- Arms Acres (Carmel, NY)
- …as identified in patient treatment plans and requested by program director. Performs utilization review , provides progress reports and develop aftercare plans in ... implementation of the multidisciplinary treatment plan; coordinates treatment plan review ; performs these activities within established time frames. Documents… more
- The Hartford (Hartford, CT)
- …+ Case management and discharge planning experience preferred + Managed care/ utilization review experience preferred + Crisis intervention skills preferred ... clinically appropriate. Advises on highly complex claims at multidisciplinary clinical review roundtables to ensure optimal outcomes. Determines when claims contain… more
- STG International (West Seneca, NY)
- …* Design and participate in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health enhancement ... activities. * Ensure consistency in evidence-based practice standards across the CBOC's. * Implement and attend provider huddles to assure situational awareness of clinic operational limitations and daily work planning. * Function as a director for the CLIA… more
- Sharp HealthCare (San Diego, CA)
- …response to therapeutic interventions via collateral calls, conjoint therapy sessions, utilization review process, and/or referrals and revises care plan ... issues.Identifies Bioethical dilemmas and initiates appropriate response.Testifies at Certification Review and Reise hearings regarding patient's current mental health… more
- Sharp HealthCare (San Diego, CA)
- …initiate, and support admissions process per policy and or department guidelines.Complete Utilization Review for admitting and ongoing treatment for patients. ... Do** To provide documentation for discharge planning, psychosocial, treatment plan, UR review , and care coordination for patients. Intake phone calls and assessment… more
- Virginia Mason Franciscan Health (Seattle, WA)
- …+ **Lead & Collaborate:** Chair or co-chair key committees such as Credentials, Peer Review , Operational, and Utilization Review . Partner with clinical staff ... to develop, implement, and champion performance improvement processes. + **Cultivate Strong Relationships:** Build trusted and collaborative relationships with all stakeholders across the hospital/medical center and the Northwest Region, fostering a supportive… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …conveying an impression which reflects favorably upon the organization. In collaboration with Utilization Review , the SW CM (PRN) will initiate and facilitate ... with the patient/family as well as the care team. Through continuous assessment and review , the SW CM (PRN) will apply critical thinking to ensure alignment and… more
- KBR (San Diego, CA)
- …compliance in meeting care goals. * Knowledge and skill in using pre-established utilization review criteria recognize and report actual or potential quality and ... current notes in the electronic medical records of all patients contacted for review by the managing physician; Routinely staffs difficult cases with the referring… more
- HCA Healthcare (Wichita, KS)
- …of critical care experience is preferred + Certification in case management or utilization review is preferred + InterQual experience is preferred **For more ... encourage you to apply for our RN Case Manager opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. **Unlock… more
- HCA Healthcare (Kansas City, MO)
- …patient needs. **What you will do in this role:** + Responsible for utilization review , discharge planning and care coordination with the patient, patient's ... to apply for our RN Case Manager opening. Our team will promptly review your application. Highly qualified candidates will be contacted for interviews. **Unlock the… more