• Clinical Utilization Review Specialist

    Community Health Systems (Franklin, TN)
    **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services to ... ensure compliance with utilization management policies. This role conducts admission and continued...conducts admission and continued stay reviews, supports denials and appeals activities, and collaborates with healthcare providers to facilitate… more
    Community Health Systems (09/03/25)
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  • Medical Director Utilization Management

    AmeriHealth Caritas (Philadelphia, PA)
    …provides organizational leadership in the operational areas of care management, utilization review, appeals , quality improvement and related policy and ... practice initiatives in collaboration with the Corporate Medical Director(s), Utilization Management and the Vice President, Medical Affairs. ;The following… more
    AmeriHealth Caritas (08/12/25)
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  • Case Manager I - Sharp Memorial Hospital…

    Sharp HealthCare (San Diego, CA)
    …documents as appropriate in the electronic medical record and provides information to the department head as indicated. + Utilization review and utilization ... **Facility:** Sharp Memorial Hospital **City** San Diego ** Department ** **Job Status** Regular **Shift** Day **FTE** 1...1 **Shift Start Time** **Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager … more
    Sharp HealthCare (07/13/25)
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  • RN Case Manager : University Hospital (Care…

    University of Michigan (Ann Arbor, MI)
    …to develop and implement a comprehensive, integrated discharge plan from the emergency department (ED). The RN Case Manager will recommend and document patient ... RN CASE MANAGER : University Hospital (Care Management) Apply Now **Job...of the interdisciplinary team in the inpatient and emergency department patient care areas. The position is unique in… more
    University of Michigan (08/20/25)
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  • RN/Case Manager -MSH-Case…

    Mount Sinai Health System (New York, NY)
    …Experience Requirements Previous experience as in homecare, long term care or utilization review preferred. Discharge Planner or Case Manager preferred. ... **Job Description** **RN/Case Manager MSH Case Management FT Days** The Case...length of stay (LOS), improved efficiency, quality and resource utilization . Assignment will be by units/clinical areas of practice… more
    Mount Sinai Health System (08/28/25)
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  • RN/Case Manager -Inpatient-Mount Sinai…

    Mount Sinai Health System (New York, NY)
    …homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum of 3-5 years? experience as a ... **Job Description** RN/Case Manager Mount Sinai West FT Days 8a-4p EOW...length of stay (LOS), improved efficiency, quality and resource utilization . Assignment will be by units/clinical areas of practice… more
    Mount Sinai Health System (08/16/25)
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  • Clinical Case Manager

    LifePoint Health (Rutherfordton, NC)
    …through the appeals process; including RAC chart audit reviews. Emergency Department (ED) Case Management1. Serves as a gatekeeper of patients being admitted to ... the hospital by facilitating initiation of care starting.2. The ED Case Manager starts initiation and utilization process, encouragement of use of reimbursable… more
    LifePoint Health (08/09/25)
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  • CDOC - Business Manager (Canon City)

    State of Colorado (Canon City, CO)
    …ten (10) calendar days from your receipt of notice or acknowledgement of the department 's action. For more information about the appeals process, the official ... CDOC - Business Manager (Canon City) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5056915) Apply  CDOC...Time Job Number CAA Canon 3441 Bus Mgr 09.2025 Department Department of Corrections Opening Date 08/26/2025… more
    State of Colorado (08/27/25)
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  • Accountant III - Payroll Manager - Youth…

    State of Colorado (Denver, CO)
    …ten (10) calendar days from your receipt of notice or acknowledgement of the department 's action. For more information about the appeals process, the official ... Accountant III - Payroll Manager - Youth Services & Hospitals Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5050742) Apply  Accountant III -… more
    State of Colorado (08/22/25)
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  • Manager , Prior Authorization RN

    Fallon Health (Worcester, MA)
    …follow us on Facebook, Twitter and LinkedIn. **Brief Summary of Purpose:** The Manager , Prior Authorization RN manages all staffing and activities related to prior ... other members of the medical management leadership team, the Manager is responsible for the quality and cost effectiveness...times are met + Creates and disseminates all required utilization reports on a daily, monthly, quarterly and annual… more
    Fallon Health (08/14/25)
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