- Travelers Insurance Company (Buffalo, NY)
- …**What Is the Opportunity?** This position is responsible for conducting in-house utilization review with emphasis on determining medical necessity for ... do and where you do it. **Job Category** Claim, Nurse - Medical Case Manager **Compensation Overview** The annual...to the compensable injury and for adhering to multi-jurisdictional Utilization Review criteria. **What Will You Do?**… more
- Lowe's (Charlotte, NC)
- …clinical position. + 3-5 Years of Experience as a Case Manager or Utilization Review Nurse in worker 's compensation + Experience in a clinical position + ... including psychosocial factors, for catastrophic and complex cases on workers ' compensation injuries. Responsible for ensuring that employees receive appropriate… more
- Lincoln Financial Group (Jefferson City, MO)
- …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position...in a career at Lincoln, we encourage you to review our current openings and apply on our website.… more
- Sutter Health (Burlingame, CA)
- …and case management within a managed care environment. Comprehensive knowledge of Utilization Review , levels of care, and observation status. Awareness of ... acute care patient experience. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …NJ State Professional Registered Nurse License or NJ Licensed Social Worker **Job ID** _2024-150722_ **Department** _CC Utilization Review_ **Site** _HMH ... caseload. Collaborates with the attending LIP, Clinical Case Manager, nurse , and other members of the treatment team, ACCESS...a case by case basis. Applies case management and utilization review principles in monitoring the delivery… more
- Hartford HealthCare (Torrington, CT)
- …the Inpatient Nurse Director & Social Work Supervisor, the Inpatient Psychiatric Utilization Review Social Worker will work collaboratively with the IP ... Psychiatry Patient Care Team to assure Utilization Review activities on a 17 bed...care requirements and effectively obtain authorizations. This UR Social Worker will also provide comprehensive clinical social worker… more
- Billings Clinic (Billings, MT)
- …starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Utilization Review RN Billings Clinic ... - 44.18 Under the direction of department leadership, the Utilization Review / Management RN. This position is...complex patients/situations and communicate to the CM and/or Social Worker as appropriate Priority 5: Escalation Refers cases that… more
- The Mount Sinai Health System (New York, NY)
- **JOB DESCRIPTION** The Utilization Review Manager for the Selikoff Centers for Occupational Health is responsible for the management of program operations ... records, and internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with multiple professionals to support and… more
- Sedgwick (Charleston, WV)
- …and consult review ; and two (2) years of experience in daily application of nurse auditing, utilization review and bill review . **Skills & ... of education and experience required to include two (2) years workers ' compensation/bill review experience in multi-state jurisdiction; prior experience… more
- Centene Corporation (Baton Rouge, LA)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... is Required as One of the Following: + LCSW- License Clinical Social Worker + LMHC-Licensed Mental Health Counselor + LPC-Licensed Professional Counselor + Licensed… more