- Community Health Systems (Franklin, TN)
- …authorizations and reduce potential denials, utilizing input from the Utilization Review Clinical Specialist. + Monitors and updates case management software ... **Job Summary** The Utilization Review Coordinator ensures efficient and...with hospital, corporate, and payer requirements. Documents outcomes in case management systems. + Reviews and closes out cases… more
- Elevance Health (Tampa, FL)
- …MSN, MPH, MPA, MSW or MBA with Health Care Concentration preferred. + Certified Case Manager Certification preferred. Please be advised that Elevance Health only ... is granted as required by law. *Must reside in the state of Florida* The ** Manager of Utilization Management** is responsible for managing a team of physical… more
- BayCare Health System (St. Petersburg, FL)
- …trust, dignity, respect, responsibility and clinical excellence. **The Team Lead Utilization Review responsibilities include:** + Directing and coordinating the ... RN (Registered Nurse) + Preferred ACM ( Case Management) + Preferred CCM ( Case Manager ) **Education:** + Required Associates in Nursing or + Preferred… more
- BayCare Health System (Tampa, FL)
- …Preferred Masters in Nursing or Business **Experience:** + Required 2 years in Utilization Review or + Required 2 years in Case Management or + Required 3 ... of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN responsibilities include:** + Functions… more
- Providence (Mission Hills, CA)
- **Description** **RN Utilization Review - Remote. This position will work full- time in a 8-hr Day shift.** Provide prospective, retrospective, and concurrent ... utilization reviews for our LA ministries. Conduct clinical reviews...remote UR environment or working as an acute hospital case manager . **Preferred Qualifications:** + Bachelor's Degree… more
- Northeast Alabama Regional Medical Center (Anniston, AL)
- …for documentation issues as they relate to the working DRG developed by the Case Manager /Coder. Assists with special projects as directed or requested by the ... Under the direction of the Case Management Coordinator, coordinates, negotiates, procures and manages...of clinical experience required. Leadership experience preferred. CM or Utilization Review experience preferred. Extensive knowledge and… more
- LA Care Health Plan (Los Angeles, CA)
- …- Active, current and unrestricted California License Licenses/Certifications Preferred Certified Case Manager (CCM) American Case Management Association ... to complete reviews and determinations within required turnaround times specific to the case type. Identifies requests needing medical director review or input… more
- Stanford Health Care (Palo Alto, CA)
- …work at Stanford Medicine | Stanford Health Care (SHC)? Are you a seasoned RN Case Manager ? Here is your opportunity to work with the Timely Discharge Department ... include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review ...improvement activities that lead to optimal patient outcomes. A Case Manager differs from other roles in… more
- Sharp HealthCare (San Diego, CA)
- …**Job Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager ... Certification; California Registered Nurse (RN) - CA Board of Registered Nursing; Accredited Case Manager (ACM) - American Case Management Association… more
- Tenet Healthcare (Detroit, MI)
- Registered Nurse (RN) - Case Manager - 2506003285 Description : Join our dedicated healthcare team where compassion meets innovation! As a Registered Nurse with ... is determined by employment status Job Description: The RN Case Manager is responsible to facilitate care...staff and ancillary departments, k) leading and facilitating Complex Case Review , l) assuring patient education is… more