- Magellan Health Services (Boise, ID)
- …and implement solutions that directly influence quality of care . General Job Information Title Care Manager ( UM / UR ) - Remote, Idaho Licensed Grade 24 ... + Maintains an active work load in accordance with National Care Manager performance standards. + Works with community agencies as appropriate. Proposes… more
- Elevance Health (Grand Prairie, TX)
- …an equivalent background. **Preferred Qualifications** + Knowledge of medical management process ( UM / UR ) and ability to interpret and apply member contracts, ... limited to: + Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient admissions, outpatient services,… more
- Cleveland Clinic (Vero Beach, FL)
- Under the general supervision of the UM Team Manager , this individual performs UM activities which includes admission review, concurrent review, ... special projects which are coordinated and directed by the UM Team Manager . May design and initiate...of admission and continued stays. + Document appropriately in UM notes to provide evidence that the UR… more
- Sharp HealthCare (San Diego, CA)
- …management process.Identify and refers situations needing immediate intervention to UR Manager , Physician Advisor, as appropriate.Participate in system ... Integrated Care Management (ICM) team the Transfer and Admissions Utilization Manager ( UM ) partners with the Centralized Patient Placement Center (CPPC) RN's… more
- Covenant Health (Nashua, NH)
- Summary Conducts medical necessity reviews in accordance with the Utilization Management ( UM ) plan for patients that are housed on a nursing unit, to include ... services and Outpatients in a Bed. Identifies delays in care . Documents and communicates findings with the care...and documents as per department guidelines. + Follows established UM processes for patients not meeting criteria by utilizing… more
- Sharp HealthCare (San Diego, CA)
- …management process. Identify and refers situations needing immediate intervention to UR Manager , Physician Advisor, as appropriate. Participate in system ... **Shift End Time** Bachelor's Degree; Bachelor's Degree in Nursing; Certified Case Manager (CCM) - Commission for Case Manager Certification; California… more
- Elevance Health (Grand Prairie, TX)
- …Nurse II** is responsible for providing case management and/or medical management ( UM / UR ) for members receiving transplant services. Within the case management ... (compact license). + Both Case Management and Medical Management ( UM / UR ) is highly desired. + Within the...care products preferred. + Certification as a Case Manager is preferred. + Previous work from home/remote experience… more
- Providence (Mission Hills, CA)
- …working with a remote UR team + Previous experience as a case manager in an acute care setting **Why Join Providence?** Our best-in-class benefits are ... **Description** The Manager of Utilization Management provides a key role...criteria. This role acts as a facilitator between the UM RNs and the ministry Care Management… more
- SSM Health (St. Louis, MO)
- …Managers colloborate with Social Workers for care coordination and discharge planning and exclude UM or UR . You can expect a patient ration of 1:22. The New ... eligible for a $25,000 Sign On Bonus! RN Case Manager opportunity to work with a colloborative team at...a team that is dedicated to providing exceptional patient care and making a difference in people's lives. Our… more
- Catholic Health Services (Melville, NY)
- …and human services agencies. Our health system has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a network ... we treat and serve our communities. We work collaboratively to provide compassionate care and utilize evidence based practice to improve outcomes - to every patient,… more