- Providence (Mission Hills, CA)
- **Description** **RN Utilization Review - Remote. This position will work full- time in a 8-hr Day shift.** Provide prospective, retrospective, and concurrent ... utilization reviews for our LA ministries. Conduct clinical reviews...UR environment or working as an acute hospital case manager . **Preferred Qualifications:** + Bachelor's Degree in Nursing. +… more
- Sharp HealthCare (San Diego, CA)
- …California Registered Nurse (RN) - CA Board of Registered Nursing; Certified Case Manager (CCM) - Commission for Case Manager Certification; Accredited Case ... Nursing + Master's Degree in a healthcare related field. + Accredited Case Manager (ACM) - American Case Management Association (ACMA) -PREFERRED + Certified Case … more
- Hackensack Meridian Health (Edison, NJ)
- …and serve as a leader of positive change. The **Care Management, Care Coordinator, Utilization Management** is a member of the healthcare team and is responsible for ... patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of stay,… more
- CareFirst (Baltimore, MD)
- …& Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination of health ... to facilitate department functions + Communicates in a timely manner to Manager appropriate information including, but not limited to, customer/case issues, reports,… more
- BayCare Health System (Tampa, FL)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN responsibilities include:** + Functions as the ... necessity of outpatient observation and inpatient stays and the utilization of ancillary services + Perform other duties as...+ Preferred ACM (Case Management) + Preferred CCM (Case Manager ) **Education:** + Required Associates in Nursing or +… more
- Avera (Sioux Falls, SD)
- …levels of care, to promote the best possible patient outcome. The case manager facilitates efficient utilization of resources and identifies patient care needs ... throughout the continuum of care. **What you will do** + Acts as liaison with hospitals and other health care service to provide treatment advice and lobby on behalf of the patients to various payor sources. + Identifies community resources which can provide… more
- GE Aerospace (Cincinnati, OH)
- …through early detection and customer notification reports (CNRs), to maximize aircraft utilization . The Fleet Manager will also develop prognostic analytics to ... + Provide effective training to airline/operator customers to improve their utilization of the self-service diagnostic tools. + Identify product failure trends… more
- Elevance Health (Indianapolis, IN)
- **Title: Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... employment, unless an accommodation is granted as required by law._ The ** Utilization Management Representative I** will be responsible for coordinating cases for… more
- Elevance Health (Latham, NY)
- ** Utilization Management Representative II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... unless an accommodation is granted as required by law._ The ** Utilization Management Representative II** is responsible for managing incoming calls, including… more
- Saint Francis Health System (Tulsa, OK)
- …in the Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to improvement of internal ... the Process Improvement/Quality Director, to appropriate clinicians and to the UM Manager . Reviews eligibility and benefits of patients, matching the level of care… more