- Dartmouth Health (Lebanon, NH)
- Overview The Manager of Utilization Management is responsible for day to day operations of the utilization review program at multiple Dartmouth Health ... communication and computer skills desired. Required Licensure/Certifications - Licensed Registered Nurse with NH eligibility - BLS certification required. *… more
- ERP International (Corpus Christi, TX)
- **Overview** ERP International is seeking a ** Registered Nurse (RN)** ** Utilization Manager ** for a full-time position in support of the **Naval Health ... staff, newcomers, as appropriate. * Participate in all phases of the Utilization Management Program (UMP) and ensure that the UMP meets established … more
- Sutter Health (Burlingame, CA)
- **Organization:** Bay Administration **Position Overview:** Responsible for Utilization Management and accurate bed placement for patients coming in from the ED. ... acute care patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the… more
- Cedars-Sinai (Los Angeles, CA)
- …thereafter as a condition of continued employment. **Req ID** : 5044 **Working Title** : Registered Nurse - Utilization Management 8 Hour Days Per Diem ... Hospitals! **What You Will Do in This Role:** The Utilization Review Case Manager validates the patient's...**Department** : Utilization Management **Business Entity** : Cedars-Sinai Medical Center **Job Category**… more
- Humana (Louisville, KY)
- …a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... services and/or benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work assignments are varied and… more
- Veterans Affairs, Veterans Health Administration (St. Louis, MO)
- …Care System (VASTLHCS), St. Louis, Missouri. The Registered Nurse Case Manager ( Utilization Management ) demonstrates leadership, experience, and creative ... approaches in providing complex patient management in delivering and improving holistic care through collaborative...VA Nurse Total Rewards The primary purpose of this Registered Nurse Case Manager (RNCM) is to… more
- UNC Health Care (Raleigh, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection by reconciling physician orders,… more
- Lucile Packard Children's Hospital Stanford (Palo Alto, CA)
- …include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient charts for timeliness ... of services as well as appropriate utilization of services; and ensuring optimum use of resources,...delivery and quality of patient care. A hospital-based case management system has as its primary goal to ensure… more
- Molina Healthcare (NV)
- …not a compact state at this time.** **Prior experience with managed care (Medicaid, Medicare) Utilization Management processes and 3 + years in management / ... performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.),… more
- Trinity Health (Silver Spring, MD)
- …acute healthcare setting required. + Extensive knowledge of payer mechanisms and clinical utilization management is required **Preferred:** + At least 5-7 years ... - 4:30pm + Reporting to the Director of Care Management + The RN Manager is responsible...RN Case Managers for in inpatient care coordination and utilization review. Oversees interactions of staff with outside activities… more