- Highmark Health (Monroeville, PA)
- …changes, regulatory requirements, etc. Serves as an educational resource to all AHN staff regarding utilization review practice and governmental commercial ... relationships across the organization in a community setting. **GENERAL OVERVIEW:** Registered nurse who is proficient in the coordination of care and manages… more
- Colorado State University (Fort Collins, CO)
- …Prepares reports or summaries related to referral activity, patient outcomes, or service utilization , as needed for institutional review or reporting. + Performs ... can thrive, grow, and make a lasting impact. + Review our detailed benefits information here. (https://hr.colostate.edu/wp-content/uploads/sites/25/2021/01/benefits-summary-afap.pdf) + Explore… more
- University of Rochester (Rochester, NY)
- …closely with the Hospital Quality Office, the Departmental Quality Teams and providers/ staff from the Division to identify opportunities for clinical safety and ... Leads and facilitates relevant conferences in collaboration with appropriate staff . Regularly reports quality improvement activities and quality outcomes to… more
- Mohawk Valley Health System (Utica, NY)
- …population. Provides direct oversight of the case manager's daily operations of utilization review practice, processes and procedures ensuring accurate member ... - SNH is responsible for the oversight of the case management staff 's authorization/coordination/ utilization and provision of member services. Duties include the… more
- Catholic Health Services (West Islip, NY)
- …Hospital Conditions of Participation. + Implements care management programs, including utilization review , intake and discharge planning. + Evaluates patient ... of Care Management: + Works collaboratively with, but not limited to, Medical Staff , Quality/Risk Management, CH Utilization and Central Appeals, Managed Care… more
- The County of Los Angeles (Los Angeles, CA)
- …administrative supervision to plan, assign, oversee, and evaluate the work of subordinate staff and provides technical guidance and support to staff within the ... and implements reporting procedures to ensure that program services utilization and revenue data are reported accurately and in...and in a timely manner. Coordinates the delivery of staff training necessary to maintain mandated levels of services.… more
- HCA Healthcare (Kissimmee, FL)
- …while supporting a balance of optimal care and appropriate resource utilization . Identify potential barriers to patient throughput and quality outcomes and ... processes, for the appropriate level of care, patient status, and resource utilization . + Conducts interdisciplinary team meetings to provide a mechanism for all… more
- HCA Healthcare (Tallahassee, FL)
- …position if current and compliant** + **Certification in Case Management, Nursing, or Utilization Review , preferred** + **Three years of nursing experience in ... throughput while supporting a balance of optimal care and appropriate resource utilization . The RN CM Care Coordinator will identify potential barriers to patient… more
- Colorado State University (Fort Collins, CO)
- …Prepares reports or summaries related to referral activity, patient outcomes, or service utilization , as needed for institutional review or reporting + Audits ... can thrive, grow, and make a lasting impact. + Review our detailed benefits information here. (https://hr.colostate.edu/wp-content/uploads/sites/25/2021/01/benefits-summary-afap.pdf) + Explore… more
- Northwell Health (Mount Kisco, NY)
- …RN Case Management and Social Work Services team. Develops processes to monitor utilization review inclusive of length of stay (LOS) and resource reduction ... procedures to improve quality of patient care and plans utilization of staff resources and activities aimed...Nursing. *Current license to practice as a Registered Professional Nurse in New York State, required, plus specialized certifications… more