- BJC HealthCare (Alton, IL)
- …to identify and resolve issues. Performs and provides consultation regarding Utilization Management and Performance Improvement programs in order to ... care, rehabilitation, 24-hour emergency care, ambulance services and more. Case Management , Utilization Review, Social Services: Provides admission and continued… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …years nursing experience with advanced level pediatric clinical experience and utilization management and/or discharge planning experience. Thorough knowledge of ... managed care, utilization management , discharges planning, and continuous quality improvement concepts. Computer Literacy. Strong interpersonal and negotiation… more
- US Tech Solutions (LA)
- …a hospital setting in a specialty area of the nursing field providing utilization management prior authorization reviews. Build strong direct relationships with ... + Minimum 3 years nursing experience with a minimum of 1 year in utilization management / prior authorization review experience. **Experience** : Utilization … more
- University of Utah Health (Salt Lake City, UT)
- …education in healthcare or a related field. + One year of experience in a utilization review or case management environment. + Basic Life Support Health Care ... prepared and delegated by social work or nurse case management by coordinating with home care agencies, post-acute care...+ Documents activities and progress in medical charts, computer billing/ utilization systems, or in other ways as directed. +… more
- Northwell Health (Melville, NY)
- … Review standard and regulations. + Performs concurrent and retrospective utilization management using evidenced-based medical necessity criteria; conducts ... + Inpatient clinical experience; 4+ years preferred. + Prior Acute Case Management and/or Utilization Review experience, preferred. + Must have experience… more
- Catholic Health Initiatives (Lexington, KY)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... the multidisciplinary team to ensure progression of care and appropriate utilization of inpatient resources using established evidence based guidelines/criteria. 5.… more
- Health Care Service Corporation (Chicago, IL)
- …not required to obtain multi-state licenses. **PREFERRED JOB REQUIREMENTS** **:** + Utilization review or utilization management experience **Telecommute:** ... reviews in accordance with the medical contract and regulations, medical criteria, utilization review, and quality of care. **JOB REQUIREMENTS** **:** + LPN with… more
- Evolent (Little Rock, AR)
- …cost-effective care. **Collaboration Opportunities** : As a Radiation Technologist in the Utilization Management department, you will work closely with other ... providers per guidelines. + Utilizing clinical guidelines approved by the Utilization Management Committee (UMC), the URN has the authority to authorize services… more
- Penn Medicine (Plainsboro, NJ)
- …Provides coverage on weekends as scheduled. + 8. To provide coverage for utilization management as needed or directed. Credentials: Education or Equivalent ... interdisciplinary treatment team in general hospital setting, providing case management and primarypsychotherapy with inpatients and partial hospital patients with… more
- Molina Healthcare (NM)
- …3-5 years clinical practice with managed care, hospital nursing or utilization management experience. **Preferred License, Certification, Association** Active, ... **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN (preferred) or LPN with a...unrestricted Utilization Management Certification (CPHM). To all current Molina employees: If… more