- Hartford HealthCare (Willimantic, CT)
- …**Title:** *Registered Nurse Case Manager (RN) - Utilization Management * **Location:** *Connecticut-Willimantic-Windham Community Memorial (10183)* ... nursing required. * Two years experience with case management , discharge planning, utilization review and/or home care required. * Knowledge of the … more
- CVS Health (Austin, TX)
- …more compassionate. And we do it all with heart, each and every day. Utilization Management - Infertility Precertification unit **Position Summary** This is a ... Work at Home role. Working hours are Mon-Fri 8-5pm in your...experience with Microsoft Office applications (Outlook, Teams, Excel) + Utilization Management is a 24/7 operation and… more
- Sanford Health (Rapid City, SD)
- …providing direct supervision of all departmental staff. Maintains a standardization of utilization management process to ensure all policies and procedures are ... Full time **Weekly Hours:** 40.00 **Department Details** Join our team as a Utilization Review and Case Management Manager and lead a high-impact, data-driven… more
- Integra Partners (Troy, MI)
- …experienced in the managed care payor environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. This individual will play a key ... UM program. Salary: $60,000.00/annual JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES The UM Nurse 's responsibilities include but are not limited to: + Perform… more
- US Tech Solutions (Columbia, SC)
- …established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency and claims knowledge/analysis to ... education with members and providers regarding health care delivery system, utilization on networks and benefit plans. Serves as member advocate through… more
- Albany Medical Center (Albany, NY)
- …clinical experience in an assigned service.* Recent experience in case management , utilization management and/or discharge planning/ home care in a high ... Day (United States of America) Salary Range: $71,612.39 - $110,999.20 Responsible for Utilization Management , Quality Screening and Delay Management for… more
- CenterWell (Austin, TX)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous...Current nursing experience in Hospital, SNF, LTAC, DME or Home Health. + Bilingual We offer tangible and intangible… more
- Truman Medical Centers (Kansas City, MO)
- …time **Work Schedule** 7:30AM - 4:00PM **Hours Per Week** 40 **Job Description** The Utilization Management Nurse (UM RN) collaborates with members of the ... into myWORKDAY (http://www.myworkday.com/trumed/d/ home .htmld) to search for positions and apply.** Utilization Mgmt Nurse RN - Care Continuity - UH Truman… more
- Sanford Health (Rapid City, SD)
- …community. **Job Summary** Provides expertise and leadership to ensure effective resource management for patient care delivery across the care continuum for assigned ... patient wellness through evidenced based practice, improved care outcomes, efficient utilization of health services, and appropriate level of care for patients… more
- Tenet Healthcare (Detroit, MI)
- …national standards for case management scope of services including: Utilization Management services supporting medical necessity and denial prevention ... potentially avoidable days Other duties as assigned. POSITION SPECIFIC RESPONSIBILITIES: Utilization Management Balances clinical and financial requirements and… more
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