- Molina Healthcare (NM)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... / MCG guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). NEVADA State Specific… more
- Katmai (Fort Carson, CO)
- …all levels of health care management to include outside agencies. Performs utilization management activities to optimize cost, quality, and access to care. ... RESPONSIBILITIES** None. **Job Requirements:** **MINIMUM QUALIFICATIONS** + Associates Degree of Nursing . Registered nurse shall be a graduate from a… more
- MTC (Quincy, FL)
- …performing the duties of the position. 11. Practice advanced cost containment and utilization management for inmate care and facility operations. 12. Maintain ... Summary:** Reports to the health services administrator. Directs the management of nursing services and the supervision...(1) year supervisory experience. Must be a licensed registered nurse in the state of Florida or compact state.… more
- Randolph Hospital (Asheboro, NC)
- …and medical staff on issues related to discharge planning and utilization management . Graduate from an accredited school of nursing , BSN preferred. Current ... cost effective, health care. Performs all aspects of discharge planning and utilization management for the patients in their assigned area, which will include… more
- RWJBarnabas Health (Elizabeth, NJ)
- …family education, clinical and financial prerequisites, pre-certification, verification of benefits, utilization management , and patient / family communication + ... Essential Functions: + Assumes responsibility for the operation and management of the department in the absence of the...and accurate bed assignment + Ensures patient, physician, and nursing needs are met while maintaining alignment with the… more
- UNC Health Care (Goldsboro, NC)
- …hospital departments: Medical Staff Services, Medical Staff Performance Improvement, Utilization Management , Clinical Documentation and Medical Student Affairs. ... record utilization and documentation. i. Collaborates with the Chief Nursing Officer to drive inter-professional patient care. Participates in the establishment,… more
- MTC (Littlefield, TX)
- …clean; utilize appropriate sanitation methods. 17. Practice basic cost containment and utilization management for patient care and facility operations. 18. ... who values helping people turn their lives around.** At Management & Training Corporation, our foundation is based upon...+ Degree in nursing + Current, valid nursing license as a Registered Nurse in… more
- Bon Secours Mercy Health (Emporia, VA)
- …mandated by CMS and Conditions of Participation for discharge planning and utilization management . Addresses opportunities or potential concerns with leadership. ... for Case Manager Certification or American Nurses Credentialing Center (ANCC) Nursing Case Management board certification (preferred) **Education** Bachelor of… more
- MVP Health Care (Tarrytown, NY)
- …clinical nursing experience + At least 2 years of experience in utilization management of sub-acute Medicare reviews + Experience with Medicare guidelines ... RN licensure + Associate or bachelor's degree in nursing (BSN preferred) + Minimum 3 years of...interaction **Your key responsibilities:** + Conduct timely and accurate utilization reviews for sub-acute Medicare cases. + Evaluate medical… more
- UTMB Health (Cleveland, TX)
- …Develops and implements quality assurance/improvement program at the facility. + Implements utilization management programs at the facility. + Assumes 24-hour ... Facility Nurse Manager - Bell Unit **Cleveland, Texas, United States** **New** Nursing & Care Management UTMB Health Requisition # 2506044 The mission of… more