- UTMB Health (Webster, TX)
- …efficient use of medically appropriate services. Integrates and coordinates utilization management activities, care coordination, discharge planning functions, ... UTMB TDCJ Hospital to specialty services hospitals. **_ESSENTIAL JOB FUNCTIONS_** **:** Utilization Management + Demonstrates thorough knowledge of Inter Qual… more
- Prime Healthcare (Inglewood, CA)
- …Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patients ... leadership and supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and … more
- Penn Medicine (Lancaster, PA)
- …Medicine Lancaster General Health is looking for an experienced RN to join our Utilization Management Specialist team! In this critical role, you'll advocate for ... we'd love to hear from you!_ **Summary** : The Utilization Management Specialist - Admissions is responsible...**Minimum Required Qualifications:** + Current licensure as a Registered Nurse , issued by the Pennsylvania Board of Nursing +… more
- Baystate Health (Springfield, MA)
- …Midpoint - Maximum $46.22 - $53.13 - $62.85 **Per Diem Hospital Case Manager / Utilization Management ** The **RN Hospital Case Manager** is a registered nurse ... MD's about safe plan for transitions + Leads the team to ensure appropriate utilization of patient resources and directs care to other settings when appropriate +… more
- Elevance Health (Miami, FL)
- ** Utilization Management Representative II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... an accommodation is granted as required by law._ The ** Utilization Management Representative II** is responsible for...given. + Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care. +… more
- Elevance Health (West Des Moines, IA)
- ** Utilization Management Representative II** **Location:** The selected candidate for this position must reside in Iowa. **_Virtual:_** This role enables ... an accommodation is granted as required by law._ The ** Utilization Management Representative II** is responsible for...given. + Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care. +… more
- Elevance Health (Durham, NC)
- **Title: Utilization Management Representative I** **Location:** **Winston Salem, North Carolina or Durham, North Carolina** **Virtual:** This role enables ... an accommodation is granted as required by law._ The ** Utilization Management Representative I** will be responsible...requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification and data… more
- Elevance Health (Costa Mesa, CA)
- ** Utilization Management Representative I** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person ... an accommodation is granted as required by law. The ** Utilization Management Representative I** is responsible for...requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification and data… more
- Saint Francis Health System (Tulsa, OK)
- …in the Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to improvement of internal ... Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License, or Clinical Social Worker (LCSW), or Professional Counselor (LPC)… more
- UNC Health Care (Hendersonville, NC)
- …management referrals. Initiates appropriate social work referrals. + Performs utilization management assessments and interventions, using collaboration with ... well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and...+ Must be licensed to practice as a Registered Nurse in the state of North Carolina or one… more