- Tenet Healthcare (Detroit, MI)
- …national standards for case management scope of services including: * Utilization Management supporting medical necessity and denial prevention * Transition ... b) leads the implementation and oversight of the hospital Utilization Management Plan using data to drive...in Nursing, Business Administration or Hospital Administration preferred. 2. Registered Nurse or LCSW/LMSW license. Must be… more
- Hartford HealthCare (Manchester, CT)
- … Management * **Organization:** **Manchester Memorial Hospital* **Title:** *Clinical Resource Management Nurse ( RN ) - Case Coordination* **Location:** ... timely and accurate information to payers. The role integrates and coordinates utilization management and denial prevention by focusing on identifying and… more
- Northwell Health (Staten Island, NY)
- …Nursing, required. + Current license to practice as a Registered Professional Nurse in New York State. + Case Management Certification, preferred. + Minimum ... another level of care according to regulatory standards. + * Performs concurrent utilization management using Interqual criteria. + Conducts chart review for… more
- Guthrie (Sayre, PA)
- …recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care in collaboration with ... degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant...admissions and short procedures by translating clinical information to Utilization Management requirements using pre ‐ determined… more
- Ventura County (Ventura, CA)
- …and patient-centered care. Under general direction, the Senior Medical Management Nurse is responsible for performing utilization review, case management ... Senior Medical Management Nurse - VCHCP Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5113983) Apply Senior Medical Management … more
- Houston Methodist (Houston, TX)
- …with HM performance that demonstrates leadership responsibility **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- ... At Houston Methodist, the Director Case Management & Social Services RN position...in the areas of care coordination, evidence- based practice, utilization management , and service excellence. Disseminates information… more
- Corewell Health (Grand Rapids, MI)
- … Management . Required + Related position(s); education and/or training experience. Preferred + Registered Nurse ( RN ) - State of Michigan Upon Hire ... Registered Nurse OR Social Worker Scope... Registered Nurse OR Social Worker Scope of work: In...coordinates the educational plan for the Behavioral Health, Care Management , and Utilization Management departments.… more
- Mount Sinai Health System (New York, NY)
- …Active RN license in the state of employment required + Certification in Case Management (CCM, ACM) or Utilization Management preferred. + 7+ years of ... experience in clinical acute clinical, utilization management , appeals management or related operations + 3+ years in a leadership or management role +… more
- Houston Methodist (Houston, TX)
- …leading multi-site or enterprise-level programs preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- ... improvements as needed. + Collaborates with HMCPA on care transition and utilization management initiatives. + Provides strategic vision and execution for case … more
- St. Luke's University Health Network (Sellersville, PA)
- …including but not limited to: RN care managers, assistants, coordinators, utilization management staff, and director. . Facilitates communication among all ... we serve, regardless of a patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager is responsible for coordinating the… more