- CVS Health (Austin, TX)
- …care experience is in behavioral health) **Preferred Qualifications** + 1+ years' experience Utilization Review experience + 1+ years' experience Managed Care + ... + Job Description Primary Job Duties & Responsibilities Drives effective utilization management practices by ensuring appropriate and cost-effective allocation of… more
- Alameda Health System (San Leandro, CA)
- …Follows AHS (Alameda Health System) and Behavioral Health Department Alameda County Utilization Review Plan to obtain authorization of acute inpatient services. ... fields in EHR. 17. Maintains current knowledge of clinical practice and Utilization Management by literature review , membership in a professional organization.… more
- McLaren Health Care (Port Huron, MI)
- **Department:** Utilization Review **Daily Work Times:** 8:00am-4:30pm **Hours Per Pay Period:** 40 **Position Summary:** Responsible for determining the ... accordance with established SOP procedures. 9. Maintains current knowledge of hospital utilization review processes and participates in the resolution of… more
- CVS Health (Austin, TX)
- …care experience is in behavioral health) **Preferred Qualifications** + 1+ years' experience Utilization Review experience + 1+ years' experience Managed Care + ... we do it all with heart, each and every day. **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and the candidate can live… more
- CVS Health (Carson City, NV)
- …cardiology **Preferred Qualifications** -1+ years' experience in either Precertification or Utilization Review -1+ years' experience Managed Care -Strong ... And we do it all with heart, each and every day. **Position Summary** **This Utilization Management (UM) Nurse Consultant role is fully remote but must reside in PST… more
- Prime Healthcare (Ontario, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/236094/ utilization - review -nurse-lvn/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... of experience in acute hospital case management or equivalent. + Utilization Management experience required. + Excellent interpersonal relationship skills with… more
- Sanford Health (Rapid City, SD)
- …patient wellness through evidenced based practice, improved care outcomes, efficient utilization of health services, and appropriate level of care for patients ... during hospitalization and on a continuum after discharge. Provides discharge-planning education and makes referrals to inter-professional teams when necessary. Initiates links with post-acute external care resources. Anticipates and/or identifies patient… more
- CVS Health (Baton Rouge, LA)
- …Responsibilities** + Lead, coach, and develop a multidisciplinary team responsible for utilization review , prior authorization, and case management functions. + ... do it all with heart, each and every day. **Position Summary** The Utilization Management Manager of Prior Authorization oversees a team of clinical professionals to… more
- Rochester Regional Health (Rochester, NY)
- …able to work independently with minimum direction. + Act as a resource for utilization review stakeholders and assists team members in clinical problem solving. ... Job Title: Registered Nurse I Department: Utilization Management Location: Rochester General Hospital Hours Per...40 hours (Full-Time) Schedule: Monday - Friday, Days SUMMARY: Review all inpatient medical necessity denials for the health… more
- UNC Health Care (Hendersonville, NC)
- … reviews in accordance with federal regulations and the health system's Utilization Review Plan. Responsibilities: + Uses approved criteria and conducts ... the health and well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and discharge review … more