- AdventHealth (Tampa, FL)
- …The RN Care Manager in collaboration with the patient/family, social workers , nurses, physicians and the interdisciplinary team, ensures patient-centered care ... physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge...(as permitted by the patient) as well as a review of the current and past inpatient and outpatient… more
- Ellis Medicine (Schenectady, NY)
- … Workers (SW). The Discharge Planner's primary function is to work with the Social Worker , Nurse Case Manager, or Utilization Management Nurse to ... utilization management activities under the direction of a registered nurse and/or social worker . Responsibilities include maintaining case files, updating… more
- St. Peters Health (Helena, MT)
- …with the patient/family, physicians, and the interdisciplinary team, the Case Management/ Utilization Review RN facilitates the patient's progress through the ... progression of care and makes referrals to a Social Worker Counselor or financial counselor, or other services as...and managed care organizations relevant to case management and utilization review activities. + Participates in performance… more
- The County of Los Angeles (Los Angeles, CA)
- …goals. + Develops and implements reporting procedures to ensure that program services utilization and revenue data are reported accurately and in a timely manner. + ... of care and establishes and modifies program monitoring and review methods as necessary. + Oversees audits and the...valid, current license to practice as a clinical social worker or marriage and family therapist issued by the… more
- Ellis Medicine (Schenectady, NY)
- …services provided by the Case Manager include, but are not limited to, utilization review , case management, care transition, collaboration with physicians and ... in a hospital environment preferred. + Previous case management, utilization review , and discharge planning experience highly...psychosocial needs and coordinate transition of care with Social Worker + Serves as nurse consultant for… more
- Sharp HealthCare (San Diego, CA)
- …position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving ... 1 **Shift Start Time** **Shift End Time** California Registered Nurse (RN) - CA Board of Registered Nursing; Bachelor's...provides information to the department head as indicated. + Utilization review and utilization managementThe… more
- Sharp HealthCare (La Mesa, CA)
- …position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving ... (CCM) - Commission for Case Manager Certification; California Registered Nurse (RN) - CA Board of Registered Nursing **Hours**...provides information to the department head as indicated. + Utilization review and utilization managementThe… more
- University of Michigan (Ann Arbor, MI)
- …position is unique in that it combines clinical/quality considerations with regulatory/financial/ utilization review demands. The position creates a balance ... for each patient/family in collaboration with the physician, social worker and all members of the interdisciplinary team in...+ Participate in venues to reduce barriers to discharge ** Utilization Review and Utilization Management**… more
- ChenMed (Philadelphia, PA)
- …assess and record patients' progress and adjust and plan accordingly + Understanding utilization review and how to leverage with inpatient staff for possible ... through external providers and healthcare systems. The Acute Care Nurse is an important member of the Complex Care...required + A minimum of one (1) year of utilization review and/or case management, home health,… more
- Cleveland Clinic (Port Saint Lucie, FL)
- …A caregiver in this role utilizes clinical expertise and understanding of utilization review requirements, discharge planning process, and Medicare regulations ... + Assist in the development of department practices and procedures for utilization review and discharge planning, ensuring compliance with managed care… more