- Beth Israel Lahey Health (Plymouth, MA)
- …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 will:** + Directs staff performance regarding UR and… more
- Beth Israel Lahey Health (Plymouth, MA)
- …is expanding its **Care Transitions Department** and seeking an experienced ** Manager of Utilization Review & Denials Management ** and ** Utilization ... CCM, ACM, or other case management certification preferred or in progress ** Manager - Utilization Review & Denials Management ** This role is ideal… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional Care Team.This is a full-time role and will be required to work ... utilization of resources, coordination of payer communication, and utilization review and management . Responsible...required or completed within three years of hire **Title:** * Manager - Utilization Review * **Location:**… more
- Houston Methodist (Houston, TX)
- …+ Five years of hospital clinical nursing experience, which includes three years in utilization review and/or case management **LICENSES AND CERTIFICATIONS - ... At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position...to physicians, nurses, and other health care providers on utilization management topics. + Initiates improvement of… more
- Children's Mercy Kansas City (Kansas City, MO)
- …development of, and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, ... quality, and Lean process improvements, and facilitating the quarterly Utilization Review Committee meetings. Provides evidence based...of hire + One of the following: American Case Management , Certified Case Manager required upon hire… more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- The Utilization Review Case Manager is responsible for working with insurance companies and managed care systems for the authorization, concurrent and ... access the full range of their benefits through the utilization review process. + Conducts admission reviews....degree such as nursing, social work, psychology, health information management or other related healthcare field is preferred or… more
- 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 ... & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection by reconciling physician orders,… more
- Community Health Systems (Franklin, TN)
- …discharge planning, and payer requirements. + Documents all utilization review activities in the hospital's case management software, including clinical ... Nursing preferred + 2-4 years of clinical experience in utilization review , case management , or...Compact State Licensure required + CCM - Certified Case Manager preferred or + Accredited Case Manager … more
- Prime Healthcare (Lynwood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/228577/rn-case- manager utilization - ... and service! Responsibilities Responsible for the quality and resource management of all patients that are admitted to the...to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,… more
- Intermountain Health (Las Vegas, NV)
- … Manager of Care Management I leads and collaborates with care management operations across utilization review , acute and emergency department care, ... with compliance and legal to support care delivery. The Manager Care Management I reports to the...+ Previous management experience in hospital care management , utilization review , ambulatory care… more
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