- Baptist Memorial (Meridian, MS)
- …Required: RN with 3 years of clinical experience Preferred/Desired: RN with Case Management or Utilization Review experience in a hospital or payer ... Overview RN Utilization Review Weekender Job Code: 22818...against standard criteria per payer guidelines + Prioritizes observation case review + Assists with level of… more
- Children's Hospital Boston (Boston, MA)
- 80451BRJob Posting Title:Per Diem RN Case Manager, Utilization Management /ReviewDepartment:Patient Services-Patient Care ... + Experience as a Case Manager (Discharge Planning and or Utilization Management ) preferred. Licensure/ Certifications: + Current Massachusetts license as a… more
- Actalent (Sunrise, FL)
- …and experience. + Valid Florida Driver's License. + Knowledge of case management and utilization review concepts, including InterQual and Milliman ... assigned. Essential Skills + Clinical review + Utilization review + Utilization management + Interqual + Milliman Commercial Guidelines + Medicaid +… more
- The Cigna Group (Sacramento, CA)
- …in state where you reside. + 3 years' experience in case management or utilization review . **Preferred requirements:** + Bachelors/CCM preferred + ... + Manages approximately 12-15 direct reports who are directly responsible for inpatient case management and all associated performance requirements for Cigna. +… more
- UNC Health Care (Eden, NC)
- …promote continuity of care and cost effectiveness through the integrating and functions of case management , utilization review and discharge planning. ... Details** Legal Employer: NCHEALTH Entity: UNC Rockingham Health Care Organization Unit: RHC Case Management Work Type: Full Time Standard Hours Per Week: 40.00… more
- Tenet Healthcare (Detroit, MI)
- …Establish goals and objectives that support overall strategic plans of the Case Management and Utilization Review strategy · Lead Group hospital Case ... Management model, staffing and skill mix, complex Case Management , and centralized utilization review · Participate in new hospital Director of … more
- Stanford Health Care (Palo Alto, CA)
- …**Required Knowledge, Skills and Abilities** + Knowledge of principles and best practices of case management , utilization review , social work, care ... employee evaluations, and program development for the Department of Social Work and Case Management . Additionally, this position serves as a resource for problem… more
- Seattle Children's (Seattle, WA)
- …caring for children with medical complexity Current or previous hospital case management or utilization review experience Current or previous case ... provides leadership, supervision, and oversight of day-to-day operations of the Case Management department. Serves as the central resource to the director to… 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 ... years of inpatient experience in a hospital environment preferred. + Previous case management , utilization review , and discharge planning experience… more