- Northeast Alabama Regional Medical Center (Anniston, AL)
- …for documentation issues as they relate to the working DRG developed by the Case Manager /Coder. Assists with special projects as directed or requested by the ... Under the direction of the Case Management Coordinator, coordinates, negotiates, procures and manages the care of patients to facilitate achievement of positive… more
- Sharp HealthCare (San Diego, CA)
- …Nursing; Master's Degree; California Registered Nurse (RN) - CA Board of Registered Nursing; Certified Case Manager (CCM) - Commission for Case Manager ... Certification; Accredited Case Manager (ACM) - American Case Management Association (ACMA) **Hours** **:** **Shift Start Time:** Variable **Shift End Time:**… more
- University of Utah Health (Salt Lake City, UT)
- …members or third-party payer. + Alerts and discusses with physician/provider and case manager /discharge planner when patient no longer meets medical necessity ... any case that surpasses expected LOS, expected cost, or over/under- utilization of resources. + Performs verbal/fax clinical review with payer as determined… more
- LA Care Health Plan (Los Angeles, CA)
- …work/licensure. The Supervisor is a subject matter expert (SME) in Care/ Case / Utilization Management and supporting regulations, policies, protocols, and ... 7 years of acute/clinical care experience. Minimum of 2 years of experience in Case /Care/ Utilization Management in an acute care or health plan setting. Minimum… more
- LA Care Health Plan (Los Angeles, CA)
- …- Active, current and unrestricted California License Licenses/Certifications Preferred Certified Case Manager (CCM) American Case Management Association ... acute hospital setting. Previous experience to have a strong understanding of Utilization Management/ Case Management practices including, but not limited to,… more
- Actalent (Fort Lauderdale, FL)
- …of education and experience. + Valid Florida Driver's License. + Knowledge of case management and utilization review concepts, including InterQual and Milliman ... Actalent is Hiring a Behavioral Health Utilization Review Nurse Job Description We are seeking...interdisciplinary team under the supervision of the Director and/or Manager /Supervisor of Medical Management. The primary role involves reviewing… more
- Actalent (Sunrise, FL)
- …Skills & Qualifications + Valid Florida Driver's License. + Knowledge of case management and utilization review concepts, including InterQual and Milliman ... Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization ...services. Under the general supervision of the Director and/or Manager /Supervisor of Medical Management, and in collaboration with the… more
- Sharp HealthCare (San Diego, CA)
- …**Job Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager ... Certification; California Registered Nurse (RN) - CA Board of Registered Nursing; Accredited Case Manager (ACM) - American Case Management Association… more
- WellSpan Health (Lebanon, PA)
- …& 1 minor holiday **General Summary** Performs a variety of duties and applies utilization and case management techniques to determine the most efficient use of ... to address patient discharge needs. Provides leadership in the integration of utilization and case management principles. **Essential Functions:** + Reviews… more
- Tenet Healthcare (Detroit, MI)
- RN Case Manager CRM Full Time Days - 2506002554 Description : DMC Sinai-Grace Hospital is DMC's largest hospital, offering a comprehensive heart center, cancer ... cardiac care for hospitals and physicians throughout the nation. Job Summary The RN Case Manager is responsible to facilitate care along a continuum through… more