- Sanford Health (Rapid City, SD)
- …community. **Job Summary** Provides expertise and leadership to ensure effective resource management for patient care delivery across the care continuum for assigned ... patient wellness through evidenced based practice, improved care outcomes, efficient utilization of health services, and appropriate level of care for patients… more
- Tenet Healthcare (Detroit, MI)
- …national standards for case management scope of services including: Utilization Management services supporting medical necessity and denial prevention ... potentially avoidable days Other duties as assigned. POSITION SPECIFIC RESPONSIBILITIES: Utilization Management Balances clinical and financial requirements and… more
- Humana (Jackson, MS)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- AmeriHealth Caritas (Washington, DC)
- **$5,000.00 SIGN ON BONUS** **Role Overview** Our Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient services, ensuring ... in the least restrictive and most effective manner. The Utilization Management Reviewer must maintain a strong...3 years of diverse clinical experience as a Registered Nurse in an Intensive Care Unit (ICU), Emergency Department… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination ... expected to work a portion of their week from home and a portion of their week at a...business. **Knowledge, Skills and Abilities (KSAs)** + Oversight of Utilization Management clinicians while championing process improvement,… more
- CVS Health (Baton Rouge, LA)
- …it all with heart, each and every day. **Position Summary** The Utilization Management Coordinator/UMNC assists in ensuring that authorization request decisions ... children, ie generators, housing, rentals) * Collaborate with care management and utilization management teams...in joint planning sessions with enrollees' school, providers and home health agencies, as needed * Coordinate with care… more
- Children's Mercy Kansas City (Kansas City, MO)
- …of, and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including patient ... To provide leadership to integrated inpatient teams; assists Director in the management of department; including personnel and fiscal management and development… more
- Providence (Mission Hills, CA)
- …strong clinical background combined with well-developed knowledge and skills in Utilization Management , medical necessity, and patient status determination. The ... Utilization Management RN must effectively and efficiently manage a diverse...Qualifications:** + Associate's Degree in Nursing. + California Registered Nurse License upon hire. + 2 years of experience… more
- BayCare Health System (Tampa, FL)
- …Occasional + **On Call:** No **Certifications and Licensures:** + Required RN (Registered Nurse ) + Preferred ACM (Case Management ) + Preferred CCM (Case Manager) ... of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians.... Review or + Required 2 years in Case Management or + Required 3 years Registered Nurse… more
- Sharp HealthCare (San Diego, CA)
- …1 **Shift Start Time** **Shift End Time** Other; California Licensed Vocational Nurse (LVN) - CA Board of Vocational Nursing & Psychiatric Technicians **Hours** ... + Other : Graduate of an accredited Licensed Vocational Nurse (LVN) program. + California Licensed Vocational Nurse...1 Year experience in the acute patient care, SNF, home health, or hospice settings. + Experience as a… more