• RN, Care Manager

    Whidbey General Hospital (Coupeville, WA)
    …anti-biotic regime, etc. The RN - Care Manager follows the hospital's Case Management / Utilization Plan that integrates the functions of utilization review, ... while in the hospital, as well as performs denial management either during admission or post discharge....of utilization review, status determination, clinical resource utilization , the discharge planning and appeal/denial management .… more
    Whidbey General Hospital (10/01/25)
    - Related Jobs
  • RN Care Coordinator

    Dignity Health (Carmichael, CA)
    …will be on care coordination communication and collaboration with utilization management nursing physicians ancillary departments insurers and post acute ... health team members the patient and/or patient representative and post acute care providers in accordance with...guidelines to ensure progression of care + Understanding how utilization management and case management more
    Dignity Health (10/24/25)
    - Related Jobs
  • Care Transitions Jobs

    Beth Israel Lahey Health (Plymouth, MA)
    …in Massachusetts + Minimum 3 years recent acute care experience + Case management or utilization review experience within the last 3 years + Proficiency in ... in people's lives.** **Job Description:** Are you a case management / utilization review professional passionate about improving care...plans and acts as a liaison between ED and post - acute providers + Ensure compliance with Medicare,… more
    Beth Israel Lahey Health (10/02/25)
    - Related Jobs
  • Licensed Social Worker (LSW) - Case…

    Bon Secours Mercy Health (Fairfield, OH)
    …mandated by CMS and Conditions of Participation for discharge planning and utilization management . Addresses opportunities or potential concerns with leadership. ... in an acute care clinical setting (preferred) + Ambulatory or post - acute , care coordination experience (preferred) _* Individuals in this position are… more
    Bon Secours Mercy Health (10/21/25)
    - Related Jobs
  • Care Coordinator RN

    Catholic Health Initiatives (Lexington, KY)
    …be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post acute ... engaging other relevant health team members, the patient and/or patient representative and post acute care providers in accordance with the patients clinical or… more
    Catholic Health Initiatives (10/11/25)
    - Related Jobs
  • Clinical Navigator (Remote)

    CareFirst (Baltimore, MD)
    **Resp & Qualifications** **PURPOSE:** The Inpatient Management Post Acute Clinical Navigator (RN) manages the timely and smooth transition from inpatient ... to home or other levels of care. Utilizing experience and skills in both case management and utilization management including proficiency in MCG to determine… more
    CareFirst (10/11/25)
    - Related Jobs
  • Transfer Center Point of Entry Nurse - Nights

    Houston Methodist (Houston, TX)
    …with a customer service focus and application of positive language principles + Understanding of pre- acute and post - acute venues of care and post - ... units through the facilitation and coordination of patient flow and bed utilization . The POE Nurse position collaborates with clinical staff and interprofessional… more
    Houston Methodist (10/20/25)
    - Related Jobs
  • Case Manager I - Scmg Integrated Care Mgmnt…

    Sharp HealthCare (San Diego, CA)
    …competency and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge planning, as ... policy.Identify opportunities for cost reduction and participate in appropriate utilization management venues.Escalate and refers cases for consultation… more
    Sharp HealthCare (10/19/25)
    - Related Jobs
  • Registered Nurse (RN) Care Transition Manager…

    Texas Health Resources (Arlington, TX)
    …potential denials. Communicates with the multidisciplinary team, patient, family, and post - acute care stakeholders to coordinate care. Coordinates with patients ... for social work intervention. 50% Ensures patients are provided post - acute options based on clinical necessity and... care hospital Req and 1 Year discharge planning/care management Pref IP acute care case … more
    Texas Health Resources (10/21/25)
    - Related Jobs
  • Hybrid Bilingual Manager, Care Integration Team

    CenterWell (Tampa, FL)
    …opportunities for managing populations and coordinating care to reduce acute and post - acute care utilization . The Manager role is hybrid with travel ... action plans that will reduce acute and post - acute care utilization . + Solicits/shares...management experience + Experience working in primary care, acute care, ambulatory care and or value-based care organizations… more
    CenterWell (08/09/25)
    - Related Jobs