- Nuvance Health (Danbury, CT)
- …in nursing, health administration, or a related field preferred * Current licensure as a registered nurse ( RN ) * Minimum of 5 years of clinical experience ... for providing strategic leadership and operational oversight for a team of utilization review staff, denials and appeals specialists, non-clinical support staff… more
- Tenet Healthcare (Detroit, MI)
- …provisions and provides interpretation of department policies, in accordance with the DMC Utilization Review Plan. Identifies the need for and drafts or defines ... to ensure timely referral, follow up and documentation. Implements and monitors utilization review process in place to communicate appropriate clinical data to… more
- Jennie Stuart Medical Center, Inc. (Hopkinsville, KY)
- …and administering activities related to clinical review , discharge planning, resource utilization , and utilization review . Your primary goal will be ... Jennie Stuart Health is seeking a dedicated Case Management Nurse to join our healthcare team on a PRN...teamwork + Experience with InterQual criteria + Understanding of utilization management + Knowledge of CMS regulations + Ability… more
- SUNY Upstate Medical University (Syracuse, NY)
- …including PC, Windows, Microsoft applications, Zoom/WebEx platforms, etc. Preferred Qualifications: Utilization management or utilization review experience, ... contracts with reimbursement entities. This is achieved through a thorough chart review and utilization of first-level screening criteria to ensure patients… more
- Dartmouth Health (Bennington, VT)
- …matriculated into a BSN program may be considered.Prior experience in utilization review , discharge planning and/or case management preferred.3-5years of ... clinical nursing experience and BS required. BSN preferred. Prior experience in utilization review , discharge planning and/or case management preferred. VT… more
- Sutter Health (San Francisco, CA)
- …+ Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** + RN - Registered Nurse of California Upon Hire **TYPICAL EXPERIENCE:** + ... and case management within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation status. + Awareness of… more
- Sutter Health (Roseville, CA)
- …**EDUCATION:** Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** RN - Registered Nurse of California Upon Hire **TYPICAL EXPERIENCE:** ... and case management within a managed care environment. Comprehensive knowledge of Utilization Review , levels of care, and observation status. Awareness of… more
- Hartford HealthCare (Manchester, CT)
- …Region serves a region of 300,000 people in 19 towns. POSITION SUMMARY: The Utilization Review Case Manager (UR CM) works in collaboration with the physician ... progression of care in the acute-care setting. * Minimum of 1 year Utilization Review experience preferred via industry clinical standards, ie, InterQual,… more
- Stanford Health Care (Palo Alto, CA)
- …affect the processes and outcomes of patient health care **Licenses and Certifications** + CA- RN ( Registered Nurse ) required **These principles apply to ALL ... responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient… more
- ERP International (Luke AFB, AZ)
- **Overview** ERP International is seeking a full time ** Registered Nurse - Case Management** in support of the56th Medical Group at Luke AFB, AZ ... Case Management Society of America (CMSA); American Accreditation Healthcare Commission/ Utilization Review Accreditation Commission (URAC); CAMH; (AAAHC); Health… more