- Catholic Health (Buffalo, NY)
- …Weekend and Holiday Rotation Hours: 8:00 am to 4:00 pm Summary: The Registered Nurse (RN) Care Manager - Utilization Review , as an active member of the ... foundational nursing clinical skills and discharge planning principles, the RN Care Manager , Utilization Review collaborates with the interdisciplinary… more
- Community Health Systems (Bullhead City, AZ)
- …of clinical review , discharge planning, resource utilization and utilization review .** The Care Manager - RN is responsible for coordinating and ... play a vital role in doing what you do best - providing quality care to our patients.** **The RN collaborates with other disciplines including social workers,… more
- UPMC (Hanover, PA)
- **UPMC is hiring a part time Professional Care Manager for our Utilization Review department in Hanover! This is a part time, day shift position with a ... rotating weekend and holiday schedule.** **Purpose:** The Care Manager (CM) coordinates the clinical and financial plan for patients. Performs overall … more
- UNC Health Care (Smithfield, NC)
- …of case management, utilization review and discharge planning. The Care Manager must be highly organized professional with great attention to detail, ... processing) to Care Management Assistant. Consult Social Worker and/or Utilization Manager per established departmental protocol. Maintain knowledge of… more
- Beth Israel Lahey Health (Burlington, MA)
- …The Inpatient Registered Nurse (RN) Case Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors ... a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse...care experience. -Two years of Case Management or Utilization Management experience desirable. - Demonstrated ability to communicate… 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 ... and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager...care determination and the appeal/denial process. + Oversees utilization review workflow processes to ensure timely… more
- Stanford Health Care (Palo Alto, CA)
- …and Abilities** + Knowledge of principles and best practices of case management, utilization review , social work, care coordination and discharge planning. ... an RN - 3+ years of experience in case management/ utilization review Why work at Stanford Medicine...while honoring its commitment to delivering evidence-based and patient-centered care . We are seeking a results-driven manager … more
- Houston Methodist (The Woodlands, TX)
- …approved utilization criteria to monitor appropriateness of admissions, level of care , resource utilization , and continued stay. Reviews level of care ... for hospital services by communicating medical information required by all external review entities, managed care contracts, insurers, fiscal intermediaries, and… more
- Ascension Health (Baltimore, MD)
- …salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes ... implement quality review programs and key performance indicators for all utilization review activities. + Interact with medical, nursing, and executive… 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....with medical terminology and in criteria for acute psychiatric care or combination of education and experience preferred. +… more
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