- Providence (Mission Hills, CA)
- …health plans. This role requires a strong clinical background combined with well-developed knowledge and skills in Utilization Management , medical necessity, ... and patient status determination. The Utilization Management RN must effectively and efficiently manage a diverse...UR environment or working as an acute hospital case manager . **Preferred Qualifications:** + Bachelor's Degree in Nursing. +… more
- Sharp HealthCare (San Diego, CA)
- …care, SNF, home health, or hospice settings. + Experience as a case manager or discharge planner interacting with managed care payers. + Experience with InterQual ... departmental guidelines during hospital stay beginning with the admission review of the case manager and reviews with the Case Manager Lead, as needed.Keeps SRS… more
- Guthrie (Sayre, PA)
- …approaches and make recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of ... Bonus For Qualified RNs! Position Summary: The Acute Case Manager utilizes industry accepted processes for achieving optimal patient,...experience in an acute care setting with strong care management , utilization review, and payer knowledge… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **RN/Case Manager MSH Case Management PT Days** The Case Manager (CM) will be responsible for all aspects of case management for an ... utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum...a. Reviews all new admissions to identify patients where utilization review, discharge planning, and/or case management … more
- UNC Health Care (Smithfield, NC)
- …form processing) to Care Management Assistant. Consult Social Worker and/or Utilization Manager per established departmental protocol. Maintain knowledge ... and cost effectiveness through the integrating and functions of case management , utilization review and discharge planning. The Care Manager must be highly… more
- Bon Secours Mercy Health (Portsmouth, VA)
- …transitions of care. + Partners with physician leader to optimize the Utilization Management Committee, providing actionable data related to utilization ... associates want to work and help communities thrive. **Job Summary:** The Manager , Care Management is responsible for day-to-day oversight, coordinating,… more
- Community Health Systems (Naples, FL)
- …spending accounts + Life and disability insurance and more **Job Summary** The Manager , Care Management is responsible for the planning, coordination, and ... oversight of care management services, including utilization review, discharge planning,...Manager leads the daily operations of the Care Management department, supervises staff, and collaborates with physicians, nurses,… more
- Sharp HealthCare (San Diego, CA)
- …and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge planning, as specified ... and guidelines.Identify opportunities for cost reduction and participate in appropriate utilization management venues.Escalate and refers cases for consultation… more
- Kaleida Health (Buffalo, NY)
- …, inpatient, outpatient, and the home health continuum, as well as managed care utilization management and coordination of care. Incumbent must maintain their ... ** Manager Patient Management ** **Location:** **Oishei Children's Hospital**...knowledge of leading practices in case management , transition… 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