- Banner Health (AL)
- …staff relations, and the charging/billing is required. A working knowledge of utilization management and patient services is required. A working knowledge ... best place to work and receive care. As an Associate Manager of RN Denials Management , you will be an integral part of leadership within the team. During your… more
- Dignity Health (Bakersfield, CA)
- …expert clinical and education resource; staff and leadership development consultant; and Utilization Management content expert for staff, leaders, physicians and ... customers across the ePH Utilization Management . This position will assist with...experience is required (or equivalent combination of education and management experience). - Bachelor's degree in Nursing ,… more
- Beth Israel Lahey Health (Cambridge, MA)
- …Three years of medical/surgical nursing care experience. Two years of case management or utilization management experience required. 3. Basic computer ... Inpatient criteria approved by the MACIPA (risk) and MAH (non-risk) Utilization Management Committees to accurately determine appropriateness for inpatient… more
- Beth Israel Lahey Health (Plymouth, MA)
- …(RN) + 3-5 years acute care nursing + Two years of recent utilization management and discharge planning experience _Preferred:_ + Bachelor's degree in ... or healthcare related field + Three years of recent utilization management and discharge planning experience + ED nursing and/or case management… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …Skills and Experiences * 2+ years of managed care experience; eg case management /health coach, utilization management and/or auditing experience (may be ... and Blue Shield of Minnesota Position Title: RN Specialist Complex Care Case Management Location: Remote Career Area: Health Services About Blue Cross and Blue… more
- Eastern Connecticut Health Network (Manchester, CT)
- …timely and accurate information to payers. The role integrates and coordinates utilization management and denial prevention by focusing on identifying and ... responsible for preoperative, concurrent, and retrospective reviews in accordance with the utilization management plan. The UM CM ensures the appropriate status… more
- Molina Healthcare (Albuquerque, NM)
- … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... IT and data analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory, professional and community… more
- Molina Healthcare (Lincoln, NE)
- … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... IT and data analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory, professional and community… more
- Community Health Systems (Naples, FL)
- …2-4 years of clinical nursing experience required + Experience in utilization review, case management , or discharge planning preferred **Knowledge, Skills ... Dental, Vision) **Job Summary** The Care Manager - LPN supports effective utilization management and discharge planning by coordinating patient care activities… more
- Health Care Service Corporation (Richardson, TX)
- …the independent practice level) of direct clinical care to the consumer. * Utilization management , discharge planning or managed care experience. * Customer ... family support services). * Provider side insurance experience. * Familiarity with Utilization Management or Case Management activities and standardized… more