- CHRISTUS Health (Hollywood Park, TX)
- …and operations for assigned areas; at CHRISTUS St. Patrick Hospital. The nurse manager affects departmental outcomes through interpretation, implementation, and ... excellence in patient care, patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically… more
- CHRISTUS Health (Wake Village, TX)
- … is required. Experience Minimum of two (2) years' experience in Case Management and/or Utilization Management is required. Licenses, Registrations, or ... Description Summary: The Registered Nurse Clinical Care Coordinator is responsible for evaluating,...errors are identified to maximize hospital reimbursement and resource utilization . * Responsible for 24/7 ongoing management … more
- Humana (Salem, OR)
- **Become a part of our caring community and help us put health first** The Manager , Utilization Management Nursing utilizes clinical nursing skills ... documentation and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Nursing works… more
- Commonwealth Care Alliance (Boston, MA)
- …care services,procedures, and facilities under the provisions of CCA's benefits plan.The Manager , Utilization Management is responsible for overseeing and ... managing the daily operation of the Utilization Management Review Nurse and...in the area of service decisions and organizational determinations.The Manager , Utilization Management reports to… more
- Providence (Mission Hills, CA)
- **Description** The Manager of Utilization Management provides a key role in leading, facilitating and managing the hospital utilization management ... The Manager assists the Regional Director of Utilization Management , Appeals & Clinical Training through...care utilization management or appeals management . **Preferred Qualifications:** + Master's Degree in Nursing… more
- CVS Health (Springfield, IL)
- …**Position Summary:** The Associate Manager is responsible for oversight of Utilization Management /Case Management staff. This position is responsible ... Nurse + 3+ years of Managed Care experience + 1+ years of Utilization Management experience + 1+ year Leadership experience (formal or informal roles) +… more
- Trinity Health (Silver Spring, MD)
- …Type:** Full time **Shift:** **Description:** The Interim Manager of Care Management & Utilization Review, under the supervision and in collaboration with ... applicable):** + State of Maryland license as a Registered Nurse + RN with BSN or RN with >...area. + Extensive knowledge of payer mechanisms and clinical utilization management is required. + Knowledge of… more
- UCLA Health (Los Angeles, CA)
- …the next level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management , you'll provide direct management ... RN licensure in CA required + Bachelors of Science, Nursing (BSN) degree required + Five or more years...(BSN) degree required + Five or more years of utilization management required + Four or more… more
- VNS Health (Manhattan, NY)
- …experience in management for a health plan or utilization /case management Required Master's Degree in Nursing or Health Care Administration Preferred ... OverviewManages the utilization management team to ensure that...and current registration to practice as a registered professional nurse in New York State Required Valid driver's license… more
- Sharp HealthCare (San Diego, CA)
- …Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse (RN) - CA Board of Registered Nursing **Hours** **:** **Shift Start ... management , utilization review, care coordination experience + California Registered Nurse (RN) - CA Board of Registered Nursing -REQUIRED **Preferred… more
