- Santa Clara Family Health Plan (San Jose, CA)
- Utilization Management Review Nurse LVN Salary Range: $74,557 - $111,835 The expected pay range is based on many factors, such as experience, education, ... guidance and direction of the UM department RN Manager or Director, the Utilization Management Review Nurse (LVN) performs prospective and retrospective… more
- Alameda Health System (San Leandro, CA)
- Clinical Nurse III, Acute Inpatient Behavioral Health Utilization Management + San Leandro, CA + John George Psychiatric Hospital + JGP Care Coordination + ... identified fields in EHR. 17. Maintains current knowledge of clinical practice and Utilization Management by literature review , membership in a professional… more
- Universal Health Services, Inc. (Temecula, CA)
- …The Southwest Healthcare Regional office in Temecula, CA is seeking a Per-Diem RN Central Utilization Review Nurse who will be responsible for carrying out ... hospital setting with (1) year in of inpatient Care Management and/or Utilization Review experience...and Abilities: Demonstrates knowledge and ensures compliance with the Nurse Practice Act, The Joint Commission and Title 22… more
- Alameda Health System (Oakland, CA)
- …plans Role Overview: Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight, strategic ... hoc duties as needed. In essence, they orchestrate efficient utilization management to deliver high-quality patient care....in the classification. Lead and manage a team of utilization review professionals providing guidance, training, and… more
- Katmai (Fort Carson, CO)
- **SUMMARY** Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE eligible beneficiaries within the ... standards for appropriate utilization of services. Perform utilization management / review for medical necessity...within the last four (4) years as a registered nurse in utilization management . +… more
- Universal Health Services, Inc. (Highlands Ranch, CO)
- …acute care, partial hospitalization, and intensive outpatient programs. Website: The Utilization Review Coordinator possesses knowledge of psychiatric clinical ... and advocates for patient length of stay and level of care. Oversees utilization review activities with other departments to ensure reimbursement for services… more
- Commonwealth Care Alliance (Boston, MA)
- …clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring ... the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer...**Essential Duties & Responsibilities:** + Conducts timely clinical decision review for services requiring prior authorization in a variety… more
- Universal Health Services, Inc. (Leesburg, VA)
- Responsibilities Join Our Team as a Utilization Review Coordinator! North Spring Behavioral Healthcare is looking for a fulltime Utilization Review ... 90 days. 401(k) with company match - Eligible after 30 days. The Utilization Review Coordinator assists admissions in screening patients at the pre-hospital… more
- Universal Health Services, Inc. (Franklin, TN)
- …need. www.rollinghillshospital.org Rolling Hills Hospital is seeking a dedicated and detail-oriented Utilization Management Manager to join our dynamic UM team. ... services and optimize reimbursement for the hospital. Qualifications: Proven experience in utilization management or a related field. Strong analytical and… more
- Universal Health Services, Inc. (West Columbia, SC)
- …precertification and verification of benefits for incoming patients. Coordinates the utilization management functions of a patient caseload through collaboration ... degree in a recognized mental health field or Registered Nurse . Experience: Minimum of two years psychiatric experience in...years psychiatric experience in chart analysis and in the utilization review field. Excellent oral and written… more
