- Molina Healthcare (Davenport, IA)
- …reports submitted to the Eastern US Quality Improvement Collaborative (EQIC) and/or utilization management committees. + Participates as needed in joint ... **JOB DESCRIPTION** **Job Summary** The Delegation Oversight Nurse provides support for delegation oversight quality improvement activities. Responsible for… more
- Trinity Health (Fresno, CA)
- …the acute care continuum for CVHP members. This includes discharge planning, utilization management , care coordination, and support for resource utilization ... an interdisciplinary team to improve patient care through the effective utilization of the facility's resources. The incumbent makes significant contributions toward… more
- Trinity Health (Fresno, CA)
- …populations across the acute care continuum. This includes discharge planning, utilization management , care coordination collaboration, and support for resource ... with an interdisciplinary team to improve patient care through the effective utilization of the facility's resources. 1. Current licensure as a Registered … more
- Houston Methodist (Sugar Land, TX)
- …state, local and federal programs + Comprehensive knowledge of discharge planning, utilization management , case management , performance improvement and ... At Houston Methodist, the Case Manager PRN (CM) position is a licensed registered nurse (RN) who comprehensively plans for case management of a target patient… more
- Whidbey General Hospital (Coupeville, WA)
- …, anti-biotic regime, etc. The RN - Care Manager follows the hospital's Case Management / Utilization Plan that integrates the functions of utilization review, ... in the areas of utilization review, status determination, clinical resource utilization , the discharge planning and appeal/denial management . The RN - Care… more
- Select Medical (Davenport, IA)
- … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... current licensure in a clinical discipline either as a Nurse or a Respiratory Therapist OR Social Work SW/MSW...what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,… more
- Select Medical (Pensacola, FL)
- … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... current licensure in a clinical discipline either as a Nurse or a Respiratory Therapist OR Social Work SW/MSW...what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …for the Casualty and Clinical Services departments which in turn includes Utilization Management , Case Management and Population Health divisions. ... + Strong skills in management of a clinical team. + Previous Utilization Management experience required. + Previous experience in Case Management … more
- Select Medical (Chicago, IL)
- … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... current licensure in a clinical discipline either as a Nurse or a Respiratory Therapist OR Social Work SW/MSW...what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,… more
- Actalent (Portland, OR)
- …+ Knowledge of Medicare and Medicaid regulations preferred. + Familiarity with utilization management processes. + Previous experience with prior authorization ... + Collect, document, and maintain all members' clinical information in health management systems to ensure compliance with regulatory guidelines. + Provide education… more