- Huron Consulting Group (Chicago, IL)
- …Join our team as the expert you are now and create your future. The Manager of Utilization Management is responsible for planning, organizing, developing, ... Review Plan and the overall operation of the Utilization Management Department in accordance with federal,...Criteria and Milliman Care Guidelines (MCG) preferred. + Current RN license from Maryland Board of Nursing. + CCM… more
- UNC Health Care (Smithfield, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection...date. **Licensure/Certification Requirements:** * Licensed to practice as a Registered Nurse in the state of North… more
- John Muir Health (Walnut Creek, CA)
- …- Case Management Preferred or Equivalent Work Experience **Certifications/Licensures:** + RN Registered Nursing - California Board of NursingRequired + BLS ... this in coordination with the interdisciplinary health team. The RN Case Manager is expected to function...practice with specialized focus on care coordination, compliance, transition management , education, and utilization management .… more
- Guthrie (Sayre, PA)
- …approaches and make recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of ... degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant...admissions and short procedures by translating clinical information to Utilization Management requirements using pre ‐ determined… more
- Sanford Health (Rapid City, SD)
- …Schedule:** Full time **Weekly Hours:** 40.00 **Department Details** Join our team as a Utilization Review and Case Management Manager and lead a ... supervision of all departmental staff. Maintains a standardization of utilization management process to ensure all policies...in medical necessity review preferred. Currently holds an unencumbered registered nurse ( RN ) license with… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Registered Nurse I Department: Utilization Management Location: Rochester General Hospital Hours Per Week: 40 hours (Full-Time) Schedule: ... Responsibilities include concurrent (as needed) and retrospective reviews. The Utilization Management Nurse will act...Support - American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse -… more
- UPMC (Pittsburgh, PA)
- Are you a registered nurse with a background in utilization management ? UPMC Health Plan is looking for you! We are hiring a full-time Utilization ... Management Care Manager to support the Utilization Management Clinical Operations Department. This position...management certification or approved clinical certification preferred + Registered Nurse ( RN ) + Act… more
- Tenet Healthcare (Detroit, MI)
- Registered Nurse ( RN ) - Case Manager - 2506003285 Description : Join our dedicated healthcare team where compassion meets innovation! As a Registered ... for case management scope of services including: Utilization Management supporting medical necessity and denial... experience preferred. 3. License to practice as a Registered Nurse in the State of Michigan.… more
- HCA Healthcare (Brownsville, TX)
- …Regional Medical Center have the opportunity to make a real impact. As a(an) Registered Nurse RN Case Manager you can be a part of change. **Benefits** ... for your patients as a (an) Registered Nurse RN Case Manager . We...patient-centered care by coordinating all aspects of hospital-based case management for his/her assigned area of responsibility in alignment… more
- St. Luke's University Health Network (Sellersville, PA)
- …regardless of a patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager is responsible for coordinating the complex ... the continuum of care. Also works with the providers, registered nurse care managers, social workers, and...limited to: RN care managers, assistants, coordinators, utilization management staff, and director. . Facilitates… more