- Monroe County, NY (Rochester, NY)
- Full Jobs List Full Exams List Registered Nurse (RN) - Utilization Review Unit, Per Diem Location: Rochester, NY Title: Registered Nurse (RN) - Utilization ... Hospital Description of Duties This position is in the Utilization Review Unit and functions as an...a professional nursing position involving responsibility for providing nursing care that may include bedside and/or clinical care… more
- Ascension Health (Baltimore, MD)
- …assigned team. + Identify and resolve issues affecting the delivery of patient care services for the assigned team. Develop and implement policies and procedures to ... key to our commitment of transforming healthcare and providing care to all, especially those most in need. Join...up of over 134,000 associates and 2,600 sites of care , including more than 140 hospitals and 40 senior… more
- Trinity Health (Silver Spring, MD)
- …Type:** Full time **Shift:** Day Shift **Description:** **Job Title:** RN Case Manager - Utilization Management **Employment Type:** Full Time **Shift:** Day ... : Holy Cross Hospital **Position Purpose:** As a Case Manager in Utilization Management, you will be...align with clinical and regulatory standards. By optimizing resource utilization and maintaining the highest standards of care… more
- Trinity Health (Fort Lauderdale, FL)
- … Plans to ensure authorization for hospital stay. Hybrid Position **_Position Purpose:_** ** Utilization Review (UR) Nurses play a vital role in healthcare by ... hospital clinical experience is required.** Recent experience in case management, utilization review , discharge planning, ongoing monitoring and evaluation of… more
- Catholic Health Services (Melville, NY)
- …why Catholic Health was named Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and ... to MCC in response to physician order, or review of updated clinical information Acts as a resource...current with industry standards and business objectives related to Utilization and Care Management as appropriate. Sound… more
- Dignity Health (Long Beach, CA)
- …+ AHA BLS + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Proficient in application of clinical guidelines ... **Responsibilities** Responsible for the review of medical records for appropriate admission status and continued hospitalization. Works in collaboration with the… more
- Swedish Health Services (Seattle, WA)
- …is a remote role. You MUST live in the state of Washington (WA) to be considered_** ** Care Manager RN** **Per diem / On call** **Day shift** The Utilization ... clinical background blended with a well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. This… more
- CareFirst (Baltimore, MD)
- …required work experience. **Experience:** 5 years Experience in a clinical and utilization review roles. 1 year demonstrated progressive leadership experience. ... Manages the utilization of referral services. Enhances quality of care by assuring compliance with policies, including safety, infection control, regulatory and… more
- Prime Healthcare (Ontario, CA)
- …school of nursing and a current state Registered Nurse license. + Minimum 3 years RN Utilization Manager working for a Health Plan. + At least 3 years of ... cost containment and demonstrates leadership to integrate the health care providers to achieve a perceived seamless delivery of...experience in utilization review , referrals, authorizations, denials and appeals.… more
- LA Care Health Plan (Los Angeles, CA)
- … Management Medical Director, on requests where determination requires extended review . Collaborates with the inpatient care team for facilitation/coordination ... Utilization Management Admissions Liaison RN II Job Category:...participates in the discharge planning process, including providing clinical review and authorization for alternate levels of care… more