- PeaceHealth (Vancouver, WA)
- …of stay consistent with external regulations and standards. + Provide utilization management including facilitating appropriate status assignment per Medicare ... management , quality assurance/quality improvement, clinical documentation and/or utilization management using Intensity Severity Discharge (ISD). (Preferred)… more
- Houston Methodist (Houston, TX)
- …while providing excellent customer/patient service. + Plays a leadership role in utilization review committee which includes identification of opportunities for ... and trends in the areas of care coordination, evidence- based practice, utilization management , and service excellence. Disseminates information and focuses the… more
- Community Health Systems (Valparaiso, IN)
- …Management is responsible for the planning, coordination, and oversight of care management services, including utilization review , discharge planning, and ... efficiently, effectively, and in compliance with organizational standards. + Oversees utilization review and discharge planning processes to ensure… more
- 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
- 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
- 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
- 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
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- …looking to add a **Supervisor of Clinical Management ** to the BlueCare Utilization Management team\. In this leadership role, you'll oversee a dedicated ... group of nurses who conduct utilization management reviews to assess medical necessity\....responsibilities include:** + Supervising daily operations of the clinical review team + Ensuring compliance with CMS and URAC… more