- Corewell Health (Royal Oak, MI)
- …discharge planning of all hospitalized patients. 1. Identifies patients that need care management services (ie utilization review ; care coordination; and/or ... relevant experience Three to five years' experience in care management , utilization review , home care..., home care and/or discharge planning. Preferred + Registered Nurse (RN) - State of Michigan License Upon Hire… more
- Corewell Health (Dearborn, MI)
- …discharge planning of all hospitalized patients. + Identifies patients that need care management services (ie utilization review ; care coordination; and/or ... relevant experience Three to five years' experience in care management , utilization review , home care..., home care and/or discharge planning. Preferred + Registered Nurse (RN) - State of Michigan Upon Hire required… more
- Sharp HealthCare (San Diego, CA)
- …position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving ... competency and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge planning, as… more
- Houston Methodist (Sugar Land, TX)
- …Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical denial management ... clinical nursing/patient care experience which includes three years in utilization review , case management or...**LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure -… more
- Mohawk Valley Health System (Utica, NY)
- …population. Provides direct oversight of the case manager's daily operations of utilization review practice, processes and procedures ensuring accurate member ... - SNH is responsible for the oversight of the case management staff's authorization/coordination/ utilization and provision of member services. Duties include… more
- Carle Health (Champaign, IL)
- …for improving patient care outcomes. The incumbent will have a deep understanding of utilization review and case management principles, case management ... experience - External Applicants Only** Hybrid Option The Registered Nurse (RN) who serves in the role of System...experience 2+ years Responsibilities Maintain current knowledge of case management and utilization review trends… more
- Banner Health (AL)
- …reduction in payer clinical denials. Collaborates with Care Coordination, physician, Utilization Review , and other internal/external departments to overturn ... Reports; + Ideal candidate will be experienced in Denials Management , Case review , and understanding of insurance....and the charging/billing is required. A working knowledge of utilization management and patient services is required.… more
- The County of Los Angeles (Los Angeles, CA)
- …the following: + Additional experience in clinical nursing. + Supervisory** experience in Utilization Review and/or Case Management . SPECIAL REQUIREMENT ... the work of staff, and evaluating employee performance. For this examination, Utilization Review is defined as provides technical and administrative direction… more
- Mount Sinai Health System (New York, NY)
- …the Daily Management Board process/practice improvement activities to facilitate the utilization of evidence and data related to Nurse Sensitive Indicators ... **Job Description** The Director of Nursing Professional Practice is a professional nurse with broad knowledge and skill in the professional practice standards, NYS… more
- Ivyhill Technologies LLC (Bethesda, MD)
- …an Associate's Degree and a minimum of 2 years of experience in Utilization Management , Referral Management , Authorization/Denials, or Medical Claims ... Team Ivyhill is currently seeking to hire Referral Management (Non- Nurse ) Reviewers to support its...review duties, seeking guidance from the product line nurse (s), and other members of the healthcare team and… more