- Tenet Healthcare (Detroit, MI)
- …and is determined by employment status Summary Description Oversees hospital utilization performance improvement and operational management of the site Case ... Management Department to promote effective utilization of hospital resources, ensure processes support appropriate reimbursement for services rendered, support… more
- Sharp HealthCare (San Diego, CA)
- …management, utilization review, care coordination experience. + California Registered Nurse (RN) - CA Board of Registered Nursing **Preferred Qualifications** + ... Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse (RN) - CA Board of Registered Nursing **Hours** **:** **Shift Start… more
- Intermountain Health (Murray, UT)
- …provides. The position requires an understanding of care management and utilization management industry benchmarks, best practices and regulatory environment for the ... their healthcare journey. + Oversees program components related to care management and utilization review for the specific line of business, across all service areas… more
- Sharp HealthCare (La Mesa, CA)
- …Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse (RN) - CA Board of Registered Nursing **Hours** **:** **Shift Start ... position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving care… more
- Community Health Systems (Siloam Springs, AR)
- **Job Summary** The Care Manager - LPN supports effective utilization management and discharge planning by coordinating patient care activities under the supervision ... of a Registered Nurse or physician. This role involves reviewing medical records...medical records to assess the appropriateness, medical necessity, and utilization of hospital services, escalating cases as needed to… more
- Community Health Systems (Bentonville, AR)
- …to live! **Job Summary** The Care Manager - LPN supports effective utilization management and discharge planning by coordinating patient care activities under the ... supervision of a Registered Nurse or physician. This role involves reviewing medical records...medical records to assess the appropriateness, medical necessity, and utilization of hospital services, escalating cases as needed to… more
- Sharp HealthCare (San Diego, CA)
- …Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse (RN) - CA Board of Registered Nursing; Accredited Case Manager (ACM) ... position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving care… more
- Munson Healthcare (Traverse City, MI)
- REQUIREMENTS: Registered Nurse in the State of Michigan. Minimum of 2 years of relevant experience, 2 years in the specialty area preferred. A BSN is required for ... those hired into the role after October 1, 2018. Charge Nurse experience preferred Demonstrates exceptional professional role model behavior that supports… more
- The County of Los Angeles (Los Angeles, CA)
- …Office of Nursing Affairs at various locations for the purpose of nurse recruitment. Performs other duties as assigned. Requirements SELECTION REQUIREMENTS: A ... AND CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board or Registered Nursing.* Applicantsmustensure the… more
- Molina Healthcare (Jackson, MS)
- …of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies to ensure ... most appropriate care at the most effective setting. *Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and under-… more