- Sanford Health (Rapid City, SD)
- …Schedule:** Full time **Weekly Hours:** 40.00 **Department Details** Join our team as a Utilization Review and Case Management Manager and lead a ... providing direct supervision of all departmental staff. Maintains a standardization of utilization management process to ensure all policies and procedures are… more
- Commonwealth Care Alliance (Boston, MA)
- …CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) ... service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has...accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy + Works… more
- Huron Consulting Group (Chicago, IL)
- …Join our team as the expert you are now and create your future. The Manager of Utilization Management is responsible for planning, organizing, developing, ... Review Plan and the overall operation of the Utilization Management Department in accordance with federal,...and may be implemented in the future._ **Position Level** Manager **Country** United States of America At Huron, we're… more
- Houston Methodist (Houston, TX)
- …Provides education to physicians, nurses, and other health care providers on utilization management topics. + Initiates improvement of department scores for ... At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position...state, local, and federal programs + Comprehensive knowledge of utilization management , case management , performance… more
- Saint Francis Health System (OK)
- …their placement in various levels of care and receipt of necessary services. The Utilization Management (UM) Registered Nurse will communicate with providers ... not all inclusive nor does it prohibit the assignment of additional duties. Utilization Review Management - Yale Campus Location: Virtual Office, Oklahoma 73105… more
- University of Utah Health (Salt Lake City, UT)
- …communication skills. + Demonstrated knowledge of payers, payer systems, cost effective utilization management and InterQual criteria. + The ability to ... and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** +… more
- CenterWell (San Juan, PR)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- CenterWell (Austin, TX)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare… more
- Dignity Health (Gilbert, AZ)
- …and Responsibilities** Under the general direction of the Director of Care Management , performs criteria-based concurrent and retrospective utilization review to ... of nursing experience + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification + Utilization Review experience **Where You'll… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- … review functions. Oversees daily operations, which include supervising staff performing utilization management activities. The goal is to achieve clinical, ... *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional...financial, and utilization goals through effective management , communication, and… more