• Care Manager ( UM / UR…

    Magellan Health Services (Boise, ID)
    …and implement solutions that directly influence quality of care . General Job Information Title Care Manager ( UM / UR ) - Remote, Idaho Licensed Grade 24 ... + Maintains an active work load in accordance with National Care Manager performance standards. + Works with community agencies as appropriate. Proposes… more
    Magellan Health Services (04/27/25)
    - Related Jobs

  • Supv Regional Care Mgmt- Integrated…

    Sharp HealthCare (San Diego, CA)
    …and CMS. Develops and implements new programs under the direction of the manager of in-patient care management and the Director of Utilization Management. ... and goals.Consults with Hospitalists in a timely and effective manner.Document UR / UM processes according to SCMG policies and procedures.Demonstrates positive… more
    Sharp HealthCare (07/09/25)
    - Related Jobs

  • Care Manager - Per Diem

    Stony Brook University (Stony Brook, NY)
    Care Manager - Per Diem **Position...review screen for inpatient and observation cases. Activity includes UR from the Emergency Room or on the unit ... Summary** At Stony Brook Medicine, a ** Care Manager ** is a valuable member of...their work and follow up with cases. **Preferred:** CM, UM , Quality, Coding, Risk or MCG Certification Working knowledge… more
    Stony Brook University (07/15/25)
    - Related Jobs

  • Manager Utilization Management

    Beth Israel Lahey Health (Burlington, MA)
    …making a difference in people's lives.** Manages the Utilization Management ( UM ) team, maintaining effective and efficient processes for determining appropriate ... regulatory and reimbursement requirements of various commercial and government payers. Manages UM department in the context of other Revenue Cycle functions such as… more
    Beth Israel Lahey Health (06/06/25)
    - Related Jobs

  • Manager of Case Management

    LifePoint Health (Hickory, NC)
    …in the absence of the Director. Accountable for the execution, adaptation, and outcome of care management as described in the initial UM plan with regard to ... Job Summary Manager of Case Management in the departments activities...beautiful foothills of North Carolina is a 355-bed acute care hospital, 81-bed Behavioral Health facility and more than… more
    LifePoint Health (07/15/25)
    - Related Jobs

  • Utilization Management Specialist

    Cleveland Clinic (Cleveland, OH)
    …RN Case Manager , Physicians and the multidisciplinary team. + Document appropriately in UM notes to provide evidence that the UR process for the case was ... and adequacy of documentation + Knowledge and experience with Care Guidelines, Medical Necessity Criteria and/or other UM... Care Guidelines, Medical Necessity Criteria and/or other UM criteria sets + Ability to assess medical records… more
    Cleveland Clinic (07/22/25)
    - Related Jobs

  • Director Physician Advisor

    Catholic Health Services (Melville, NY)
    …and human services agencies. Our health system has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a network ... we treat and serve our communities. We work collaboratively to provide compassionate care and utilize evidence based practice to improve outcomes - to every patient,… more
    Catholic Health Services (06/27/25)
    - Related Jobs