- Texas Health Resources (Fort Worth, TX)
- …regulatory and contractual requirements. * Maintains a working knowledge of care management , utilization review changes, authorization changes, contract ... a registered nurse in LTAC, acute care setting or utilization review required * LTAC, Critical care...Provides consultation to medical and nursing staff, health information management and payers on potential issues with reimbursement of… more
- Molina Healthcare (CT)
- …lead level non-clinical healthcare services support for care management , care review , utilization management , transitions of care, behavioral health, ... and timely completion. * Actively participates in department auditing program to review and communicate findings with staff and identify opportunities for improved… more
- Elevance Health (IN)
- …required. **Preferred Skills, Capabilities, and Experiences:** + Previous experience in case management / utilization management with a broad range of ... offers superior clinical mental health and substance use disorder management , a comprehensive employee assistance program, work/life support, specialty programs… more
- HCA Healthcare (Blacksburg, VA)
- …established chain of command. .In a RN Case Manager role, you will perform utilization management reviews and communicates information to third party payers .You ... member of this team, you will develop a case management plan of care for new and reoccurring patients...apply for our RN Case Mgr PRN opening. We review all applications. Qualified candidates will be contacted for… more
- HCA Healthcare (Salem, VA)
- …chain of command.** **. In a RN Case Manager role, you will perform utilization management reviews and communicates information to third party payers** **. You ... member of this team, you will develop a case management plan of care for new and reoccurring patients...for our RN Case Manager Behavioral Health opening. We review all applications. Qualified candidates will be contacted by… more
- Diversicare Healthcare Services & Diversicare Ther (Hoover, AL)
- …current license in respective field. 2. Knowledge of healthcare reimbursement, utilization management , and discharge planning. 3. Experience providing strategic ... in and facilitate Engage/72 HR Admission meetings as part of the care management system. + Manage the restorative nursing program, integrating it with the activity… more
- Prime Therapeutics (Harrisburg, PA)
- …information into the appropriate delivery system to initiate the EAP, Care and Utilization management programs. + Demonstrates flexibility in areas such as job ... application process. + Refers patients/EAP clients to the Care Management team for a provider, EAP affiliate, or Facility....$17.85 - $25.48 based on experience and skills. To review our Benefits, Incentives and Additional Compensation, visit our… more
- Diversicare Healthcare Services & Diversicare Ther (Hartford, AL)
- …Degree in nursing 2. RN License 3. Knowledge of healthcare reimbursement, utilization management , and discharge planning. 4. Experience providing strategic ... in and facilitate Engage/72 HR Admission meetings as part of the care management system. + Manage the restorative nursing program, integrating it with the activity… more
- Veterans Affairs, Veterans Health Administration (Chesapeake, VA)
- …treatment provided to patients; patient satisfaction activities; patient safety and risk management activities; and utilization management . Assists in ... (credentialing and privileging). Develops policies and procedures to assure effective management , ethics, safety, communication, and quality within the section and… 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. ... and employ safe work habits. + Utilize available information management systems in daily practice for patient care and...facility staff members to facilitate patient care. + Accurately review and confirm completeness of patient chart and report… more