- University of Rochester (Rochester, NY)
- …(RHIT) Program Preferred **_or_** + Licensure/credentials in clinical specialty such as Registered Nurse , Licensed Practical Nurse , or Emergency Medical ... Attend registry vendor sponsored training workshops/meetings to maximize trauma registry utilization and performance. Registry Admin Duties + Oversee the conversion,… more
- Colorado State University (Fort Collins, CO)
- …and getting authorizations/pre-authorizations + Experience as a Medical Assistant, Licensed Practical Nurse , Registered Nurse , or other relevant medical ... buildings. Live in Fort Collins Fort Collins has been home to CSU since the University's inception in 1870....summaries related to referral activity, patient outcomes, or service utilization , as needed for institutional review or… more
- HCA Healthcare (Dallas, TX)
- …Informatics. **Licensure/Certifications:** + Current (per State) RN license for RN applicants. + Nurse or Health Informatics Certification encouraged. ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage,… more
- HCA Healthcare (Nashville, TN)
- …treatment is reimbursed by contacting managed care organizations and completing initial utilization review . Documents in Midas as required. Involves mobile ... to advocate for patients in regard to managed care organizations + Conducts utilization review for managed care cases in admissions/intake department +… more
- UNC Health Care (Rocky Mount, NC)
- …and cost-efficient care of patients through such case management functions as utilization review and discharge planning. May facilitate the execution of ... reviews for private insurance companies, Medicare and Medicaid, in accordance with utilization review guidelines. Tactfully and effectively informs Manager of… more
- Commonwealth Care Alliance (Boston, MA)
- … Home and Clinical teams to support consistency and quality across BH and Health Home providers. * Participate in case review meetings and rounds as needed to ... partnerships. This position works closely with CCA's Behavioral Health, Health Home , Network, and Clinical teams to ensure a seamless provider experience… more
- Wellpath (Franklin, TN)
- …or Care Management Certification + RN preferred EXPERIENCE + Previous utilization review and/or case management and pre-certification experience + Knowledge ... discounts * Preferred banking partnership and discounted rates for home and auto loans *Eligibility for perks and benefits...difference** The Regional Care Manager (RCM) is responsible for utilization review , care coordination, and daily care… more
- HCA Healthcare (Sun City Center, FL)
- …Healthcare Quality) OR CHCQM (Diploma in American Board of Quality Assurance and Utilization Review Physicians). _Individuals without CPHQ or_ CHCQM _will be ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage,… more
- Nuvance Health (Poughkeepsie, NY)
- …preferred. Must have current RN license. Preferred experience in Utilization Review /Management. Location: Vassar Brothers Medical Center Work Type: Full-Time ... ER and Observation units Under the general supervision of the Director, The Nurse Case Manager role provide clinically-based case management to support the delivery… more
- UnityPoint Health (Des Moines, IA)
- …agencies and payers to plan and execute a safe discharge + Collaborate with Utilization Management team on continued stay review . + Collaborates with patients, ... continuity through elimination of fragmentation of care/service and facilitates the effective utilization of resources. Serves as educator and a central source of… more