- Community Health Systems (Franklin, TN)
- **Job Summary** The Remote PRN Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital ... services to ensure compliance with utilization management policies. This role conducts admission and continued stay reviews, supports denials and appeals activities,… more
- Tenet Healthcare (Detroit, MI)
- RN Utilization Review - Case Management - 2506004107 Description : Join our dedicated healthcare team where compassion meets innovation! As a Registered Nurse ... to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient's resources and right to… more
- Sharp HealthCare (San Diego, CA)
- …Degree in Nursing; Bachelor's Degree in Nursing; Master's Degree; California Registered Nurse (RN) - CA Board of Registered Nursing; Certified Case Manager ... (CCM) - Commission for Case Manager Certification; Accredited Case Manager (ACM) - American Case Management Association (ACMA) **Hours** **:** **Shift Start… 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 ... review for medical necessity of outpatient observation and inpatient stays and the utilization of ancillary services + Perform other duties as assigned by the… more
- 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...Qualifications:** + Associate's Degree in Nursing. + California Registered Nurse License upon hire. + 2 years of experience… more
- ChenMed (Houston, TX)
- …We're rapidly expanding and we need great people to join our team. The Nurse Case Manager 1 (RN) is responsible for achieving positive patient outcomes ... into acute and post-acute facilities, as well as, their home environments. The Nurse Case Manager 1 (RN) role also involves establishing relationships with… more
- WellSpan Health (York, PA)
- …**_Occasional Weekend_** **General Summary** Performs a variety of duties and applies utilization and case management techniques to determine the most efficient use ... patient discharge needs. Provides leadership in the integration of utilization and case management principles. **Duties and Responsibilities** **Essential… more
- WellSpan Health (Lebanon, PA)
- …Weekend rotation **General Summary** Performs a variety of duties and applies utilization and case management techniques to determine the most efficient use of ... address patient discharge needs. Provides leadership in the integration of utilization and case management principles. **Duties and Responsibilities** + Reviews… 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