- BriteLife Recovery (Englewood, NJ)
- …assigned What we need from you? + Minimum of 2-3 years of experience in utilization review, case management , or insurance coordination in a behavioral health ... compliance. + Maintain compliance with payer policies, HIPAA regulations, and internal utilization management protocols. + Monitor trends in denials, approvals,… more
- Brockton Hospital (Brockton, MA)
- …while optimizing resource utilization . Provides training to staff on case management methods and techniques. Establishes monitoring mechanisms to identify ... and develops reports that clearly monitor all areas of utilization / case management . Provides data, guidance...RN with Master's Degree + Current License as Registered Nurse in the Commonwealth of Massachusetts… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is...player. Must be able to work independently. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- MVP Health Care (Schenectady, NY)
- …New York State Licensure as a Registered Nurse required. + Certification in Case Management required within 24 months after hire. + At least 3 years of ... interaction **Your key responsibilities:** + Utilize the essentials of an integrated utilization management and case management model that includes… more
- HCA Healthcare (Wichita, KS)
- …the case management department and reports directly to the Hospital Case Management Director. This RN CM participates in outstanding customer service ... management regulatory guidelines per CMS. + Manages VPro utilization for case management vendors...Current Licensure in the State of Kansas as a Registered Nurse ( RN ) or Current… more
- UPMC (Washington, PA)
- …care/treatment, The Joint Commission Standards, Federal/State regulations relative to utilization / case management , discharge planning, Medicare, Medicaid, ... The Manager oversees the day-to-day operations of the Case management department under the direction...team performance and desired patient outcomes is needed. + Registered Nurse ( RN ) *Current licensure… more
- SSM Health (Midwest City, OK)
- …with hospital policies **Qualifications:** + RN or relevant licensure/certification in case management or social work + Experience in hospital or healthcare ... in standard work. + May also be responsible for: utilization management process, ED case ...Professional Regulation (IDFPR) State of Work Location: Missouri + Registered Nurse ( RN ) Issued by… more
- Crouse Hospital (Syracuse, NY)
- …and outreach programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse ( RN ) to track and manage data ... 8:00am-4:30pm, requires 6 weekends a year. Utilization Management Registered Nurse ( RN...(3) - Five (5) years acute hospital experience. + Case Management or Utilization … more
- HCA Healthcare (Portsmouth, NH)
- …Case Manager opening and continue to learn! **Job Summary and Qualifications** The Registered Nurse ( RN ) CM is responsible for promoting patient-centered ... supporting a balance of optimal care and appropriate resource utilization . Provides case management services...years experience in clinical nursing Required InterQual experience Preferred Registered Nurse license for New Hampshire or… more
- HCA Healthcare (Portsmouth, NH)
- …knowledge and expertise! **Job Summary and Qualifications** **Job Summary and Qualifications** The Registered Nurse ( RN ) CM is responsible for promoting ... supporting a balance of optimal care and appropriate resource utilization . Provides case management services...years experience in clinical nursing Required InterQual experience Preferred Registered Nurse license for New Hampshire or… more