- Sanford Health (Rapid City, SD)
- …Schedule:** Full time **Weekly Hours:** 40.00 **Department Details** Join our team as a Utilization Review and Case Management Manager and lead a ... value across the care continuum. You'll shape and execute utilization strategies that become the standard for how we... nursing experience required. Two years experience as a case manager preferred. One year of leadership/management… more
- Acacia Network (Bronx, NY)
- …services are fully integrated, bilingual and culturally competent. POSITION OVERVIEW The Utilization Manager is responsible for the day-to-day functions of ... special projects as directed. REQUIREMENTS + Minimum of 2 years of case management and/or utilization review experience + Associate degree required;… more
- CVS Health (UT)
- …utilization of available resources and optimal, cost-effective outcomes. + Telephonic clinical case management with Medicare population. + Uses Motivational ... English **Preferred Qualifications** + Crisis intervention skills preferred + Managed care/ utilization review experience preferred + Case management and… more
- CVS Health (Springfield, IL)
- …Services and strategies, policies and programs are comprised of network management, clinical coverage, and policies. **Position Summary** Our Case Managers use ... needs and benefit plan eligibility and facilitates integrative functions using clinical tools and information/data. + Utilizes case management processes… more
- Tenet Healthcare (Commerce Township, MI)
- RN Case Manager - Clinical Res Mgmt - 2506004213 Description : **Up to $10,000 Sign on Bonus, based on relevant experience** Are you a results-driven leader ... is determined by employment status Job Summary The RN Case Manager is responsible to facilitate care...patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient's resources and… more
- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: The Pediatric Clinical Case Manager 's primary responsibility is to facilitate the continuum of care for an assigned number of pediatric cases by ... managing, coordinating, facilitating and monitoring resources to achieve optimal clinical outcomes, utilization of services and financial...for all patients within the unit/core service area. The Case manager is integral to the team… more
- CVS Health (LA)
- …The Manager , Utililzation Management, conducts oversight and management of clinical team processes including the organization and development of high performing ... however, Louisiana residence is preferred. **Fundamental Components** + Reinforces clinical philosophy, programs, policies and procedures. + Communicates strategic… more
- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: The Clinical Case Manager will... utilization of services, and financial goals. The Clinical Case Manager oversees the ... RN or acute care, transitional care, or chronic care RN/ case management experience OR Associates degree in Nursing and...RN or acute care, transitional care, or chronic care RN/ case management experience required. *If Associate in Nursing, must… more
- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: The Emergency Department RN Clinical Case Manager will facilitate transitional care for an assigned number of cases by managing, coordinating, ... facilitating, and monitoring resources to achieve optimal clinical outcomes, utilization of services, and financial...of services, and financial goals. The Emergency Department RN Clinical Case Manager oversees the… more
- CVS Health (OH)
- …locations in New Albany OH, Chandler AZ or High Point NC.** Precertification Nurse Case Manager is responsible for reviewing medical records to determine the ... and claims history to address potential impact on current case review and eligibility. + Drives effective utilization...additional support from the health care team. + Applies clinical expertise and knowledge of utilization management… more