- Trinity Health (Berwyn, IL)
- …are currently looking for an experienced Authorization Referral Coordinator. Reporting to the Manager of Utilization Management and working under general ... the clinical team per protocol. Refers requests to the nurse reviewer or medical director if criteria or guidelines...and assist with in-network referrals. + Escalate requests to nurse reviewers or medical directors when guidelines are not… more
- Children's Mercy Kansas City (Kansas City, MO)
- …of, and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including patient ... management and accountability Qualifications + Bachelor's Degree in nursing and + 3-5 years experience + Experience in... and + 3-5 years experience + Experience in Utilization Review + Master's Degree in nursing … more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... to support the safety net required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II is primarily responsible for… more
- Sharp HealthCare (San Diego, CA)
- …; Master's Degree; California Registered Nurse (RN) - CA Board of Registered Nursing ; Certified Case Manager (CCM) - Commission for Case Manager ... will track and maintain this certification.For Sr Spec ICM assigned to Utilization Management , Train-the-Trainer certification may substitute for ACM or CCM.… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... safety net required to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is responsible for executing the day-to-day operations… more
- Catholic Health Services (Melville, NY)
- …why Catholic Health was named Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and ... has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a...additional clinical documentation. + Acts as liaison between the Utilization and Appeals Management Department and the… more
- Sharp HealthCare (San Diego, CA)
- …by our recruitment and hiring teams. **What You Will Do** To provide comprehensive utilization management and coordination of care for SRS Members. Ensure timely ... **Shift Start Time** **Shift End Time** California Licensed Vocational Nurse (LVN) - CA Board of Vocational Nursing...in a hospital or clinical setting. + 2 Years utilization /Case Management experience, preferably in a Managed… more
- Prime Healthcare (Lynwood, CA)
- …care nursing experience preferred. At least one year experience in case management , discharge planning or nursing management , preferred.4. Current BCLS ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/228577/rn-case- manager utilization… more
- Community Health Systems (Franklin, TN)
- … preferred + 2-4 years of clinical experience in utilization review, case management , or acute care nursing required + 1-3 years work experience in care ... and efficiency of hospital services to ensure compliance with utilization management policies. This role conducts admission...Nursing required + Bachelor's Degree in Nursing… more
- Geisinger (Pittston, PA)
- …base clinically and administratively through active participation in professional, and educational nursing activities to enhance skills as manager , leader, and ... professional development supervisor with development and ongoing maintenance of New Manager Training Program, Ambulatory Nurse Leader program, and developing,… more