- Alameda Health System (Oakland, CA)
- Director, Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + ... Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing...the classification. + Lead and manage a team of utilization review professionals providing guidance, training, and… more
- Corewell Health (Caledonia, MI)
- …and continued stay. Educates medical staff/other health care professionals regarding utilization management and quality requirements. Makes recommendations and ... provides financial and utilization management (UM) information to other members...multiple clinical settings, or related experience Required + Registered Nurse (RN) - State of Michigan required How Corewell… more
- Providence (Anaheim, CA)
- …+ Upon hire: California Registered Nurse License + 3 years Experience in utilization management and/or case management . + 3 years Clinical experience in ... **Description** Responsible for providing utilization review and coordination of care...or related field. + Upon hire: Certification in Case Management (CCM) **Why Join Providence?** Our best-in-class benefits are… more
- AmeriHealth Caritas (Lafayette, LA)
- …ability to meet productivity standards in a fast-paced, high-volume utilization review environment **Licensure** + An active Registered Nurse (RN) license in ... **Role Overview** Under the direction of a supervisor, the Utilization Management Reviewer evaluates medical necessity for inpatient and outpatient services,… more
- UNC Health Care (Smithfield, NC)
- …stay, and discharge reviews in accordance with federal regulations & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is ... case management referrals. Initiates appropriate social work referrals. 3. Utilization Management Process - Performs utilization management… more
- Access Dubuque (Dubuque, IA)
- …reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You will ... Management Assistant answers first level calls in Utilization Review for HealthCheck360 participants. They will... Management Assistant Cottingham & Butler/ SISCO Utilization Management Nurse Cottingham &… more
- Prime Healthcare (Lynwood, CA)
- …With Us! (https://careers-primehealthcare.icims.com/jobs/236088/rn-case-manager utilization - review /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... and service! Responsibilities Responsible for the quality and resource management of all patients that are admitted to the...to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,… more
- Henry Ford Health System (Warren, MI)
- …required. + Bachelor of Science Nursing required OR four (4) years Case Management / Appeal/ Utilization Management experience in lieu of bachelor's degree. ... Under minimal supervision, reviews and screens the appropriateness of services, the utilization of hospital resources and the quality of patient care rendered.… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... to support the safety net required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II is primarily responsible for… more
- AmeriHealth Caritas (Washington, DC)
- **$5,000.00 SIGN ON BONUS** **Role Overview** Our Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient services, ensuring ... the patient's needs in the least restrictive and most effective manner. The Utilization Management Reviewer must maintain a strong working knowledge of federal,… more