- Villa of Hope (Rochester, NY)
- …coordinator, providers, director of LHTC and administrative team, including billing and utilization review . + Triages potential admissions and when needed ... JOB TITLE: Intake Coordinator- RN/ Evening DEPARTMENT/PROGRAM: Medical Services SUPERVISOR: Nurse Manager/Health Coordinator PAY GRADE: 82 FLSA STATUS: NON EXEMPT… more
- Community Health Systems (Tucson, AZ)
- …and administration of the activities of clinical review , discharge planning, resource utilization and utilization review . Acts as a liaison between ... **Part Time position , working Day shift Weekends in Care Management / Case Management at Northwest Medical Center in Tucson, AZ** **$2500 sign on bonus offered… more
- Health Care Service Corporation (Albuquerque, NM)
- …practice in state of operations + 3 years clinical experience, including 2 years utilization review or case management experience + Quality improvement ... Professional Health Care Quality (CPHQ Certification) + NCQA/CMS Auditing experience + Utilization Management background + Knowledge of Millman Care Guidelines… more
- Houston Methodist (The Woodlands, TX)
- …state, local and federal programs + Progressive knowledge of discharge planning, utilization management , case management , performance improvement and managed ... registered nurse (RN) responsible for comprehensively planning for case management , which includes care transitions and discharge planning of a targeted patient… more
- CVS Health (Phoenix, AZ)
- …experience as a Registered Nurse (RN). + 2+ years of experience in utilization management . + Active, current, and unrestricted RN licensure in state of ... key business areas. + May develop/assist in development and review new training content. + May collaborate/deliver inter and...Nurse (RN). + 5+ years of experience in utilization management . + Bachelor's degree in Nursing… more
- Stony Brook University (Stony Brook, NY)
- … Department may include the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes UR ... cases for authorization for in patient stay. + Staff review short stay, long stay and complex cases to...assigned. Identifies, follows and documents Avoidable delays in Care Management Program. Reviews and documents on patients who were… more
- Stanford Health Care (Palo Alto, CA)
- …in clinical research, research, ICU, other intensive care setting, pediatrics, case management or nurse navigation preferred + Human subjects' protection and ... with minimal directions. + Understand and respond to multiple personalities and work/ management styles. + Resource management / utilization knowledge in… more
- Northwell Health (Mount Kisco, NY)
- …Case Management and Social Work Services team. Develops processes to monitor utilization review inclusive of length of stay (LOS) and resource reduction ... facility best practices and makes recommendations for process improvement. Oversees resource utilization for the hospital and provides specific data analysis on … more
- CareFirst (Baltimore, MD)
- …5 years medical-surgical or similar clinical experience OR 5 years' experience in Medical Review , Utilization Management or Case Management at CareFirst ... of regulatory and accreditation requirements, understanding of appeals process and utilization management , and systems software used in processing appeals.… more
- HCA Healthcare (Lake City, FL)
- …do. We want you to apply! **Job Summary and Qualifications** Provides hospital case management / utilization review and discharge planning to assure that the ... manner. **What qualifications you will need:** + (RN) Registered Nurse + Associate Degree + One year experience in... and/or supervisory / management position involving case management / utilization review /responsibility in an acute… more