- Cedars-Sinai (Los Angeles, CA)
- …Utilization Review Case Manager - 8 Hour Days **Department** : Utilization Management **Business Entity** : Cedars-Sinai Medical Center **Job Category** : ... named us one of America's Best Hospitals. Summary of Essential Duties: + The Utilization Management (UM) Registered Nurse - Medicare Short Stay & Concurrent… more
- University of Rochester (Rochester, NY)
- …and Regulations. The Pharmacy Medication Utilization and Inventory Compliance Manager has direct supervision and management responsibilities for the pharmacy ... locations, and is intended to be a 'line manager ' level of responsibility, covering shifts typical of their...in hospital pharmacy administration + Graduate degree in business management (or another relevant field) Preferred ** KNOWLEDGE ,… more
- LA Care Health Plan (Los Angeles, CA)
- … of National Committee for Quality Assurance (NCQA) requirements for Utilization Management or Care Management (CM). Knowledge of Department of Health ... Utilization Management Nurse Specialist RN II...implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service,… more
- Prime Healthcare (Sherman Oaks, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/239073/case- manager - utilization - management ... or management , preferred. + Current BCLS certificate preferred. + Knowledge of Milliman Criteria and InterQual Criteria preferred. Pay Transparency Sherman Oaks… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Registered Nurse I Department: Utilization Management Location: Rochester General Hospital Hours Per Week: 40 hours (Full-Time) Schedule: Monday - ... class as needed. Responsibilities include concurrent (as needed) and retrospective reviews. The Utilization Management Nurse will act as a resource on denial … more
- Prime Healthcare (Lynwood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/237903/rn-case- manager utilization ... year experience in case management , discharge planning or nursing management , preferred.4. Current BCLS (AHA) certificate, preferred.5. Knowledge of Milliman… more
- Community Health Systems (Franklin, TN)
- …hospital revenue cycle preferred ** Knowledge , Skills and Abilities** + Strong knowledge of utilization management principles, payer guidelines, and ... appropriateness, and efficiency of hospital services to ensure compliance with utilization management policies. This role conducts admission and continued… more
- Hackensack Meridian Health (Edison, NJ)
- …to transform healthcare and serve as a leader of positive change. The **Care Management , Care Coordinator, Utilization Management ** is a member of the ... Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to...the state of New Jersey regulations for Nursing. **Education, Knowledge , Skills and Abilities Required:** + BSN or BSN… more
- CareFirst (Baltimore, MD)
- …business. ** Knowledge , Skills and Abilities (KSAs)** + Oversight of Utilization Management clinicians while championing process improvement, change adoption ... **Resp & Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination… more
- Molina Healthcare (North Las Vegas, NV)
- …services professionals in some or all of the following functions: care management , utilization management , behavioral health, care transitions, long-term ... * Assists in implementing health management , care management , utilization management , behavioral health...and unrestricted in state of practice. * Certified Case Manager (CCM), Certified Professional in Health Care Management… more