- Select Medical (St. Louis, MO)
- …allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and ... discharge planning process. + The primary job functions in Case Management include: + Clinical Interventions/Discharge Planning...Licensure per state guidelines in clinical or related discipline ( RN Preferred) OR a Bachelor's or Master's in a… more
- BJC HealthCare (St. Louis, MO)
- …of RN experience + At least 2 years of leadership experience + Utilization Review experience + RN Case Coordination experience **Overview** **St. Louis ... **City/State:** Saint Louis, Missouri **Categories:** Case Coordination **Job Status:** Full-Time **Req ID** :...Children's Place St. Louis, MO 63110 + Supervises the Utilization Review and Navigator teams + Excellent team culture!… more
- US Tech Solutions (MI)
- …+ Application and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards ... needs to ensure appropriate administration of benefits + Utilizes case management and quality management ...accreditation guidelines and company policies and procedures **Skills:** + Utilization review + RN + Assure care… more
- HCA Healthcare (Salt Lake City, UT)
- …What you will do in this role: + You will work collaboratively with RN case managers, acute care nurses, physicians, insurance companies, and other staff ... integrity. We care like family! Jump-start your career as a(an) Social Worker Case Manager today with St. Mark's Hospital. **Benefits** St. Mark's Hospital offers a… more
- UPMC (Pittsburgh, PA)
- …of experience. + 3 years of experience in behavioral, clinical, utilization management , home care, discharge planning, and/or case management required + ... care and services across the continuum of care with case management , physicians, pharmacy, behavioral health, and...2 years of hire to remain in role) + Registered Nurse ( RN ) **Licensure, Certifications,… more
- Tufts Medicine (Haverhill, MA)
- …our High Pointe House Facility in Haverhill, MA, and Skilled Nursing Facility management and oversight. Hours: Full Time 40 Hours Location: Lowell MA and Haverhill ... **Minimum Qualifications:** 1. Bachelor's degree in Nursing (BSN). 2. Massachusetts RN Licensure. 3. Five (5) years of palliative, hospice, complex care… more
- Diversicare Healthcare Services & Diversicare Ther (Hartford, AL)
- …nursing 2. RN License 3. Knowledge of healthcare reimbursement, utilization management , and discharge planning. 4. Experience providing strategic leadership, ... of insurers 10. Must have understanding of regulatory requirements 11. Previous case management experience preferred (EOE) **Job ID** _2025-63820_ **Type**… more
- AdventHealth (Hinsdale, IL)
- …skills + Data analysis skills + Current working knowledge of discharge planning, utilization management , care management , performance improvement and managed ... for each position may vary based on geographical location. **Category:** Case Management **Organization:** UChicago Medicine AdventHealth Hinsdale **Schedule:**… more
- Elevance Health (Ashburn, VA)
- …within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of ... **Telephonic Nurse Case Manager II** **Location:** This...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum requirements:**… more
- AdventHealth (Hinsdale, IL)
- …documents avoidable days, and facilitates progression of care. Collaborates with Utilization Management staff for collaboration on patient status changes ... AND EXPERIENCE PREFERRED:** . Current working knowledge of discharge planning, utilization management , care management , performance improvement and… more