- University of Rochester (Rochester, NY)
- …Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500009 Utilization Management Work Shift: UR - Day (United States of America) ... knowledge of hospital clinical practice guidelines to support the most thorough review of the medical record. Other duties as assigned. **MINIMUM EDUCATION &… more
- Sharp HealthCare (Santee, CA)
- …all notes and billing daily.Completes all tasks and documentation needs (ie utilization management , plan of care, medical necessity reviews) based on ... requirements.PT Spec II additional standardsSupports clinic needs for documentation review and training. + Professional and Departmental DevelopmentIdentifies needs… more
- Banner Health (Mesa, AZ)
- …leader behaviors each and every day. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained through the ... and advanced technology that includes the da Vinci Surgical System. Becker's Hospital Review named Banner Desert Medical Center as one of the top 50 busiest… more
- Three Saints Bay (Port Hueneme, CA)
- …or managerial functions + Two (2) years of experience directly related with utilization of Content Management Systems, learning Management Systems, and/or ... (R&M) Modeling, Prediction, Allocation and Analysis for program evaluations, review , or implementation. **Desired Qualifications:** + Demonstrated experience analyzing… more
- Ochsner Health (Jefferson, LA)
- …This job manages expense management , vendor relationships, contract management , standardization and consolidation processes and utilization analysis. ... supply utilization improvements. + Good judgment, organizational and time management skills. + Consulting and group presentation skills. + Ability to travel… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role MagnaCare provides Utilization Review / Case Management / Medical Management /Claims Review services to its clients. Care Coordinators ... facilitate care management and utilization review by performing data collection & data entry, and effectively communicating with Nurse Case… more
- Banner Health (Tucson, AZ)
- …leader behaviors each and every day. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained through the ... and communicates pertinent, timely information to payers and others to fulfill utilization and regulatory requirements. 6. Educates internal members of the health… more
- HCA Healthcare (Ocala, FL)
- …RN experience required + 4 year Bachelor Degree preferred. + Certification in Case Management or Utilization Review preferred HCA Florida Ocala Hospital is ... supporting a balance of optimal care and appropriate resource utilization . + Provides case management services for...apply for our RN Case Manager opening. We promptly review all applications. Highly qualified candidates will be directly… more
- Baylor Scott & White Health (Temple, TX)
- …for assessing and coordinating patient care across the continuum to include case management , social work, utilization review and care coordination to ... ongoing problem solving related to care coordination, discharge planning, case management and utilization review . Monitors processes and systems to ensure… more
- Elevance Health (Grand Prairie, TX)
- …with providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** + Requires ... the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care… more