- Actalent (Minnetonka, MN)
- …the medical necessity of post-acute stays. Essential Skills + Expertise in utilization management and utilization review . + Experience in acute care and ... Utilization Management Nurse Job Description As...inpatient rehabilitation, and long-term acute care hospitals. Responsibilities + Review and document prior authorization and concurrent stay requests.… more
- University of Utah Health (Salt Lake City, UT)
- …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** ... + Demonstrated knowledge of payers, payer systems, cost effective utilization management and InterQual criteria. + The...Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of… more
- Ventura County (Ventura, CA)
- …direction, the Senior Medical Management Nurse is responsible for performing utilization review , case management , and quality improvement functions to ... be used to fill current and future Regular (including Temporary and Fixed-term), Intermittent, and Extra Help vacancies for..., Disease Management , Quality Assurance, HEDIS and/or Utilization Review . NECESSARY SPECIAL REQUIREMENTS + Must… more
- Prime Healthcare (Inglewood, CA)
- …provides leadership and supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and ... Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patients… more
- Actalent (Santa Barbara, CA)
- …treatment modalities, community standards, and professional nursing standards. Essential Skills + Utilization management and review experience. + Strong ... to various Health Services operational units. These units include Utilization Management , Case Management , Enhanced...program terms. If eligible, the benefits available for this temporary role may include the following: * Medical, dental… more
- State of Colorado (Pueblo, CO)
- …are understood, actionable, and tied to CMHHIP's improvement goals. + Participate in utilization management and review activities when requested, applying ... a start date prior to January 5, 2026 This position will receive a short-staffing temporary pay differential of 4% from July 1, 2025 - June 30, 2026. Colorado Mental… more
- University of Utah Health (Salt Lake City, UT)
- …education in healthcare or a related field. + One year of experience in a utilization review or case management environment. + Basic Life Support Health ... prepared and delegated by social work or nurse case management by coordinating with home care agencies, post-acute care...+ Documents activities and progress in medical charts, computer billing/ utilization systems, or in other ways as directed. +… more
- New York State Civil Service (Albany, NY)
- …mental illness in a clinical capacity, as well as experience with utilization management and/or utilization review . ? The ideal candidate(s) will have ... direct care and utilization management experience, including familiarity with the review ...time, agencies may recruit and hire employees by making temporary appointments.At a future date (within one year of… more
- Emory Healthcare/Emory University (Decatur, GA)
- …_,_ and leadership programs + And more **Description** We're seeking a **Clinical Utilization Review Nurse Preceptor (Registered Nurse / RN)** . This individual ... will be responsible for training, mentoring, and coaching for the Utilization Review Department and must be an expert in the utilization review functions… more
- University of Utah Health (Salt Lake City, UT)
- …trust that are integral to our mission. EO/AA_ + The Staff Utilization Coordinator is responsible for providing healthcare operational support services, including ... Timekeeping team. + Collaborating closely with Nursing Leadership, the Staff Utilization Coordinator reviews and develops schedules based on agreed-upon staffing… more