- UNC Health Care (Goldsboro, NC)
- …of an accredited program of professional nursing required. Licensure/Certification Current Registered Nurse licensure in North Carolina. BLS certification ... frontline staff input regularly recognized and implemented to enhance patient care. Management is supportive of maintaining a healthy work-life balance for staff… more
- Catholic Health Initiatives (Lexington, KY)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the...their practice. 13. Performs other duties as assigned, including utilization review as necessary. **Job Requirements** **Required… 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...required. **Qualifications** **Required** : A Bachelor's degree or a nurse working on their degree with an RN… more
- University of Southern California (Arcadia, CA)
- …timely and accurate information to payers. The role integrates and coordinates utilization management , care facilitation, and discharge planning functions. The ... follows up to resolve problems with payers as needed. + Completes utilization management for assigned patients. + Coordinates/facilitates patient cares… more
- Nuvance Health (Danbury, CT)
- …in Milliman and InterQual Guidelines required * Minimum of 2-3 years experience as Utilization Management Nurse in an acute care setting required, minimum ... If unable to resolve, escalate to the PA and Utilization Review (UR) Leadership. * Coordinate with...the interdisciplinary care team * Current working knowledge of utilization management , performance improvement and managed care… more
- Highmark Health (Jefferson Hills, PA)
- …including but not limited to: appropriateness of care, documentation requirements, utilization review principles and criteria, insurance benefits and ... utilization . Serves as key team members in the management of readmissions, length of stay, ED utilization...a clinical nursing role + Current State of PA RN licensure OR Current multi-state licensure through the enhanced… more
- Mohawk Valley Health System (Utica, NY)
- …region in all types of weather conditions. PREFERRED: + Experience in quality improvement and utilization review . + At least 2 years of case management or ... Job Summary As a member of the MVHS Care Management clinical team, the Quality Coordinator RN ...RN license from the NY State Board of Registered Nursing. + Current CPR certification. Disclaimer Qualified applicants… more
- Nuvance Health (Carmel, NY)
- …quality indicators such as avoidable delays, length of stay, resource utilization , patient satisfaction, patient flow, outlier management , and readmissions ... Program (MBSAQIP) * Robotic Center of Excellence - Surgical Review Corporation (SRC) At Putnam Hospital, our team members...Putnam Pride is all about. *Summary* The Case Manager RN , working in conjunction with the centralized denial prevention… more
- HCA Healthcare (Kissimmee, FL)
- …through clinical screenings and assessments in collaboration with both hospital Case Management and the Rehab Medical Director. Job Duties and Responsibilities: + ... + Functions as primary contact for external and internal case management and referring physician. Establishes and maintains effective working relationships with… more
- Beth Israel Lahey Health (Needham, MA)
- …practice model. **Job Description:** **Essential Responsibilities:** 1. Performs utilization management , care coordination, and discharge planning ... third weekend & rotating holiday required) Job Summary: The RN Case Manager (CM) facilitates the coordination of care.... 4. Knowledge of discharge planning practices, understanding of utilization review practices including third party payer… more