- Highmark Health (Pittsburgh, PA)
- …advisor and third party payers. + Maintains a working knowledge of care management , care coordination changes, utilization review changes, authorization ... etc. Serves as an educational resource to all AHN staff regarding utilization review practice and governmental commercial payer guidelines. Adheres to… more
- Providence (Anchorage, AK)
- …care environment. Accountabilities include assessment and planning, coordination of care, resource utilization management and/ or review , discharge planning, ... **Description** The Inpatient Registered Nurse (RN) Care Manager provides professional, comprehensive, patient...of specialty + 1 year of experience in care management or utilization review in… more
- Baystate Health (Springfield, MA)
- …management as outlined in the evidence based practice guidelines + Uses Utilization Analysis / Management principles, insures that patient's site of care ... preferred + Requires a working knowledge of community resources and Utilization /Quality Review standards. Understanding of the hospitals patient placement… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …+ Through governance and performance monitoring, oversees all Workers' Compensation (WC) Case Management and Utilization Review (UR) Programs. + Collaborates ... for the Casualty and Clinical Services departments which in turn includes Utilization Management , Case Management and Population Health divisions.… more
- Texas Health Resources (Fort Worth, TX)
- …experience as a registered nurse in LTAC, acute care setting or utilization review required * LTAC, Critical care or Progressive Care experience preferred ... contractual requirements. * Maintains a working knowledge of care management , utilization review changes, authorization...non-covered services. Additional perks of being a Texas Health Nurse * Benefits include 401k and EAP for PRN… more
- UPMC (Pittsburgh, PA)
- …of health insurance experience required. + 1 year of experience in clinical, utilization management , home care, discharge planning, and/or case management ... by the interdisciplinary team summarizing clinical and social history, healthcare resource utilization , case management interventions. Update the plan of care… more
- Community Health Systems (Oro Valley, AZ)
- …administration of the activities of clinical review , discharge planning, resource utilization and utilization review . **Essential Functions** + Conducts ... varying week days and some weekend shifts in Case Management ** Candidates need acute hospital experience, prior case ...advancement is possible. **What you'll do:** As a Registered Nurse you'll play a vital role in doing what… more
- Sharp HealthCare (San Diego, CA)
- …with 0-2 errors; Have the ability to proof work.Knowledge of insurance, utilization review , scheduling requirements and support of front desk ... **Shift Start Time** **Shift End Time** California Licensed Vocational Nurse (LVN) - CA Board of Vocational Nursing &...related to front desk responsibilities including scheduling and telephone management . Acts as a positive role model and ensures… more
- Bassett Healthcare (Cooperstown, NY)
- …(patient requiring a bariatric bed, special equipment, interpreter svc, etc.). + Review previous patient history and updates CL with key patient attributes ... with medical staff regarding patient status, bed placement, payer requirements, and utilization of resources. + Manages Logistic Center staffing process for assigned… more
- Johns Hopkins University (Baltimore, MD)
- …of new clinical programs ensuring timely completion, quality and safety, and fiscal management . + Work with the Clinical Directors, Nurse Supervisors and ... with Patient Access Services for GI Ambulatory and Endoscopy. + Collaborate with the Nurse Manager to review and streamline services for international and VIP… more