- UNC Health Care (Smithfield, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and...date. **Licensure/Certification Requirements:** * Licensed to practice as a Registered Nurse in the state of North… more
- UPMC (Pittsburgh, PA)
- …license. This role will review requests for authorization for behavioral health services. The Utilization Management (UM) Care Manager is responsible for ... Health Plan is hiring a full-time Behavioral Health UM Care Manager to support our UM Clinical...Case management certification or approved clinical certification preferred + Registered Nurse ( RN ) *Current licensure… more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) ... service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key...applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance… more
- Community Health Systems (Bentonville, AR)
- …awards as a best place to live! **Job Summary** The Care Manager - LPN supports effective utilization management and discharge planning by coordinating ... care activities under the supervision of a Registered Nurse or physician. This role involves...utilization management and discharge planning programs to enhance care delivery and compliance. + Performs other duties as… more
- Community Health Systems (Bentonville, AR)
- **Job Summary** The Care Manager - LPN supports effective utilization management and discharge planning by coordinating patient care activities under the ... supervision of a Registered Nurse or physician. This role involves reviewing medical records...utilization management and discharge planning programs to enhance care delivery and compliance. + Performs other duties as… more
- St. Luke's University Health Network (Stroudsburg, PA)
- …of a patient's ability to pay for health care . The Registered Nurse or Social Worker Care Manager is responsible for coordinating the complex ... of care . Also works with the providers, registered nurse care managers, social... care management, including but not limited to: RN care managers, assistants, coordinators, utilization… more
- St. Luke's University Health Network (Bethlehem, PA)
- …of a patient's ability to pay for health care . The Registered Nurse or Social Worker Care Manager is responsible for coordinating the complex ... of care . Also works with the providers, registered nurse care managers, social... care management, including but not limited to: RN care managers, assistants, coordinators, utilization… more
- AdventHealth (Orlando, FL)
- …2 medical/hospital nursing experience [Required] + Registered Nurse ( RN ) [Required] **Preferred qualifications:** + Prior Care Management/ Utilization ... ROLLINS STREET, Orlando, 32803 **The role you'll contribute:** The RN Care Manager in collaboration...potential denials, documents avoidable days, and facilitates progression of care . Collaborates with Utilization Management staff for… more
- Texas Health Resources (Arlington, TX)
- Registered Nurse ( RN ) Care Transition Manager - Full Time Work location: Texas Health Arlington 800 W. Randol Mill Road TX 76012 Work hours: Full ... experience Pref IP acute care case management experience preferred. Licenses and Certifications RN - Registered Nurse Upon Hire Req And CPR -… more
- AdventHealth (Winter Park, FL)
- …and rehabilitation at the AdventHealth Orthopedic Institute **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, ... progression through the continuum of care . The RN Care Manager ensures efficient...valid State of Florida or multistate license as a Registered Nurse + 2 years of medical/… more
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