- Seattle Children's (Seattle, WA)
- …for children with medical complexity Current or previous hospital case management or utilization review experience Current or previous case management or ... In partnership with the director, Care Coordination provides leadership, supervision, and oversight of...utilization review leadership experience **Compensation Range** $115,277.00 - $172,915.00 per… more
- Trinity Health (Wilmington, DE)
- **Employment Type:** Part time **Shift:** **Description:** **RN Care Manager - Utilization Management** **Location:** Saint Francis Hospital **Department:** ... Care Management / Utilization Review **Schedule:** Per Diem | 1 Weekend...an RN Case Manager in an acute care setting with a focus on Utilization … more
- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... concurrent medical record review for medical necessity and level of ...this position is able to cover a multitude of utilization review functions through point of entry,… more
- Alameda Health System (Oakland, CA)
- …trends and changes in healthcare delivery as it pertains to utilization review (eg, medical necessity, level of care ) by participating in appropriate ... System Utilization Management SUM Utilization Review...in orientation of fresh staff as requested by the Manager of Utilization Management. 17. Maintains knowledge… more
- Prime Healthcare (Lynwood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/219588/case- manager %2c-rn utilization - ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care nursing… more
- Actalent (Olympia, WA)
- …management and care coordination. + Experience with EPIC software. + Utilization review and appeals handling capabilities. + Discharge planning and ... for RN Case Managers! Job Description This role in care management focuses on transitions of care ,...in care management focuses on transitions of care , including coordination and medication reconciliation, aiming to reduce… more
- Baptist Memorial (Meridian, MS)
- Overview RN Utilization Review Weekender Job Code: 22818 FLSA Status Job Family: NURSING Job Description Title: RN Utilization Review Weekender Job ... appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse works...standard criteria per payer guidelines + Prioritizes observation case review + Assists with level of care … more
- Beth Israel Lahey Health (Burlington, MA)
- …Care , Physician Advisors Works collaboratively managing the process of Utilization Review throughout the system **As a health care organization, we have a ... collaboration with the Physician Advisors, Collaborates and helps facilitate the Utilization Review Committee. Continuously monitors processes for opportunities… more
- US Tech Solutions (Columbia, SC)
- …mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review /case management/clinical/or combination; 2 of 4 years ... Identifies and makes referrals to appropriate staff (Medical Director, Case Manager , Preventive Services, Subrogation, Quality of care Referrals, etc.).… more
- Helio Health Inc. (Syracuse, NY)
- …+ Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care , or managed care setting. ... of federal and state regulations applicable to treatment and reimbursement. + Utilization review procedures and techniques. Our Comprehensive Employee Benefits… more