- Hartford HealthCare (Manchester, CT)
- …Manchester Region serves a region of 300,000 people in 19 towns. POSITION SUMMARY: The Utilization Review Case Manager (UR CM) works in collaboration with ... in the acute-care setting. * Minimum of 1 year Utilization Review experience preferred via industry clinical ...Care and status on all patients through collaboration with Case Manager . * Demonstrates thorough knowledge in… 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
- University of Utah Health (Salt Lake City, UT)
- …UR committee any case that surpasses expected LOS, expected cost, or over/under- utilization of resources. + Performs verbal/fax clinical review with payer as ... members or third-party payer. + Alerts and discusses with physician/provider and case manager /discharge planner when patient no longer meets medical necessity… more
- Sharp HealthCare (San Diego, CA)
- …Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** Accredited Case Manager (ACM) - American Case Management Association (ACMA); ... Bachelor's Degree in Nursing; Master's Degree; Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse (RN)… more
- Guthrie (Troy, PA)
- …care plan for patients, based on assessed needs and available resources. The Acute Case Manager monitors clinical approaches and make recommendations for ... alternate levels of care. The Acute Case Manager also performs Utilization ...Identifies opportunities to continue or reduce costs and optimize case reimbursement. a) Identifies cost/ clinical outlier patients… more
- Stanford Health Care (Palo Alto, CA)
- …and performance/quality improvement activities that lead to optimal patient outcomes. A Case Manager differs from other roles in professional nursing/health care ... not intended to provide direct patient care; rather, a Case Manager will be assigned to specific...by identifying opportunities for improvement in such areas as clinical outcomes, utilization of resources and concurrent… more
- CVS Health (Baton Rouge, LA)
- … review experience . Waiver experience . Crisis intervention skills . Certified Case Manager (CCM) certification . Familiarity with EMR **Education** Master's ... heart, each and every day. **Position Summary** Applies advanced clinical judgement to facilitate appropriate member physical health and... practice experience as an LMHP + 1+ years' Case management and discharge planning experience + Must possess… 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
- University of Michigan (Ann Arbor, MI)
- RN CASE MANAGER : University Hospital (Care Management) Apply Now **Job Summary** The RN Case Manager assesses, develops, implements, coordinates and ... utilization of resources while promoting quality outcomes. **Organizational Relationships** The RN Case Manager reports directly to the Manager of Care… 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 ... vary by location and is determined by employment status Job Description: The RN Case Manager is responsible to facilitate care along a continuum through… more
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