- Ventura County (Ventura, CA)
- …Inpatient Psychiatric unit of the Ventura County Medical Center including utilization management , transfer coordination, discharge planning, and securing ... CANDIDATE The ideal candidate is an experienced Mental Health Nurse with a background in utilization review...and review; + Performs daily clinical reviews to support utilization and quality management , ensuring compliance with… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …safe discharge coverage for all hospital units. + Participates in utilization management initiatives/opportunities for improvement through departmental committee ... Position Purpose: Works in partnership with physicians, nurse case managers, and other disciplines to ensure...Florida. + 3 years minimum experience in discharge planning, utilization management , or case management .… more
- UPMC (Pittsburgh, PA)
- Are you a registered nurse with a background in utilization management ? Are you interested in the opportunity to work from home? UPMC Health Plan is looking ... for you! We are hiring a full-time Utilization Management Care Manager to support...2 years of experience in a clinical and/or case management nursing required. + Minimum of 1-year… more
- WellSpan Health (York, PA)
- …- day shift_** **General Summary** Performs a variety of duties and applies utilization and care management techniques to determine the most efficient use ... address patient care transition needs. Provides leadership in the integration of utilization and care management principles throughout the hospital. **Duties and… more
- Bassett Healthcare (Cooperstown, NY)
- …timely and accurate information to payors. The role integrates and coordinates utilization management , care facilitation, and discharge planning functions. The ... efficient delivery of care in appropriate setting. + Completes utilization management and quality screening for assigned...Registered Professional Nurse , if applying as a nurse , required + Case Management certification, preferred… more
- Sutter Health (Roseville, CA)
- …Administration **Position Overview:** Conducts preauthorization, concurrent, and retrospective utilization management review using the department's accepted ... and at the appropriate level of care. Coordinates the utilization management , resource management , discharge...accredited school of nursing + Bachelor's in Nursing preferred. **CERTIFICATION & LICENSURE:** + RN-Registered Nurse… more
- UPMC (Pittsburgh, PA)
- …Nurse (RN) with an active PA License required + BSN Preferred + Case management nursing preferred. + Minimum 1 year of health insurance experience preferred. ... Nurse Clinical Care Coordinator is responsible for delivering nursing assessments and evaluations within recognized standards of ...+ 1 year of experience in clinical, utilization management , home care, discharge planning, and/or… more
- UCLA Health (Los Angeles, CA)
- Description At UCLA Health, the Utilization Management (UM) Review Nurse plays a vital role in ensuring the delivery of high-quality, evidence-based care. ... and CMS criteria required + A minimum of three years of experience in utilization management , preferred + Team leading or management experience, preferred… more
- Sutter Health (Emeryville, CA)
- …Advisor will work closely with the medical staff, including house staff, and all utilization management (UM) personnel, Care Management (CM) personnel to ... organization's goals and objectives for ensuring the effective, efficient utilization of health care services. The PA will develop...of care such as Home Health, Hospice, Advance Illness Management (AIM), and Palliative Care. Skilled Nursing … more
- Sutter Health (Modesto, CA)
- …Advisor will work closely with the medical staff, including house staff, and all utilization management (UM) personnel, Care Management (CM) personnel to ... organization's goals and objectives for ensuring the effective, efficient utilization of health care services. The PA will develop...of care such as Home Health, Hospice, Advance Illness Management (AIM), and Palliative Care. Skilled Nursing … more