- Healthfirst (NM)
- … management, identifying alternative care options, and discharge planning** + **Certified Case Manager ** + **Interqual and//or Milliman knowledge** + **Knowledge ... This position is 100% Remote** **Duties//Responsibilities:** + **Provides case management services for assigned member caseloads which includes:** +… more
- Queen's Health System (Honolulu, HI)
- …manages administrative and clinical operations of Emergency Department and Inpatient Case Management services. * Develops, implements, monitors and evaluates for ... (5) years nursing experience with at least three (3) years experience in Case Management. * Two (2) years supervisory/leadership experience. * Prior experience in a… more
- Community Based Care of Brevard, Inc. (Orlando, FL)
- Salary: $65,000/year Position Summary: The UM Program Manager provides oversight and management of service authorization data validation, reporting and trend ... provider invoices, reviews line-by-line entries, and submits to finance for payment. The UM Program Manager reconciles ARGOS Dependency Cases to FSFN for… more
- Providence (Santa Rosa, CA)
- …degree for Case Management/ UM Review: Nursing or related field. + Certified Case Manager (CCM) or Accredited Case Manager (ACM) upon hire + ... **Description** RN Manager - Case Management unit at...related field - Nursing Preferred. + Bachelor's degree for Case Management/ UM Review: Nursing or related… more
- Fallon Health (Worcester, MA)
- …and/or G drive. + Manage applicable queues in both the core system (QNXT UM and Call Tracking) and the case management application (TruCare). + ... **Brief Summary of Purpose:** Under the direction of the Manager of Prior Authorization, communicates with contracted and non-contracted… more
- Molina Healthcare (GA)
- …The license must be active and unrestricted in state of practice. Certified Case Manager (CCM), Certified Professional in Health Care Management certification ... JOB DESCRIPTION **Job Summary** The Supervisor, Healthcare Services UM leads and supervises a multidisciplinary team of...Georgia RN licensure and at least 3 years of UM experience. The candidate must have strong organization, communication,… more
- Molina Healthcare (Orlando, FL)
- …medications safety and medication use policies). **KNOWLEDGE/SKILLS/ABILITIES** The Pharmacist, UM will be responsible for reviewing coverage determinations and ... in a timely, compliant, and accurate manner. The Pharmacist, UM will also be responsible for serving as a...changes for the upcoming year. + Works with the Case Management department as part of a member-centered interdisciplinary… more
- Sharp HealthCare (San Diego, CA)
- …Professional in Healthcare Quality (CPHQ) - National Association for Healthcare Quality; Certified Case Manager (CCM) - Commission for Case Manager ... - National Association for Healthcare Quality -PREFERRED + Certified Case Manager (CCM) - Commission for ...and enforce policies and procedures for HSM that involve Case Management and UM . Serves as the… more
- ERP International (Yuma, AZ)
- **Overview** ERP International, LLC is seeking a **Registered Nurse - Case Manager ** for a full-time position at the Camp Pendleton **Branch Health Clinic** in ... for community resources. * Integrate CM and utilization management ( UM ) and integrating nursing case management with...for professional growth and development as related to the case manager position and maintenance of CM… more
- OhioHealth (Columbus, OH)
- …- in our careers and in our communities. **Job Description Summary:** The Case Manager extender works collaboratively with all interdisciplinary staff internal ... room and bed charges and performing charge reconciliation. The case manager extender is well organized, highly...utilization management/clinical decisions beyond level of authority to care coordination/ UM team and Manager /Director of UM… more