- Molina Healthcare (GA)
- …of healthcare services professionals in some or all of the following functions: care management, utilization management, behavioral health, care transitions, ... performance of one or more of the following activities: care review, care management, utilization ...care team (ICT) meetings. * Functions as hands-on manager responsible for supervision and coordination of daily integrated… more
- Beth Israel Lahey Health (Plymouth, MA)
- …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who We ... and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you...care determination and the appeal/denial process. + Oversees utilization review workflow processes to ensure timely response to… more
- Helio Health Inc. (Syracuse, NY)
- …to track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting ourSyracuse ... Assist in developing and administering policies and procedures for utilization . + Negotiating access to care for...also take into account information provided by the hiring manager and program Job LocationsUS-NY-Syracuse Category Case/ Care … more
- Children's Mercy Kansas City (Kansas City, MO)
- …nursing + required within 4 years of hire + 1-2 years experience + Experience in Utilization Review + One of the following: Licensed RN - MO, Registered Nurse ... and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including patient statusing… more
- Sharp HealthCare (San Diego, CA)
- …and Abilities** + Knowledge of medical terminology, healthcare finances, alternative care options, utilization management, health plan criteria, established ... **FTE** 1 **Shift Start Time** **Shift End Time** California Licensed Vocational Nurse (LVN) - CA Board of Vocational...medical services that meet medical criteria. The review of care is region specific and consists of outpatient healthcare… more
- Prime Healthcare (Montclair, CA)
- …Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred. 3. Five years acute care nursing experience preferred. At least ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/230024/case- manager -%28rn-%29 utilization… more
- Prime Healthcare (Lynwood, CA)
- …Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care nursing experience preferred. At least one ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/228577/rn-case- manager utilization… more
- Prime Healthcare (San Dimas, CA)
- …Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care nursing experience preferred. At least one ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/229285/case- manager -%28rn%29 utilization… more
- Houston Methodist (Houston, TX)
- …Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent ... prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members, as well as...hospital. Provides education to physicians, nurses, and other health care providers on utilization management topics. +… more
- Molina Healthcare (GA)
- …healthcare services professionals in some or all of the following functions: utilization management, care management, behavioral health and other programs. Leads ... oversees one or more of the following key health care services functions: care management, utilization...education and experience. * At least 3 years health care management/leadership required. * Registered Nurse (RN), Licensed… more
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