- Highmark Health (Jefferson Hills, PA)
- …including but not limited to: appropriateness of care, documentation requirements, utilization review principles and criteria, insurance benefits and ... BSN **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + ACM Certification (Accredited Case Manager ) - American Case Management Association -… more
- Northwell Health (Staten Island, NY)
- … management and clinical pathways, variance analysis and trending, quality management/ utilization review and home care/discharge planning, preferred. + Keeps ... concurrent utilization management using Interqual criteria. + Conducts chart review for appropriateness of admission and continued length of stay. + Contacts… more
- Carnival Cruise Line (Miami, FL)
- This role reports to the Senior Manager of Case Management and oversees the daily operations of crew case management. The Manager leads a team of ... stakeholders, supporting disability claims, and facilitating return-to-work planning. The Manager also escalates high-risk cases, conducts utilization reviews,… more
- University of Southern California (Alhambra, CA)
- …understanding of the process. Some of the major duties of the Case Manager overlap into inpatient duties including: Concurrent review of all patients to ... In collaboration with the interdisciplinary team, the Case Manager provides care coordination services...5 years Clinical experience + Req 2 years Ambulatory case management or utilization review … more
- Saint Francis Health System (OK)
- …reimbursement issues and participate in treatment teams, Patient Care Committee, and the Utilization Review Staff Committee by providing data and contributing to ... not all inclusive nor does it prohibit the assignment of additional duties. Utilization Review Management - Yale Campus Location: Virtual Office, Oklahoma 73105… more
- Banner Health (Phoenix, AZ)
- …provider networks, and regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained ... nursing. Our Care Management staff is seeking an RN Case Manager to work closely with members...of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through… more
- HCA Healthcare (Kissimmee, FL)
- …opportunity compelling, we encourage you to apply for our RN Case Manager PRN opening. We promptly review all applications. Highly qualified candidates will ... each individual is recognized. Submit your application for the opportunity below:RN Case Manager PRNHCA Florida Poinciana Hospital **Benefits** HCA Florida… more
- Access Dubuque (Dubuque, IA)
- …Dubuque office and is also available remotely. **Key Responsibilities:** + Provide telephonic case management and utilization review for assigned consumers. ... Bilingual RN Case Manager **Cottingham & Butler/ SISCO**...preferred. + **Experience:** Minimum 2 years of clinical practice. Case management or utilization review … more
- Highmark Health (Pittsburgh, PA)
- …Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory ... as an educational resource to all AHN staff regarding utilization review practice and governmental commercial payer...CERTIFICATIONS** **Required** + None **Preferred** + ACM Certification (Accredited Case Manager ) - American Case … more
- Henry Ford Health System (Detroit, MI)
- …+ Proficiency with computers, electronic health records (EHR), database systems, and utilization review / case management documentation systems. + Knowledge of ... to offer. Register today by following this link: qrco.de/bffvep Job Summary: The Case Manager -RN plays a pivotal role in coordinating comprehensive patient care,… more