- Brockton Hospital (Brockton, MA)
- …delays through problem resolution and follow-up. Monitors on-site case managers and utilization review staff to ensure compliance with Signature Healthcare ... management experience Proven experience in coordinating discharge planning and utilization review experience required. Prior management experience required.… more
- RWJBarnabas Health (Newark, NJ)
- …candidates must have at least 3 years of recent experience in Case Management, Utilization Review , or Discharge Planning, and a minimum of 2 years in ... experience required. This role focuses on clinical resource management, utilization review , discharge planning, and patient advocacy....Current and valid license to practice as a Registered Nurse or Social Worker in the state… more
- Houston Methodist (Nassau Bay, TX)
- At Houston Methodist, the Case Manager (CM) position is a registered nurse (RN) responsible for comprehensively planning for case management, which includes care ... treatment outcomes. The CM position holds joint accountability with the social worker for discharge planning and continuity of care and assures that admission… more
- ChenMed (Hampton, VA)
- …care and cost effectiveness through the integrating and functions of case management, utilization review and discharge planning. The Case Manager will adhere to ... counseling required to complete complex discharge plan to social worker . + Facilitates interdisciplinary patient care rounds and/or conferences...etc. + Minimum of seven (7) plus years of utilization review /case management. + Minimum of seven… more
- LA Care Health Plan (Los Angeles, CA)
- …and unrestrited California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required ... Requirements Light Additional Information Preferred: Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), … more
- UNC Health Care (Raleigh, NC)
- …care and cost effectiveness through the integrating and functions of case management, utilization review and discharge planning. The Care Manager must be highly ... issues with complex patients and identify trends. Formulate potential solutions with Utilization Manager and Social Worker and continuously monitor cases/follow… more
- UNC Health Care (Smithfield, NC)
- …care and cost effectiveness through the integrating and functions of case management, utilization review and discharge planning. The Care Manager must be highly ... issues with complex patients and identify trends. Formulate potential solutions with Utilization Manager and Social Worker and continuously monitor cases/follow… more
- New York State Civil Service (Sherrill, NY)
- …policy, treatment, and therapeutic programs, and serves on committees such as placement, utilization review , medical records review , and related committees, ... Pathologist 2, Teacher 4 (and all parenthetics), Training Specialist 1 (Nursing), and Utilization Review Coordinator. Additional Comments * If you are currently… more
- Houston Methodist (Sugar Land, TX)
- …the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical denial management ... Seven years clinical nursing/patient care experience which includes three years in utilization review , case management or equivalent revenue cycle clinical role… more
- Cedars-Sinai (Beverly Hills, CA)
- …for medical necessity, appropriateness of care and level of care. Use evidence based review guidelines to conduct utilization review as is appropriate to ... utilization of medical services within the parameters of the workers compensation benefits and/or Utilization decisions. This includes appropriate movement… more