- Elevance Health (Washington, DC)
- …4 days each week. The office is located at 609 H. Street NE.** The ** Manager of Utilization Management** **ll** is responsible for managing a team of physical ... and acuity. + Provides direct oversight and is responsible for Utilization Management execution/decision making for managed member populations. Primary duties may… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 251212-5613FP-001 Location East Hartford, CT Date Opened 12/16/2025 12:00:00 AM Salary ... we invite you to learn more about joining our team as a Utilization Review Nurse Coordinator! The State of Connecticut (https://portal.ct.gov/) , Department of… more
- Community Health Systems (Franklin, TN)
- …- Registered Nurse - State Licensure and/or Compact State Licensure required + CCM - Certified Case Manager preferred or + Accredited Case Manager (ACM) ... for medical necessity, discharge planning, and payer requirements. + Documents all utilization review activities in the hospital's case management software,… 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
- Sharp HealthCare (San Diego, CA)
- …Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** Accredited Case Manager (ACM) - American Case Management Association (ACMA); ... Bachelor's Degree in Nursing; Master's Degree; Certified Case Manager (CCM) - Commission for ...or case management experience. + 3 Years case management, utilization review, care coordination experience.… 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
- 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
- Community Health Systems (Franklin, TN)
- … Utilization Review Clinical Specialist. + Monitors and updates case management software with documentation of escalations, avoidable days, authorization numbers, ... **Job Summary** The Utilization Review Coordinator ensures efficient and effective management...with hospital, corporate, and payer requirements. Documents outcomes in case management systems. + Reviews and closes out cases… more
- Catholic Health (Kenmore, NY)
- …NYS RN license + Holds, or will obtain within one year of hire, Certified Case Manager (CCM) + Certification in a Nationally Recognized Utilization Review ... 8 am- 4 pm Summary: The Registered Nurse (RN), Utilization Review, as an active member of the Middle...Middle Revenue Cycle and interdisciplinary care team, provides comprehensive Utilization Review to patients and families in the hospital… more
- Behavioral Center of Michigan (Warren, MI)
- …to help educate the staff and physicians regarding charting. REPORTS TO: Utilization Review Lead/ Manager QUALIFICATIONS: + High School Diploma or equivalent. ... Under general supervision, the Utilization Review Coordinator provides professional assessment, planning, coordination,...those duties include all tasks requested by the UR Manager , CEO or Medical Director to meet the needs… more