• Utilization Review Nurse Supervisor I

    The County of Los Angeles (Los Angeles, CA)
    …to Medicare and Medi-Cal reimbursement. + Analyzes cases for referral to the physician advisor to ensure that the admission or continued stay is being questioned ... or experience. + Analyzes cases for referral to the physician advisor to ensure that the admission or continued stay is being questioned based upon appropriate… more
    The County of Los Angeles (05/22/25)
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  • Per Diem RN - Case Management - Sharp Grossmont…

    Sharp HealthCare (La Mesa, CA)
    …other members of the interdisciplinary team to develop relationships and provide pre admission status recommendations for admissions as well as implement a ... and document patient classification (status and level of care) for all admissions utilizing established criterion sets.The RN CM has accountability for maintaining… more
    Sharp HealthCare (07/18/25)
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  • Case Manager (RN)- ED- Evenings

    Tidelands Health (Georgetown, SC)
    …appropriate, cost-effective care. The position proactively identifies potential patient admissions and patients with needs for discharge to appropriate community ... The position works with physicians to identify appropriate patient status for admission to the acute care hospital (inpatient versus observation). **What you will… more
    Tidelands Health (06/24/25)
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  • Case Manager I - Sharp Memorial Hospital - FT…

    Sharp HealthCare (San Diego, CA)
    …team to develop relationships and provide preadmission status recommendations for admissions as well as implement a comprehensive, integrated discharge plan from ... and document patient classification (status and level of care) for all admissions utilizing established criterion sets.The RN CM I has accountability for maintaining… more
    Sharp HealthCare (07/13/25)
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  • Coordinator, Master's Programs Recruitment…

    Binghamton University (Binghamton, NY)
    …Professional Posted On: Fri Jul 25 2025 Job Description: Budget Title: Academic Advisor (SL-3) Salary: $57,500 - $62,500 The School of Management (SOM) at Binghamton ... with the development and implementation of comprehensive recruitment strategies, admissions processes and robust support systems to enhance student retention,… more
    Binghamton University (07/26/25)
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  • RN Utilization Review Full Time Days

    Tenet Healthcare (Detroit, MI)
    …Performing accurate medical necessity screening and timely submission for Physician Advisor reviews Collaborating with payors, physicians, office staff and ancillary ... balancing cost and quality to assure optimal clinical and financial outcomes Completes admission reviews for all payors and sending admission reviews for payors… more
    Tenet Healthcare (07/31/25)
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  • Utilization Manager (RN)

    UNC Health Care (Hendersonville, NC)
    …communities we serve. Summary: The Utilization Manager (UM) assesses new admissions , continued stay and discharge review cases for medical necessity, appropriate ... system's Utilization Review Plan. Responsibilities: + Uses approved criteria and conducts admission review/class change review as trigger by patient admission to… more
    UNC Health Care (06/24/25)
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  • System Utilization Management SUM Specialist

    Alameda Health System (Oakland, CA)
    …assisting admitting physicians in assigning the correct patient class upon admission and providing education to enhance physician understanding of patient ... observation, outpatient). 3. Expeditiously refer cases to the internal/external Physician Advisor for review of requests that may not meet medical necessity… more
    Alameda Health System (08/04/25)
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  • Observation Utilization Review RN

    Trinity Health (Fort Lauderdale, FL)
    …regarding appropriate process of telephonic and submission of cases Reviews hospital admissions to ensure appropriate admission status in accordance with ... Reviewer for Observation services. * Maintains a working relationship with onsite Physician Advisor * Educates Observation Case Managers, including week-end staff… more
    Trinity Health (08/02/25)
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  • Registered Nurse (RN), Clinical Case Manager PRN

    LifePoint Health (Hickory, NC)
    …issues and anticipates opportunities to reduce expenses and capture revenue from admission through discharge. * Educates physicians and staff on Case Management ... *4. Clinical Assessment & Care Planning** Performs patient/family assessments on admission to identify individualized care management needs. * Collaborates with… more
    LifePoint Health (07/16/25)
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