- HCA Healthcare (Overland Park, KS)
- …while promoting quality outcomes through the continuum of care. Reviews and performs utilization review functions on each assigned patient per hospital policy ... apply for our PRN Registered Nurse Case Manager opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. **Unlock… more
- Elevance Health (Seven Hills, OH)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... law._** The **Clinical Pharmacist** is responsible for managing the selection and utilization of pharmaceuticals and supports core clinical programs such as DUR, DIS… more
- Carle Health (Urbana, IL)
- … issues in appropriate locations, including but not limited to: case management/ utilization review software and the multidisciplinary plan of care document ... with patient/family and physician to determine next level of care Conducts case review presentations to educate peers on unique or challenging cases and scope of… more
- Access Dubuque (Dubuque, IA)
- …also available remotely. **Key Responsibilities:** + Provide telephonic case management and utilization review for assigned consumers. + Develop, implement, and ... + **Experience:** Minimum 2 years of clinical practice. Case management or utilization review experience strongly preferred. + **Skills:** Strong communication,… more
- HCA Healthcare (Ogden, UT)
- …(BLS or BCLS) and Certification.** + **Certification in case management or utilization review preferred.** + **InterQual experience preferred.** Ogden Regional ... supporting a balance of optimal care and appropriate resource utilization . **What you will do in this role:** +...apply for our RN Case Manager PRN opening. We review all applications. Qualified candidates will be contacted for… more
- MTC (Graceville, FL)
- …improvement committee. 7. Closely monitor all potential catastrophic events and perform utilization review and tracking. 8. Submit and implement recommendations ... Monitor delivery of mental health care, audit patient records, review and complete monthly statistical reports, analyze, distribute, and...for improvements in services and optimal utilization of staff. 9. Develop and monitor effectiveness of… more
- Crouse Hospital (Syracuse, NY)
- …requirements related to acute care discharge planning + Preferred - Acute care utilization review experience Benefits Overview: + Medical, Dental, Vision, FSA, ... day management of the RN Care Managers in the department, including Utilization Management, Discharge Planning and Denials and Appeals functions. + Assessing… more
- ManpowerGroup (Plano, TX)
- …required; AA degree is a plus. + Minimum of 2+ years experience in a utilization review environment or similar work experience. + Knowledge of private insurance, ... Workers Compensation, and Medicare guidelines related to utilization review . + Proficient with Microsoft Office (Word & Excel); experience with medical billing… more
- Dartmouth Health (Bennington, VT)
- …matriculated into a BSN program may be considered.Prior experience in utilization review , discharge planning and/or case management preferred.3-5years of ... clinical nursing experience and BS required. BSN preferred. Prior experience in utilization review , discharge planning and/or case management preferred. VT… more
- Pomona Valley Hospital Medical Center (Pomona, CA)
- …financial system. This position requires a strong understanding of payer policies, utilization review workflows, admission criteria, and hospital revenue cycle ... or equivalent. Three years' experience in patient access, hospital admissions, utilization review , or insurance authorization. Strong communication, critical… more