- Saint Francis Health System (Tulsa, OK)
- …in the Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to improvement of internal ... the Process Improvement/Quality Director, to appropriate clinicians and to the UM Manager . Reviews eligibility and benefits of patients, matching the level of care… more
- LifePoint Health (Wilson, NC)
- …delivery of healthcare services. The Case Manager integrates the roles of Utilization Management , Case Management and Discharge Planning. The Case ... compact RN license - BLS optional **Job:** **Nursing* **Organization:** ** **Title:** *Case Manager - RN ED* **Location:** *NC-Wilson* **Requisition ID:** *7462-9340* more
- CDPHP (Latham, NY)
- …care experience in a hospital setting required. + Minimum one (1) year quality/ utilization management experience in health care setting preferred. + Experience ... for CDPHP members through collaboration with the Outpatient Care Manager whose role it is to follow our member...with utilization management software including Facets, Macess and… more
- Dignity Health (Mesa, AZ)
- …and Responsibilities** Under the general direction of the Director of Care Management , performs criteria-based concurrent and retrospective utilization review to ... use of resources; promote quality patient care; assist with patient care management ; comply with applicable standards and regulations and provide information and… more
- BayCare Health System (Tampa, FL)
- …and Licensures:** + Required RN (Registered Nurse) + Preferred ACM (Case Management ) + Preferred CCM (Case Manager ) **Education:** + Required Associates ... of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN responsibilities include:** + Functions as the… more
- Elevance Health (Indianapolis, IN)
- …I** The Behavioral Health Care Manager I is responsible for conducting utilization management reviews for mental health and substance use disorder inpatient ... in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance Health location at least… more
- Trinity Health (Mishawaka, IN)
- …and detail-oriented **RN** **Case Manager ** to coordinate patient care, utilization management , and discharge planning. This role ensures quality outcomes, ... of clinical nursing experience; critical care experience preferred + Case management certification preferred + Strong communication, critical thinking, and computer… more
- Mount Sinai Health System (New York, NY)
- …Excel and Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A. ... **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front...EOW** To maintain front end operations of the Case Management Department by monitoring all incoming correspondence and ensuring… more
- Prime Healthcare (Ontario, CA)
- …school of nursing and a current state Registered Nurse license. + Minimum 3 years RN Utilization Manager working for a Health Plan. + At least 3 years of ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/222731/ utilization -review-rn/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityPrime Healthcare… more
- Ascension Health (Murfreesboro, TN)
- …preferred. American Heart Association or American Red Cross accepted. + Case Manager credentialed from the Commission for Case Manager Certification (CCMC) ... of hire. **Additional Preferences** + One year of **recent** experience in Case Management required. + Local and national travel options are available depending on… more