- WellSpan Health (York, PA)
- Utilization Management Nurse (RN) - Case Management - Day (Temporar Location: WellSpan Health, York, PA Schedule: Full Time Schedule Temporary Role ... WellSpan's geographic footprint. General Summary Performs a variety of reviews and applies utilization and case management techniques to determine the most… more
- CoreCivic (Brentwood, TN)
- …will pay $82,000 - $97,400 with a 10% bonus eligible._ **SUMMARY:** The Manager, Utilization Management / Case Management provides Utilization Review ... the organization under the direction of the Senior Director, Case Management and within the established policies...government laws and regulations. + Manages a team of utilization management nurses.Provides direction and supports staff… more
- Houston Methodist (The Woodlands, TX)
- …for state, local and federal programs + Comprehensive knowledge of discharge planning, utilization management , case management , performance improvement ... PRN (CM) position is a licensed registered nurse (RN) who comprehensively plans for case management of a target patient population on a designated unit(s). This… more
- Excellus BlueCross BlueShield (Utica, NY)
- …cases to the Medical Director for review. Refer to and work closely with Case Management to address member needs. Participates in rotating on-call schedule, as ... depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of… more
- McLaren Health Care (Detroit, MI)
- …degree in coding/medical records/billing or healthcare related field + Two years of case management or utilization review, billing, or coding experience ... observation) based on medical necessity. 2. Performs concurrent and retrospective utilization management -related activities and functions to ensure that… more
- UCLA Health (Los Angeles, CA)
- …can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management , you'll provide direct management to a team of UM ... (BSN) degree required + Five or more years of utilization management required + Four or more...complex federal and private insurance regulations + Ability to travel /attend off-site meetings and conferences + ACM - Accredited… more
- Catholic Health (Buffalo, NY)
- …hospital and community or obtained within 6 months + National Certification in Case Management preferred EXPERIENCE + Two (2) years medical surgical nursing ... Review, as an active member of the Care Management and interdisciplinary care team, provides comprehensive Utilization...utilization review experience in the role of a Case Manager or Disease Manager, Population Health, Discharge Planning… more
- UTMB Health (Friendswood, TX)
- …ensure optimal quality, cost, and service/outcomes. Supports and actualizes the UTMB Utilization Review/ Case Management program by utilizing clinical ... + Supervises the operational management of the Utilization Review/ Case Management program to...Standard office equipment. **_WORK ENVIRONMENT_** **:** + May involve travel . + May involve occasional shift work and weekends… more
- Houston Methodist (Houston, TX)
- …(MSW) + Master's in nursing preferred **WORK EXPERIENCE** + Five years experience in inpatient case management , social work or utilization management or ... to ensure operational effectiveness and efficiency of admission, concurrent and retrospective utilization management and medical claims functions to meet and… more
- Houston Methodist (Houston, TX)
- …Mgmt Social Svcs position is responsible for strategy, function and operations of the Case Management & Social Work department. This position is an integrated, ... entity committees as a voice for the department. + Sets direction for Case Management /Social Services which supports strategic and operational plans, and overall… more
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