required ... department. Website: https://www.brookeglenhospital.com/ POSITION SUMMARY As directed by the Director of Assessment and Referral, the Call Specialist coordinates… more
- Providence (San Pedro, CA)
- …Services (CMS) guidelines and regulations. Under the direction of the Medical Director the Admissions Coordinator evaluates internal and external referrals for ... rehabilitation services. This position is accountable for monitoring of appropriate utilization of unit services in accordance with current Center for… more
- Universal Health Services (San Antonio, TX)
- …Standards, providing on-site education to manage difficult cases, and assisting the Director of Utilization Management with department processes and ... Key Responsibilities: + Maintains knowledge of all facets of Utilization Management + Supports Director ...payers and analysis of various reports. + Collaborates with Admissions , Business Office, and Health Information Management … more
- Robert Half Office Team (Monterey Park, CA)
- Description The Utilization Management Nurse Specialist LVN promotes the quality and cost effectiveness of medical care by applying clinical acumen and the ... review depending on case findings. Functions & Job Responsibilities * The Utilization Management Nurse Specialist LVN will facilitate, coordinate, and approve… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will facilitate, coordinate, and approve… more
- Colorado State University (Fort Collins, CO)
- …resources will be considered. + Four years of combined forest products utilization experience and forest or natural resource management program administration ... Posting Detail Information Working TitleWood Utilization and Marketing Program Specialist Position LocationFort Collins, CO Work LocationPosition is fully remote… more
- Billings Clinic (Billings, MT)
- …leadership and Physician Advisor, per department process or procedure *Insurance and Utilization Management *Maintains working knowledge of CMS requirements and ... prior to starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Utilization Review RN CARE MANAGEMENT (Billings Clinic… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …safe discharge coverage for all hospital units. + Participates in utilization management initiatives/opportunities for improvement through departmental committee ... within the appropriate time frame. + Notifies the Medical Director of all acute care admissions not...Florida. + 3 years minimum experience in discharge planning, utilization management , or case management .… more
- University of Utah Health (Salt Lake City, UT)
- …communication skills. + Demonstrated knowledge of payers, payer systems, cost effective utilization management and InterQual criteria. + The ability to ... medical advancement, and overall patient outcomes. **Responsibilities** + Applies approved utilization criteria to monitor appropriateness of admissions with… more
- ProgenyHealth (Elk Grove Village, IL)
- ProgenyHealth is a leading provider of care management solutions for premature and medically complex newborns. Our program promotes appropriate utilization , ... for the members. The clinical care nurse serves as a nurse reviewer for admissions , lengths of stay and a facilitator for discharge planning. This position functions… more