- Beth Israel Lahey Health (Plymouth, MA)
- …years recent, broad clinical experience in the hospital setting + Experience with utilization management within the last 3 years required + An understanding ... establish the appropriate level of care using Interqual criteria. + Integrates clinical knowledge with billing knowledge to review, evaluate, and appeal clinical… more
- Point32Health (MA)
- …Care. The Clinical Manager will also work closely with the SCO management team to monitor Utilization metrics specifically related to Acute/SNF admission and ... Manager will also work closely with the SCO management team to monitor Utilization metrics specifically...HP staff to identify and address opportunities to manage utilization /cost, improve quality, identify gaps in knowledge … more
- Guthrie (Binghamton, NY)
- …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 (Raleigh, NC)
- …form processing) to Care Management Assistant. Consult Social Worker and/or Utilization Manager per established departmental protocol. Maintain knowledge ... the integrating and functions of case management , utilization review and discharge planning. The Care Manager...+ **Three (3) years of experience in hospital Case Management strongly preferred for this role.** ** Knowledge /Skills/and… more
- UNC Health Care (Raleigh, 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
- Guthrie (Sayre, PA)
- …timely, coordinated, and cost- effective manner. The Manager -of Case Management supports utilization management , discharge planning, denial prevention, ... right time. + Manages and assumes responsibility for day-to-day operations of utilization management , care coordination, and discharge planning activities. +… more
- Whidbey General Hospital (Coupeville, WA)
- …home health, Hospice, skilled nursing, anti-biotic regime, etc. The RN - Care Manager follows the hospital's Case Management / Utilization Plan that integrates ... resource utilization , the discharge planning and appeal/denial management . The RN - Care Manager serves...prior to the end of shift. Maintains a working knowledge of payer contracts and regulatory requirements and UM… more
- CaroMont Health (Gastonia, NC)
- …in case management , home health, quality and/or utilization management , community or hospital setting preferred. Thorough knowledge of general ... in case management , home health, quality and/or utilization management , community or hospital setting preferred. Thorough knowledge of general… more
- HCA Healthcare (Brandon, FL)
- …We want your knowledge and expertise! **Job Summary and Qualifications** The Manager for Case Management Services reports to the Case Management ... **Introduction** Do you have the career opportunities as a(an) Manager of Case Management you want with...supporting a balance of optimal care and appropriate resource utilization . **What you will do in this role:** +… more