- Alameda Health System (Oakland, CA)
- System Utilization Management SUM Utilization Review ...+ Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time ... + FTE:1 + Posted:Today **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review RN is responsible for ensuring the appropriate… more
- Penn Medicine (Princeton, NJ)
- …living your life's work? **Schedule:** Full Time **Summary:** + Conducts Utilization Management reviews for Princeton House patients, assigned by the ... in the SQL Database as per department policies and procedures. Conducts Utilization Management reviews for assigned patients, regardless of their insurance,… more
- Great River Health (West Burlington, IA)
- …maintaining compliance with the CMS Conditions of Participation for Utilization Management .What you will do + Review inpatient encounters for medical ... 4-6 years clinical experience Required + Previous experience in Utilization Review Preferred + Knowledge of the...patients. + Managing one's own time to ensure effective Utilization Management . + Giving full … more
- Beth Israel Lahey Health (Plymouth, MA)
- …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** ... **Job Type:** Regular **Time Type:** Full time **Work Shift:** Day (United States of...and Serve Your Community!** **In your role as a Utilization Review & Denials Management … more
- Mount Sinai Health System (New York, NY)
- …and efficient care to patients, the delivery of comprehensive front-line Case Management services, including utilization management , care facilitation and ... management is preferred Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West...by focusing on patient processes. 9. Develops and implements Utilization Review (UR) based on internal data… more
- AmeriHealth Caritas (Charleston, SC)
- …. **Responsibilities:** Under the direction of the Supervisor, the Behavioral Health Utilization Management Reviewer is responsible for completing medical ... all information necessary to perform a thorough medical necessity review . It is within the BH UM Reviewer...of behavioral health and substance use disorder experience.; + Utilization management experience in a managed care… more
- Monroe Plan for Medical Care (Albany, NY)
- …Title: Utilization Reviewer RN ID:UM41-ALBANY Location:Albany Job Type: Full -time Date Posted:04/17/2025 Openings:1 Department: Utilization Management ... a supportive, inclusive culture! We are currently looking for an experienced and qualified, full time RN for Utilization Management . We offer competitive… more
- Matrix Providers (Aurora, CO)
- … management , utilization review or case management . Licensure/Registration: Current, full , active, and unrestricted license to practice as ... Utilization Review Nurse (RN) Location: Aurora,...Handbook) + 401(k) Plan Minimum Requirements Registered Nurse (RN) Utilization Management : Degree/Education: Bachelor-s degree in nursing.… more
- Centers Plan for Healthy Living (Margate, FL)
- …accepting applications for Full Time Registered Nurse without experience. The Utilization Management Clinical Reviewer works within a multidisciplinary ... care or support in their home to improve their quality of life. Utilization Management Clinical Reviewer will assess and process all authorization requests… more
- Hartford HealthCare (Hartford, CT)
- …and more than 30 different specialties. *_ Job Description_* The Surgical Clinical Reviewer 's (SCR) chief responsibility is to collect and submit reliable data to ... over the course of the patient's care through effective utilization of the hospital and surgeons' office record systems....departments, and others whose support is necessary for the management and success for the program. . Serves as… more