- US Tech Solutions (May, OK)
- …HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review . . MUST HAVE 1 YEAR OF UTILIZATION ... or recommendation. . Data gathering requires navigation through multiple system applications. . Staff may be required to contact the providers of record, vendors, or… more
- Dignity Health (Chandler, AZ)
- …of the Director of Care Management, performs criteria-based concurrent and retrospective utilization review to support and encourage the efficient and effective ... + Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is warranted… more
- Dignity Health (Gilbert, AZ)
- …of the Director of Care Management, performs criteria-based concurrent and retrospective utilization review to support and encourage the efficient and effective ... + Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is warranted… more
- Ventura County (Ventura, CA)
- …the general and specialized principles, practices, techniques and methods of utilization review /management, discharge planning or case management. + utilize ... Senior Registered Nurse - Hospital Management Utilization Print...needs; + Communicates the plan to physicians, patient, family/caregivers, staff & appropriate community agencies; + Reviews, monitors, evaluates… more
- Veterans Affairs, Veterans Health Administration (Salt Lake City, UT)
- Summary The Utilization Management (UM) Registered Nurse (RN) executes position responsibilities that demonstrate leadership, experience, and creative approaches ... standard, please visit https://www.va.gov/ohrm/QualificationStandards/. Preferred Experience: Master's prepared Registered Nurse . 5 years Utilization Management Experience and/or… more
- Beth Israel Lahey Health (Plymouth, MA)
- …using Interqual criteria. + Integrates clinical knowledge with billing knowledge to review , evaluate, and appeal clinical denials related to the care provided to ... clinical experience in the hospital setting + Experience with utilization management within the last 3 years required +...our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition… more
- Hackensack Meridian Health (Hackensack, NJ)
- **The Advanced Practice Nurse (APN) utilizes a patient-centered coordinated care model, demonstrating competencies in leadership, direct clinical practice, ... nursing program. 2. Master's or Doctorate degree from an accredited Nurse Practitioner program. 3. Maintains clinical competencies through continuing education and… more
- McLaren Health Care (Port Huron, MI)
- **Department:** Utilization Review **Daily Work Times:** 8:00am-4:30pm **Hours Per Pay Period:** 40 **Position Summary:** Responsible for determining the ... accordance with established SOP procedures. 9. Maintains current knowledge of hospital utilization review processes and participates in the resolution of… more
- McLaren Health Care (Bay City, MI)
- …accordance with established SOP procedures. 8. Maintains current knowledge of hospital utilization review processes and participates in the resolution of ... **Department:** Utilization Management **Shift:** Days **Daily Work Times:** 8am...reviews with payer/providers. 7. Actively participates in clinical case review /rounds with the interdisciplinary team regarding continued stays … more
- Saint Francis Health System (OK)
- …reimbursement issues and participate in treatment teams, Patient Care Committee, and the Utilization Review Staff Committee by providing data and ... levels of care and receipt of necessary services. The Utilization Management (UM) Registered Nurse will communicate...nor does it prohibit the assignment of additional duties. Utilization Review Management - Yale Campus Location:… more