- Georgetown Behavioral Health Institute (Georgetown, TX)
- …Knowledgeable of insurance coverage and billing practices preferred. Previous experience in utilization review or case management desirable. + Knowledge, ... a 118 bed inpatient behavioral health hospital and seeking a full-time Outpatient Utilization Review Coordinator. This position is responsible for working with… more
- Banner Health (AZ)
- …employment options by offering remote and hybrid work settings. The Registered Nurse RN Medical Management Services is required to be technologically ... tool for contracted and noncontracted status,) and more. The RN Medical Management Services review ...agencies, provider networks, and regulatory agencies. MINIMUM QUALIFICATIONS Requires Registered Nurse ( RN ) licensure in… more
- Tenet Healthcare (Detroit, MI)
- Registered Nurse ( RN ) -...for case management scope of services including: Utilization Management supporting medical necessity and denial ... Description : Join our dedicated healthcare team where compassion meets innovation! As a Registered Nurse with us, you'll have the opportunity to make a… more
- ERP International (Luke AFB, AZ)
- **Overview** ERP International is seeking a full time ** Registered Nurse - Case Management ** in support of the56th Medical Group at Luke AFB, AZ ... Management Society of America (CMSA); American Accreditation Healthcare Commission/ Utilization Review Accreditation Commission (URAC); CAMH; (AAAHC); Health… more
- Jennie Stuart Medical Center, Inc. (Hopkinsville, KY)
- Jennie Stuart Health is seeking a dedicated Case Management Nurse to join our healthcare team on a PRN basis. This role is integral to our patient care system, ... psychosocial support throughout the continuum of care. The Case Management Nurse will be based at our...related to clinical review , discharge planning, resource utilization , and utilization review . Your… more
- Sharp HealthCare (La Mesa, CA)
- …3 Years Recent acute care nursing experience or case management experience. + California Registered Nurse ( RN ) - CA Board of Registered Nursing ... Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA...the department head as indicated. + Utilization review and utilization managementThe RN … more
- Tenet Healthcare (Detroit, MI)
- … Utilization Management Plan using data to drive hospital utilization performance improvement, c) ensures medical necessity review processes are completed ... case management scope of services including: * Utilization Management supporting medical necessity and denial...in Nursing, Business Administration or Hospital Administration preferred. 2. Registered Nurse or LCSW/LMSW license. Must be… more
- Hartford HealthCare (Manchester, CT)
- … Management * **Organization:** **Manchester Memorial Hospital* **Title:** *Clinical Resource Management Nurse ( RN ) - Case Coordination* **Location:** ... of 300,000 people in 19 towns. POSITION SUMMARY: The Utilization Review Case Manager (UR CM) works...accurate information to payers. The role integrates and coordinates utilization management and denial prevention by focusing… more
- Northwell Health (Staten Island, NY)
- …care according to regulatory standards. + * Performs concurrent utilization management using Interqual criteria. + Conducts chart review for appropriateness ... license to practice as a Registered Professional Nurse in New York State. + Case Management... and clinical pathways, variance analysis and trending, quality management / utilization review and home care/discharge… more
- Guthrie (Sayre, PA)
- …experience: five (5) years of experience in an acute care setting with strong care management , utilization review , and payer knowledge. A Case Management ... levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care...degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant… more