- Prime Healthcare (San Dimas, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/214914/case- manager -%28rn%29 utilization ... perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness.… more
- Alameda Health System (Oakland, CA)
- …requirements. 16. Participate in orientation of fresh staff as requested by the Manager of Utilization Management. 17. Maintains knowledge of current trends and ... System Utilization Management SUM Utilization Review RN...system. 9. Conduct concurrent and admission reviews of patient records to assess medical necessity and adherence to evidence-based… more
- Access Dubuque (Dubuque, IA)
- …the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You will be responsible ... for reviewing medical records , coordinating with healthcare providers, and ensuring that patients...Staffing Services Administrative Assistant Express Employment Professionals Assistant Store Manager Kwik Stop Kwik Stop Utilization Management… more
- Mount Sinai Health System (New York, NY)
- …electronic documentation within the hospital Eagle and Canopy systems or written record keeping. Responsible for accurate filing of records , obtaining medical ... **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front...(IPRO Discharge Appeals / Insurance requests) + Support Appeals Nurse / Manager by confirming status of… more
- Baptist Memorial (Meridian, MS)
- …Job Description Title: RN Utilization Review Weekender Job Summary The Utilization Review Nurse is responsible for evaluating the medical necessity and ... appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse works with providers, insurance companies and… more
- Sharp HealthCare (San Diego, CA)
- …Degree in Nursing; Bachelor's Degree in Nursing; Master's Degree; California Registered Nurse (RN) - CA Board of Registered Nursing; Certified Case Manager ... (CCM) - Commission for Case Manager Certification; Accredited Case Manager (ACM) - American Case Management Association (ACMA) **Hours** **:** **Shift Start… more
- ChenMed (North Miami Beach, FL)
- …into acute and post-acute facilities, as well as, their home environments. The Nurse Case Manager 1 (RN) role also involves establishing relationships with ... or other appropriate means of communication. + Introduces self to patient/family and explains Nurse Case Manager 's role and processes to contact the Nurse … more
- Trinity Health (Fort Lauderdale, FL)
- **Employment Type:** Full time **Shift:** **Description:** Functions as Primary Nurse Reviewer for Observation services. * Maintains a working relationship with ... Plans to ensure authorization for hospital stay. Hybrid Position **_Position Purpose:_** ** Utilization Review (UR) Nurses play a vital role in healthcare by making… more
- Elevance Health (Richmond, VA)
- ** Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... employment, unless an accommodation is granted as required by law._ The ** Utilization Management Representative I** will be responsible for coordinating cases for… more
- HCA Healthcare (Houston, TX)
- …set us apart from any other healthcare provider. We are seeking a(an) Registered Nurse Case Manager to join our healthcare family. **Benefits** The Woman's ... passion for patient care. Apply today for our Registered Nurse Case Manager opportunity. **Job Summary and...in accordance with procedures set forth in the Hospital Utilization Management Plan and the criteria and standards approved… more