- Houston Methodist (Katy, TX)
- At Houston Methodist, the Manager Centralized Utilization Review (UR) position is responsible for leading the daily operations of the Utilization Review ... of care, and payer requirements. Reporting to the Director of Centralized Utilization Review, the Centralized Manager , UR position supports enterprise strategies… more
- UNC Health Care (Chapel Hill, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and...of patient data and treatments. Communicates daily with the Case Manager to manage level of care… more
- Community Health Systems (Franklin, TN)
- …escalated challenges. Communicates Utilization Review information with facility Case Manager Directors, proactively sharing KPI (Key Performance indicator) ... **Job Summary** The Manager of Utilization Review oversees a...utilization review nurses and coordinators, ensuring compliance with clinical regulatory standards, and enhancing the overall utilization… more
- UNC Health Care (Smithfield, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and...of patient data and treatments. Communicates daily with the Case Manager to manage level of care… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …of any of the following: CPHM (Certified Professional in Healthcare Management), CCM (Certified Case Manager ), ACM (Accredited Case Manager ) required or ... *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional...utilization management activities. The goal is to achieve clinical , financial, and utilization goals through effective… more
- Sharp HealthCare (San Diego, CA)
- …other requirements for the position, and employer business practices. **What You Will Do** The Clinical Case Manager 's (CCM) role is to be a patient advocate ... options for patients and are provided excellent care. The Clinical Case Manager will be...community service data for at high risk persons for under- utilization of oncology health services. + Implements Plan of… more
- Children's Mercy Kansas City (Kansas City, MO)
- …KS or MO Compact within 60 days of hire + One of the following: American Case Management, Certified Case Manager required upon hire + Employees must obtain ... Case Management or equivalent within 730 days + Employees must obtain Certified Case Manager or equivalent within 730 days + Refer to Nursing and Advanced… more
- Elevance Health (CA)
- **Behavioral Health Care Manager I, Utilization Management** **Work Hours M-F 8am-5pm PST** **Work Location: Virtual, California** This role enables associates ... an accommodation is granted as required by law. The **Behavioral Health Care Manager I, Utilization Management** is responsible for managing psychiatric and… more
- HealthTrust Workforce Solutions (Savannah, GA)
- **RN (Registered Nurse) or LCSW (Licensed Clinical Social Worker) Manager Case Management** **Memorial Health University Medical Center** **Full-Time - Days ... for in the safest and most compassionate way. **Job Summary and Qualifications** The ** Manager Case Management** reports to the Case Management Director and… more
- Elevance Health (Washington, DC)
- …days each week. The office is located at 609 H. Street NE.** The **RN** ** Manager - Utilization Management** is responsible for managing a team of physical ... and acuity. + Provides direct oversight and is responsible for Utilization Management execution/decision making for managed member populations. Primary duties may… more