- University of Miami (North Miami, FL)
- …University 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… more
- Sharp HealthCare (San Diego, CA)
- …+ Collaboration and teamwork Provides consultation and direction for Case Manager Utilization Management, and non -clinical support team members regarding ... End Time** Bachelor's Degree; Bachelor's Degree in Nursing; Certified Case Manager (CCM) - Commission for ...area of specialty. + 2 Years clinical experience in Utilization Review, Discharge Planning and/or Case Management… more
- Beth Israel Lahey Health (Burlington, MA)
- …just taking a job, you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient ... **Work Shift:** Day (United States of America) **FLSA Status:** Non -Exempt **When you join the growing BILH team, you're...effectively with medical and hospital staffs. - Case Manager experience as well as Utilization Review… more
- Elevance Health (Washington, DC)
- Manager ll HCMS - Utilization and Case Management (JR142403) **Location:** This position requires travel to our Washington, DC office 4 days each week. The ... Qualifications:** + Masters in related Health/Nursing field preferred. + Certified Case Manager Certification preferred. + 3 years management experience… more
- Dignity Health (Phoenix, AZ)
- …unrestricted Arizona RN license + National certification of any of the following: CCM (Certified Case Manager ), ACM (Accredited Case Manager ) required or ... **Responsibilities** **This role is for the Arizona and Nevada markets.** The Utilization Management (UM) Manager is responsible for managing day-to-day UM… more
- VNS Health (Manhattan, NY)
- …Degree or equivalent work experience in management for a health plan or utilization / case management Required + Master's Degree in Nursing or Health Care ... York State Required + Valid driver's license or NYS Non -Driver photo ID card, may be required as determined...related field, including three years of progressive experience in case or utilization Management Required + Effective… more
- Stanford Health Care (Palo Alto, CA)
- …Skills and Abilities** + Knowledge of principles and best practices of case management, utilization review, social work, care coordination and discharge ... delivering evidence-based and patient-centered care. We are seeking a results-driven manager to further develop the framework for clinical, operational, and… more
- University of Miami (Miami, FL)
- …The University of Miami Health System has an exciting opportunity for a per diem Utilization Case Manager to work at Sylvester Support Services Building. The ... clinical utilization and identifying the need for continued authorization. The Utilization Case Manager coordinates with the Nurse Case Manager… more
- Munson Healthcare (Traverse City, MI)
- …about the patient's clinical status and progression of care. + Consults with case manager and/or physician advisor as necessary to resolve progression-of-care ... for appropriate level of care. + Coordinates with ED Case Manager to recommend alternate placement from...with patients, families, interdisciplinary team members, payers and external case managers Why work as a Utilization … more
- University of Utah Health (South Salt Lake, UT)
- …members or third-party payer. + Alerts and discusses with physician/provider and case manager /discharge planner when patient no longer meets medical necessity ... any case that surpasses expected LOS, expected cost, or over/under- utilization of resources. + Performs verbal/fax clinical review with payer as determined… more