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The Utilization Management Nurse oversees the care of a participant as they move from one health care facility, such as a hospital or nursing home, to another facility or their home.
$79,040 a yearFull-timeExpandApply NowActive JobUpdated 2 months ago - UpvoteDownvoteShare Job
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Managed care/utilization review experience preferred. Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program.
$29.1 - $62.31Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The Utilization Management Nurse collaborates as necessary with other members of the health care team to ensure the above according to the mission of CHRISTUS. The Utilization Management Nurse III is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services.
Full-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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The Utilization Management (UM) Coordinator (CIDD) supports the comprehensive coordination of medical services including intake, screening, and referrals to Florida Community Care (FCC) care management and promotes/supports quality effectiveness of healthcare services.
Full-timeExpandApply NowActive JobUpdated 16 days ago - UpvoteDownvoteShare Job
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Manage the operations and activities of the Care Coordination Department including discharge planning, utilization management and high-risk case management. Director Care Coordination- Major Responsibilites Criteria A: Establishes and coordinates communication with all Utilization Regulatory Agencies i.e. Qualidigm, NGS, etc., State and Third Party Payers to address Utilization Management Issues and Denials.
$49.76 - $92.4 an hourFull-timeExpandApply NowActive JobUpdated 21 days ago - UpvoteDownvoteShare Job
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Requires a strong clinical background blended with a well-developed knowledge and skills in Utilization Management, medical necessity and patient status determination. 2 years Experience as a case manager in an acute care setting.
$52.09 - $79.1 an hourFull-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Utilization review, prior authorization, Care management, Case management, interqual, ncqa, ncqa standards. As a part of the Utilization Management team the Utilization Review RN is a member of the Care Coordination team.
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Overall, the Vice President of Case Management plays a crucial role in optimizing patient care, ensuring efficient utilization of resources, facilitating interdisciplinary teamwork and care coordination amongst the region care teams, and maintaining compliance with regulatory standards.
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The RN Care Manager provides education to nurses, physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge Planning and care coordination.
Full-timeExpandApply NowActive JobUpdated 25 days ago - UpvoteDownvoteShare Job
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The Forensic Registered Nurse Case Manager performs medical forensic case management and coordination of interdisciplinary clinical service delivery, utilization of community resources, follow up care, and referrals to services for adolescent and adult patients who receive forensic nurse examiner services at Forensic Nursing Services of Providence.
$15,000Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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2+ years of healthcare/managed care experience, preferably in the following related areas of responsibility: Utilization Management and/or Quality Management. 5+ years of healthcare/managed care experience, preferably in the following related areas of responsibility: Utilization Management and/or Quality Management.
$24 - $35 an hourFull-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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As a Utilization Management Coordinator, you report to the Supervisor of Utilization Management and partner closely with the Care Navigation & Intake teams. Contribute as an active and enthusiastic member of the UM team, and continually monitor, evaluate, and make recommendations for enhancements to the utilization management process.
Full-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Monogram’s innovative, in-home approach utilizes a national nephrology practice powered by a suite of technology-enabled clinical services, including case and disease management, utilization management and review, and medication therapy management services that improve health outcomes while lowering medical costs across the healthcare continuum.
Full-timeExpandApply NowActive JobUpdated 21 days ago - UpvoteDownvoteShare Job
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Certified Case Manager (CCM) - Commission for Case Manager Certification; Accredited Case Manager (ACM) - American Case Management Association (ACMA); Bachelor's Degree in Nursing; California Registered Nurse (RN) - CA Board of Registered Nursing; Bachelor's Degree.
Full-timeExpandApply NowActive JobUpdated 12 days ago - UpvoteDownvoteShare Job
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Under the direction of Utilization Management (UM) leadership, the UM Coordinator processes prior authorization with established criteria. As Dignity Health Medical Foundation continues to grow and establish new premier care centers we provide increasing support and investment in the latest technologies finest physicians and state-of-the-art medical facilities.
Full-timeExpandApply NowActive JobUpdated 29 days ago
registered life care utilization management jobs Title: registered nurse case manager Company: Sunrise Hospital
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