- Rady Children's Hospital San Diego (San Diego, CA)
- …Degree in Nursing 4 years nursing in an acute hospital or 2 years Case Management , Utilization Review , or Discharge Planning experience in an acute hospital ... coordinating discharge needs, quality of care, and implementing the utilization management process for acute inpatients. Case... process for acute inpatients. Case Managers perform concurrent review and denials management based on acute… more
- Ochsner Health (New Orleans, LA)
- …discharge plans based on patient's individualized needs. Registered Nurse ( RN ) Case Manager - Case Management OMC Jefferson Highway PRN To perform ... discharge planning, case management or utilization review . **Certifications** Required - Current registered nurse license in state of practice. Basic… more
- Actalent (Rancho Cordova, CA)
- Job Title: Utilization Review Nurse Job Description The Registered Nurse will review cases for medical necessity across all levels of care, ... that patients receive appropriate and necessary treatment. Responsibilities + Review medical cases for necessity at all levels of.... + Collaborate with healthcare teams to facilitate effective utilization management . + Employ MCG criteria and… more
- HCA Healthcare (Cypress, TX)
- …to physicians, patients, families and caregivers **What qualifications you will need:** + ( RN ) Registered Nurse + Bachelors Degree, or Associate Degree ... case management scope of services including + Utilization Management supporting medical necessity and denial...encourage you to apply for our Registered Nurse Case Manager PRN opening. We review … 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 (UM) Care Manager is responsible for utilization review of health plan services and...management certification or approved clinical certification preferred + Registered Nurse ( RN ) + Act… more
- Sharp HealthCare (San Diego, CA)
- …case management experience. + 3 Years case management , utilization review , care coordination experience. + California Registered Nurse ( RN ) - ... Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA...the department head as indicated. + Utilization review and utilization managementThe RN … more
- Crouse Hospital (Syracuse, NY)
- …management of the RN Care Managers in the department, including Utilization Management , Discharge Planning and Denials and Appeals functions. + Assessing ... agreements. Care Coordination Manager Requirements: + Licensed as a Registered Nurse in New York State +...acute care discharge planning + Preferred - Acute care utilization review experience Benefits Overview: + Medical,… more
- Carle Health (Champaign, IL)
- …with or by the authorization of the Chief Medical Officer and works with our Utilization Management RN team, Clinical Denials Management team and ... the new providers regarding utilization and case management objectives. + Conducts medical record review ...clinical review on cases referred by Care Management staff /Social Work (remove) Utilization … more
- Catholic Health (Buffalo, NY)
- …Care Hospital Setting + Minimum five (5) years of experience working within Utilization Review /Case Management /Clinical Documentation Integrity or + Minimum ... interdisciplinary care team and works in conjunction with the Utilization Review Manager and Manager Clinical Documentation...EDUCATION + Bachelor of Science Nursing (BSN) degree + Registered Nurse with a current New York… more
- Dignity Health (Bakersfield, CA)
- **Job Summary and Responsibilities** As a Utilization Management RN , you will be crucial in ensuring accurate and compliant medical necessity decisions. Your ... . You'll work closely with both Pre-Service and In-Patient Utilization Management teams to ensure appropriate and... RN Program. - Clear and current CA Registered Nurse ( RN ) license. -… more