- RWJBarnabas Health (New Brunswick, NJ)
- …1 to 2 weeks in advance for potential conflicts or issues, Patient Care Management Monitors the quality of service and utilization standards and assumes general ... years of related departmental experience required Two years of progressive management experience in related field preferred Certifications Licenses Registered … more
- Bassett Healthcare (Cooperstown, NY)
- …exceptions, as measured by direct supervisory observation and random supervisory chart review + Demonstrates consideration of safety, effective utilization of ... quality of life possible. What you'll do The STAT Nurse RN will provide clinical support and direct patient...than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback +… more
- CareFirst (Baltimore, MD)
- …working in Care Management , Home Health, Discharge Coordination and/or Utilization Review . **Preferred Qualifications** : + Knowledge and experience with ... (RN) embedded at a partnering hospital will conduct concurrent review of inpatient level of care, managing the timely...of care. Utilizing experience and skills in both case management and utilization management , the… more
- Penn Medicine (Lancaster, PA)
- …license and daily access to an insured vehicle. Preferred Qualifications + Knowledge of Utilization review or managed care + Experience with home visits + ... management platform/analytics. + Analyzes data to identify under/over utilization ; improve resource consumption; promotes potential reduction in cost and… more
- Highmark Health (Pittsburgh, PA)
- …including but not limited to: appropriateness of care, documentation requirements, utilization review principles and criteria, insurance benefits and ... effective resource utilization . Serves as key team members in the management of readmissions, length of stay, ED utilization , and patient/family… more
- HCA Healthcare (Dallas, TX)
- …federal regulation pertaining to federally funded programs as they relate to utilization review , discharge planning and financial reimbursement. + Conducts ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...approval of patients in the Rehab unit. Manages the Utilization Review process and maintaining continued stay… more
- CareFirst (Baltimore, MD)
- …working in Care Management , Home Health, Discharge Coordination and/or Utilization Review . **Preferred Qualifications:** + Knowledge and experience with MCG ... (RN) embedded at a partnering hospital will conduct concurrent review of inpatient level of care, managing the timely...of care. Utilizing experience and skills in both care management and utilization management , the… more
- State of Massachusetts (Boston, MA)
- …placement along the continuum of care. This vital role encompasses Utilization Review , Performance Improvement, Risk Assessment, Infection Surveillance, and ... a general summary and not all inclusive):_**__*/* * /Oversee case coordination, utilization review , discharge planning, and resource allocation across assigned… more
- Dignity Health (Bakersfield, CA)
- …on clinical protocols. Essesntial functions include: - Communicate effectively and interact with the utilization review nurse and health plans daily or as ... and cost effectiveness of medical care through strict adherence to all Utilization Management (UM) Policies and procedures promptly, efficiently and accurately.… more
- Villa of Hope (Rochester, NY)
- …coordinator, providers, director of LHTC and administrative team, including billing and utilization review . + Triages potential admissions and when needed ... JOB TITLE: Intake Coordinator- RN/ Evening DEPARTMENT/PROGRAM: Medical Services SUPERVISOR: Nurse Manager/Health Coordinator PAY GRADE: 82 FLSA STATUS: NON EXEMPT… more