- Elevance Health (Wallingford, CT)
- ** Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... an accommodation is granted as required by law._ The ** Utilization Management Representative I** will be responsible...requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification and data… 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 ... Current/active North Carolina or compact RN license - BLS optional **Job:** ** Nursing * **Organization:** ** **Title:** *Case Manager - RN ED* **Location:**… more
- Rochester Regional Health (Rochester, NY)
- …and direct oversight of day-to-day responsibilities of nursing team members. The Assistant Nurse Manager is the main contact for a variety of nursing ... M-F- 7-330pm, 8-430pm, or rotating with evening hoursSUMMARY:The Assistant Nurse Manager is responsible for the clinical...within practice areao Completes at least one clinical research utilization (CRU) form for submission to Nursing … more
- University Medicine (Providence, RI)
- SUMMARY: Reporting to the Manager of Case Management , the nurse case manager is responsible for providing comprehensive screenings, assessment, care ... self- management for patients with chronic conditions. The Nurse Case manager is integrated in the...to the right level of care and decrease unnecessary utilization . The nurse case manager … more
- Rochester Regional Health (Rochester, NY)
- …nursing personnel, physicians and providers*In collaboration with the Nurse Manager /Director, investigates and resolves patient/family/significant other ... Job Title: Assistant Nurse Manager Department: SSDU Location: RGH...ANM is the main contact for a variety of nursing functions in support of management 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 ... hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of...healthcare field + At least five (5) years of nursing experience + Certified Case Manager (CCM),… more
- Ellis Medicine (Niskayuna, NY)
- …of Practice and Nursing 's social Policy Statement. The Nurse Manager participates in performance improvement/research activities; maintains professional ... Basic Function: The Nurse Manager (NM) actualizes the vision,...Ellis Medicine and maintains standards of the practice for nursing as defined by the American Nurses Association, Code… more
- Tenet Healthcare (Detroit, MI)
- …national standards for case management scope of services including: Utilization Management supporting medical necessity and denial prevention. Transition ... Registered Nurse Case Manager Contingent Days -...q) and other duties as assigned. POSITION SPECIFIC RESPONSIBILITIES: Utilization Management : Balances clinical and financial requirements… 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...(IPRO Discharge Appeals / Insurance requests) + Support Appeals Nurse / Manager by confirming status of… more
- Veterans Affairs, Veterans Health Administration (Fargo, ND)
- …forms. Evaluates resources and trends to support continuous improvement of resource utilization and management of Community Care expenditures. Serves as the ... - Home and Community Based Services (HCBS) Case Manager . In this vital role, you'll ensure Veterans receive...requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse… more