- Northeast Alabama Regional Medical Center (Anniston, AL)
- Under the direction of the Case Management Coordinator, coordinates, negotiates, procures and manages the care of patients to facilitate achievement of positive ... appropriate. Participates in performance improvement initiatives related to the management of patient care. Works with physicians to ensure...they relate to the working DRG developed by the Case Manager /Coder. Assists with special projects as… more
- Hackensack Meridian Health (Brick, NJ)
- …to transform healthcare and serve as a leader of positive change. The **Care Management , Care Coordinator, Utilization Management ** is a member of the ... patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **RN/ Case Manager MSH Case Management FT Days** The Case Manager (CM) will be responsible for all aspects of case ... or utilization review preferred. Discharge Planner or Case Manager preferred. Manager or...patients where utilization review, discharge planning, and/or case management will be needed using standardized… more
- UNC Health Care (Raleigh, NC)
- …effectiveness through the integrating and functions of case management , utilization review and discharge planning. The Care Manager must be highly ... Management team is seeking a System-wide Complex Case Manager to provide support to a...Care Management Assistant. Consult Social Worker and/or Utilization Manager per established departmental protocol. Maintain… more
- Prime Healthcare (National City, CA)
- … Case Management Department under the direction of the assigned Case Manager /Social Worker assist with development and implementations of discharge plans. ... EDUCATION, EXPERIENCE, TRAINING Required qualifications 1. Knowledge of Discharge Planning/ Utilization Management / Case Management terminology and… more
- Molina Healthcare (GA)
- …active and unrestricted in state of practice. * Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM), ... services professionals in some or all of the following functions: utilization management , care management , behavioral health and other programs. Leads… more
- Actalent (Fort Lauderdale, FL)
- …of education and experience. + Valid Florida Driver's License. + Knowledge of case management and utilization review concepts, including InterQual and ... Review Nurse Job Description We are seeking a dedicated Utilization Management Nurse (UMN) who will work...interdisciplinary team under the supervision of the Director and/or Manager /Supervisor of Medical Management . The primary role… more
- Actalent (Sunrise, FL)
- …Additional Skills & Qualifications + Valid Florida Driver's License. + Knowledge of case management and utilization review concepts, including InterQual and ... Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing requests for… more
- University of Utah Health (Salt Lake City, UT)
- …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** ... members or third-party payer. + Alerts and discusses with physician/provider and case manager /discharge planner when patient no longer meets medical necessity… more
- Molina Healthcare (Iowa City, IA)
- …the pharmacy benefit changes for the upcoming year. + Works with the Case Management department as part of a member-centered interdisciplinary care team. ... (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management ), clinical pharmacy… more