- Veterans Affairs, Veterans Health Administration (Chicago, IL)
- …knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ... registration will meet the requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse who has completed an… more
- Veterans Affairs, Veterans Health Administration (Albuquerque, NM)
- …knowledge of Fee federal regulations, VHA guidelines, medical review criteria, care management and utilization management processes, inter-facility transfer ... registration will meet the requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse who has completed an… more
- Trinity Health (Columbus, OH)
- …demeanor in difficult situations. . Knowledge of the functional operations of utilization management , discharge planning, care coordination and transitions of ... This is done with the intentions of cost effective utilization of hospital resources, minimizing out of pocket expenses...Education: RN Case Manager: Graduate from a school of nursing . . . Baccalaureate degree in nursing … more
- Elevance Health (Chillicothe, OH)
- …associates, and may be involved in process improvement initiatives. + Submits utilization /authorization requests to utilization management with documentation ... fully integrated care plan. Engage the individual's support network and oversee management of their physical health, behavioral health, and long-term services and… more
- HCA Healthcare (Sanford, FL)
- …in Case Management is preferred + BSN is preferred + Certification in Case Management , Nursing or Utilization Review is preferred HCA Florida Lake Monroe ... with physicians, patients, families, hospital staff, and outside agencies + Performs utilization management reviews and communicates information to third party… more
- Kaleida Health (Buffalo, NY)
- …and tactics to successfully execute, support, implement, and monitor the DRG and Utilization Management Clinical Denial teams Work Plan and, assists in the ... Director, Clinical & DRG Denials will work collaboratively with physicians, nursing staff, Quality, Finance and others to develop, implement and maintain… more
- New York State Civil Service (Albany, NY)
- …adolescents with mental illness in a clinical capacity, as well as experience with utilization management and/or utilization review. ? The ideal candidate(s) ... will have direct care and utilization management experience, including familiarity with the review of medical evidence, psychiatric evidence, a knowledge base of… more
- New York State Civil Service (Albany, NY)
- …adolescents with mental illness in a clinical capacity, as well as experience with utilization management and/or utilization review. ? The ideal candidate(s) ... will have direct care and utilization management experience, including familiarity with the review of medical evidence, psychiatric evidence, a knowledge base of… more
- UnityPoint Health (Des Moines, IA)
- …agencies and payers to plan and execute a safe discharge + Collaborate with Utilization Management team on continued stay review. + Collaborates with patients, ... + Area of Interest: Nursing + FTE/Hours per pay period: 1.0 +...elimination of fragmentation of care/service and facilitates the effective utilization of resources. Serves as educator and a central… more
- HCA Healthcare (Largo, FL)
- …of experience in a healthcare environment + Previous experience in accreditation, quality, utilization management , or risk management required. + Knowledge ... and Qualifications** We are seeking a Director of Quality Management . As our Director, you will provide direction to...you will provide direction to ensure the facilitation and utilization of diverse strategies and communication for quality and… more