- Elliot Health System (Londonderry, NH)
- …experienced Nurses who meet the requirements below! Apply today! About the Job: The Case Manager RN will collaborate with other members of the health care team ... On Bonus paid in 3, 6, and 12 months RN Case Manager Who We Are: The...pride in serving their community, patients, and families. Our Nurse Case Managers observe best practices and strive to… more
- UNC Health Care (Chapel Hill, NC)
- …care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management ... and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and...date. **Licensure/Certification Requirements:** * Licensed to practice as a Registered Nurse in the state of North… more
- University of Miami (North Miami, FL)
- …of Miami UHealth - CTU at SoLe Mia has an exciting opportunity for a Utilization Case Manager . CORE JOB FUNCTIONS + Adhere and perform timely reviews for ... services requiring an authorization for continuation of care + Follows the authorization process using established criteria as set forth by the payer or clinical guidelines + Accurate review of coverage benefits and limitations to determine continued… more
- Dignity Health (Phoenix, AZ)
- …**Responsibilities** **This role is for the Arizona and Nevada markets.** The Utilization Management (UM) Manager is responsible for managing day-to-day UM ... necessity determinations; processes appeals and reconsiderations. Act as a working manager within Utilization Management, performing essential duties and… more
- Humana (Boise, ID)
- …**Use your skills to make an impact** **Required Qualifications** + Active Licensed Registered Nurse ( RN ) in Virginia or enhanced compact license, ... of our caring community and help us put health first** The Manager , Utilization Management Nursing utilizes clinical nursing skills to support the coordination,… more
- UCLA Health (Los Angeles, CA)
- …for assessing and coordinating care for a diverse group of patients. This in-patient utilization review case manager position will work on-site at our UCLA ... coordination of care. In this role you will perform utilization review while assuring the delivery of concurrent and...accepted for current UCLA Health Nursing staff) + CA RN License and BLS certification + Recent experience in… more
- Humana (Jefferson City, MO)
- …**Required Qualifications:** **Must meet** **one** **of the following:** + Active unrestricted registered nurse license in the state of Virginia or reside ... manager required. **Additional Information:** **Workstyle:** Remote work at Home **Location for Registered Nurse :** must reside in the state of Virginia or… more
- Catholic Health Services (Melville, NY)
- …Health was named Long Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and ... from payors for additional clinical documentation. |Acts as liaison between the Utilization and Appeals Management Department and the physician of record, as… more
- Covenant Health (Bangor, ME)
- …of the VP of Accountable Care Operations & Population Health Strategy the Utilization Review Case Manager will work collaboratively with other members of ... the healthcare team. The nurse case manager also acts as an... conducts medical necessity reviews in accordance with the Utilization Management (UM) plan for patients that are housed… more
- Beth Israel Lahey Health (Burlington, MA)
- … Utilization Review Nurse **Job Description:** The Inpatient Registered Nurse ( RN ) Case Manager for Hospital at Home Care Transitions coordinates ... to meet the needs of the department. **Minimum Qualifications:** Education: * Registered Nurse , Bachelors Degree or commensurate experience preferred. Licensure,… more
