- Elevance Health (Washington, DC)
- …and experience, which would provide an equivalent background. **Preferred Qualifications** + Utilization review / utilization management experience is a must ... by managing and overseeing non-clinical medical management specialists to ensure utilization regulatory compliance and member service delivery. **Primary duties may… more
- Penn Medicine (Lancaster, PA)
- …license and daily access to an insured vehicle. Preferred Qualifications + Knowledge of Utilization review or managed care + Experience with home visits + ... _The Ambulatory Care Management team is actively seeking a new Ambulatory Care Manager to join their dynamic and patient-centered department. This role supports the… more
- Hartford HealthCare (Farmington, CT)
- …between service/program level management and system support functions including Finance, Utilization Management, Revenue Cycle and Compliance. Works in support of ... areas under Revenue Cycle including financial clearance, benefit verification, utilization management, billing/follow-up, denial management and compliance. This includes… more
- Trinity Health (Fresno, CA)
- **Employment Type:** Part time **Shift:** **Description:** This position coordinates utilization review service for defined patient populations across the acute ... care continuum. This includes discharge planning, utilization management, care coordination collaboration, and support for resource utilization . This position… more
- Ochsner Health (New Orleans, LA)
- …3 years of hospital-based experience in discharge planning, case management or utilization review . **Certifications** Required - Current registered nurse license ... based on patient's individualized needs. Registered Nurse (RN) Case Manager - Case Management OMC Jefferson Highway PRN To...of the conditions of participation as it relates to utilization review and discharge planning. + Maintains… more
- Carnival Cruise Line (Miami, FL)
- …stakeholders, supporting disability claims, and facilitating return-to-work planning. The Manager also escalates high-risk cases, conducts utilization reviews, ... This role reports to the Senior Manager of Case Management and oversees the daily...seafarers and their families with professionalism and empathy. + Review clinical care plans for appropriateness and support the… more
- University of Southern California (Alhambra, CA)
- …+ Req 5 years Clinical experience + Req 2 years Ambulatory case management or utilization review experience within the last three years + Req Ability to work ... their understanding of the process. Some of the major duties of the Case Manager overlap into inpatient duties including: Concurrent review of all patients to… more
- HCA Healthcare (El Paso, TX)
- …and retrospective review of patient medical records for purposes of utilization review , compliance with requirements of external review agencies ... Working knowledge of case management philosophy/process/role, needs assessment, principles of utilization review /quality assurance, use of InterQual(R) or other… more
- HCA Healthcare (Gainesville, FL)
- …and/or cellular therapy is required. + Certification in case management, nursing, or utilization review desired. + Bachelors degree required. HCA Florida North ... you passionate about delivering patient-centered care?** Submit your application for RN Case Manager Hematology position and spend more time at the bedside with the… more
- AECOM (New Orleans, LA)
- …planning + Financial Management + Works in collaboration with stakeholders (typically Capture Manager , Team Leads and I&G Leadership) to review and approve labor ... to I&G Director for annual budgets and business planning, staff utilization , department resource needs (hardware/software needs, strategic investments) and other… more