- Houston Methodist (The Woodlands, TX)
- …and eligibility for state, local, and federal programs + Progressive knowledge of utilization management , case management , performance improvement, and ... At Houston Methodist, the Utilization Review Nurse (URN) PRN position is a...coverage determinations (LCDs & NCDs). This position collaborates with case management in the development and implementation… more
- CoreCivic (Brentwood, TN)
- …and a responsibility to better the public good. CoreCivic is currently seeking a ** Utilization Management / Case Management Nurse** located at our ... remote out of our Brentwood, TN office location._ The Utilization Management / Case Management ...the information to facilitate process improvement. + Domestic US travel may be required. **Qualifications:** + Graduate from an… more
- Commonwealth Care Alliance (Boston, MA)
- …& Utilization Mgmt Position Summary: Commonwealth Care Alliance's (CCA) Utilization Management (Authorization) Unit is primarily responsible for the ... under the provisions of CCA's benefits plan. The Manager, Utilization Management is responsible for overseeing and...* Act as liaison with medical director, provider relations, case management and quality teams to support… more
- CareFirst (Baltimore, MD)
- …week. **ESSENTIAL FUNCTIONS:** + Trains staff on standards of practice of Utilization Management and reimbursement methodologies and treatment coding. + Manages ... in standard medical practices and insurance benefit structures. + Proficient in utilization management processes, standards, and managed care. + Knowledge of… more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) ... authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role...work may be required on a rotational basis; some travel to home office may be required. **Required Education… more
- State of Connecticut, Department of Administrative Services (New Haven, CT)
- … review and/or quality assurance programs; + Conducts various types of case reviews for quality and appropriate medical management , cost containment, ... Utilization Review Nurse (40 Hour) Office/On-Site Recruitment #...+ Incumbents in this class may be required to travel . Conclusion AN AFFIRMATIVE ACTION/EQUAL OPPORTUNITY EMPLOYER The State… more
- Houston Methodist (Sugar Land, 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
- Guthrie (Sayre, PA)
- …clinical approaches and make recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the ... , utilization review, and payer knowledge. A Case Management certification or obtaining a ...as necessary in the performance of this position. + Travel for this position is sometimes required. + Participation… more
- Genesis Healthcare (York, PA)
- …Five to seven years of clinical nursing experience is required. Prior experience in utilization review, case management or discharge planning is required. ... a meaningful impact in the communities we serve. Responsibilities The Manager, Case Management is responsible for the clinical, administrative, and financial… more
Recent Jobs
-
Program Analyst Principal
- SAIC (Arlington, VA)
-
Plasma Cutting System Operator/Programmer
- SpaceX (TX)
-
Senior Mainframe DB2 System Programmer
- Ensono (Chicago, IL)
-
Systems Engineer / Principal Systems Engineer (AHT)
- Northrop Grumman (Hollywood, MD)
Related Job Searches:
Case,
Case Management,
Management,
Travel,
Travel Case Management,
Utilization