- Covenant Health (Bangor, ME)
- …the supervision 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 advocate... conducts medical necessity reviews in accordance with the Utilization Management (UM) plan for patients that are housed… 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 ... coordination of care. In this role you will perform utilization review while assuring the delivery of...RN License and BLS certification + Recent experience in case management, utilization management and discharge planning… more
- Morris Hospital (Morris, IL)
- …using evidenced-based clinical guidelines. Performs duties in accordance with the Utilization Review Plan. Demonstrates thorough knowledge of performance measure ... in acute hospital setting. + Strong clinical expertise. + Prior experience in utilization management or case management preferred. + Ability to maintain… more
- LifePoint Health (Danville, VA)
- *Registered Nurse, RN - Utilization Review Case Manager * Job Type:Full Time|Days *$10,000 Sign-on Bonus Eligibility for Full-Time, Bedside RNs* ** Must ... have Utilization Review experience.** ** * ** *Your...offering safe discharge planning is the use of a Utilization RN and Case Manager ...the use of a Utilization RN and Case Manager RN, in conjunction with a… more
- University of Miami (Miami, FL)
- …please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Utilization Review Case Manager ... of Miami is currently seeking a Prior Authorization Nurse Case Manager . The incumbent purose is to...forth by the payer or clinical guidelines + Accurate review of coverage benefits and payer policy limitations to… more
- Beth Israel Lahey Health (Burlington, MA)
- …a job, you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital and Medical ... Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality...Case Manager experience as well as Utilization Review experience ( review medical… more
- Avera (Sioux Falls, SD)
- …from Avera facilities as Swing Bed transfers. + Supports compliance with Utilization Review Process. Case Manager will have ongoing conversation with ... Transfer Center RN and accepting physician. The Transfer Center Case Manager reviews patients for medical necessity,...Utilization Review staff on patients status and ongoing coverage +… more
- CVS Health (Beckley, WV)
- …+ Foster care experience + Crisis intervention skills + Managed care/ utilization review experience + Certified Case Manager (CCM) certification + ... care more personal, convenient and affordable. **Position Summary** The Case Manager RN (CM RN) is responsible...face member visits + Using clinical tools and information/data review , conducts an evaluation of member's needs and benefit… more
- Mayo Clinic (Jacksonville, FL)
- …care coordination, resource utilization , and clinical documentation. The RN Case Manager will function within the Mayo Clinical Nursing Professional ... Case Manager provides leadership through education on case management/ utilization management concepts, committee work, research, and community… more
- Prime Healthcare (Kansas City, MO)
- …and maintain current. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/194396/rn- case - manager - utilization - review ... met. Work with both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently and use… more