- Nuvance Health (Danbury, CT)
- …with CMS, Joint Commission, and other regulatory bodies related to discharge planning, utilization review , and care transitions. 6. Monitor and analyze key ... - One of America's 50 Best Hospitals * Surgical Review Corporation (SRC) - Robotic Center of Excellence *...Work or a related field required. Current CT Registered Nurse (RN) license. Minimum of 5 years of progressive… more
- OhioHealth (Powell, OH)
- …direct patient care with administrative leadership, ensuring high-quality service delivery, staff coordination, and smooth daily operations. The LPN Supervisor will ... serve as the go-to leader for clinical and support staff , managing scheduling, supervising and mentoring team members, and overseeing clinical workflows. Key… more
- BJC HealthCare (Belleville, IL)
- …nursery, medical and surgical services plus critical care. Care Management includes Utilization Management ( Utilization Review ), Discharge Planning, Social ... Services, Clinical Outcomes (Care Managers), Discharge Transition Coaches, Nurse Practitioners, and Clinical Documentation Improvement. **Preferred Qualifications** **Role… more
- Pacific Medical Centers (Renton, WA)
- …Management RN is responsible for the supervision of case management (CM) and utilization management (UM) functions of US Family Health Plan to achieve cost-effective ... utilization of resources. This is accomplished through the proactive...and processed in a timely manner. It includes timely review of medical necessity and authorization for all admitted… more
- Covenant Health Inc. (Knoxville, TN)
- …full access to the medical doctors in our facility. 9 North has a registered nurse on duty around the clock. Skilled caregivers on this unit also include licensed ... updates on federal and state regulations and disseminates information to staff . Recruiter:Lacey Spoon || ###@covhlth.com Responsibilities + Will schedule the ARD's… more
- HCA Healthcare (Gainesville, FL)
- …and improve the patient flow program effectiveness as it relates to utilization review , resource management, and discharge planning and care coordination. ... location._** It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential...PCP's to address and resolve issues related to facility utilization and patient flow process and facilitate strong working… more
- Veterans Affairs, Veterans Health Administration (San Diego, CA)
- …coordinated care delivery model. Coordinates with the patient care team to review clinic appointment availability ( utilization ) to ensure that clinic schedules ... ensures accurate scheduling, and communicates with Veterans, providers, and clinical staff . Maintains HIPAA standards, resolves issues, and supports smooth clinic… more
- Calvary Hospital (Bronx, NY)
- …pertinent data. 8. Knowledge of and experience in Quality Assessment and Improvement, Utilization Review . 9. Ability to develop management systems to track data ... has been denied. Conducts interdepartmental meetings related to the quality and utilization of clinical services. Serves on various Hospital committees as assigned.… more
- Community Health Systems (Carlsbad, NM)
- …clinical nursing experience required + 3-5 years of experience in care management or utilization review required + 1-3 years of leadership experience in a ... to the Care Management team. The Director works collaboratively with staff , physicians, and community resources to deliver patient-centered care and achieve… more
- CenterWell (Atlanta, GA)
- …Assisting in resolution of inquiries, requests, and complaints from patients + Ongoing chart review / audit of clinical staff to ensure quality care and ... intent Overseeing other clinicians which includes Physicians, Advanced Registered Nurse Practitioners (ARNP), and Physicians Assistants (PA) in: + Maintaining… more