- 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)
- 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
- Molina Healthcare (WA)
- …Active, unrestricted Certified Case Manager (CCM) Some experience with Utilization Management processes is desirable (InterQual, MCG guidelines) , discharge ... care or medical or behavioral health settings. Prior experience in Utilization Management and discharge planning. **Preferred License, Certification,… 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/236088/rn-case- manager utilization… more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- The Utilization Review Case Manager is responsible for working with insurance companies and managed care systems for the authorization, concurrent and ... and NOT a remote position.* Requirements + Education: Clinical degree such as nursing , social work, psychology, health information management or other related… more
- Cleveland Clinic (Cleveland, OH)
- …with one of the most respected healthcare organizations in the world. As a Utilization Management Specialist, you will perform UM activities, such as admission, ... a minimum of 85% on IRR quarterly. + Complete Utilization Management for assigned patients with a...Nursing + Current state licensure as a Registered Nurse (RN) + Basic Life Support (BLS) Certification through… 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
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination ... Nursing **Knowledge, Skills and Abilities (KSAs)** + Oversight of Utilization Management clinicians while championing process improvement, change adoption… 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 ... patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of… more
- Saint Francis Health System (Tulsa, OK)
- …not all inclusive nor does it prohibit the assignment of additional duties. Utilization Management - Laureate Campus Location: Tulsa, Oklahoma 74136 **EOE ... Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to...completed the basic professional curricula of a school of nursing as approved and verified by a state board… more