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The Utilization Review Manager (URM) serves as the liaison between Great Circle treatment teams, funding sources, and external partners to obtain and review all clinical and medical services for clients at Great Circle locations.
$50,000 - $55,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Attend and/or participate in facility meetings as directed by Center Manager (may include utilization review, infection control, disaster preparedness, etc.) They implement ABA programs and Behavior Intervention Plans directed by a Board Certified Behavior Analyst (BCBA)/Case Manager.
Starting at $18 an hourPart-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The Foster Care Case Manager promotes effective utilization of support services to achieve permanency for children and families. Position Summary: The Foster Care Case Manager (FCCM) is responsible for safety and services to children and families in foster care.
$43,000 - $47,000 a yearFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Under the direction of the Director, Care Coordination, the Utilization Review RN performs activities which support the Utilization Management functions. The Utilization Review RN is responsible for the delivery of the Utilization Management process not limited to and including: making clinical recommendations regarding medical necessity for admission and continues stay, screens patients for client specific guidelines regarding insurance, Medicare and/or Medicaid guidelines, send payor specific Notice of Admission and continued stay reviews.
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Utilization Review Specialist Job DescriptionUnique opportunity to join Maryhaven, Central Ohio’s largest and most comprehensive behavioral services provider specializing in addiction recovery.
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The Utilization Review (UR) Nurse is responsible for the clinical review and documentation for services requiring prior authorization. Minimum of two (2) years Utilization Management experience is preferred.
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Current working knowledge of discharge planning, utilization management, case management, performance improvement, disease or population management and managed care reimbursement. Assists in the collection and reporting of financial indicators including case mix, LOS, cost per case, excess days, resource utilization, readmission rates, denials and appeals.
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UTILIZATION REVIEW / CASE MANAGEMENT RN - Part Time, Weekends. Conducts concurrent and retrospective chart review for clinical, financial and resource utilization information.
Part-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The LVN case transition coordinator performs utilization review by using criteria that demonstrate medical necessity to achieve reimbursement for services and ensuring appropriate utilization of hospital resources.
$33 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Under the general supervision of the case management Director acts as a patient advocate/case manager to hospital clients. F) Is a clinical resource to admitting department and provides ongoing education on the effective resources of the Pre Admission Case Manager and Quality/Case Management Department to physicians, physician office staff, nursing.
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Exp in utilization review/Case mgt, and discharge planning, care coordination across the continuum of care in collaboration with the physician and other members of the health care team.
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Currently recruiting a Registered Nurse (RN) Case Manager near Palm Springs, California, to provide care to family members of Active Duty heroes in the Wounded, Ill, and Injured Warriors (WII)under the Psychological Health Transition to Care Initiative in the Case Management/Utilization Management Divisionat Naval Hospital 29 Palms.
$123,947.2Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The Utilization Review Specialist will work as a part of the multi-disciplinary team (MDT) and is responsible for maintaining standards of care and competency, ethical treatment of patients, understanding of addiction and the medications used for detoxification purposes, managing symptoms of withdrawal with comprehensive triage, consistent documentation on care, review and implementation of treatment orders.
$19.25 an hourExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The RN Case Manager Assistant is responsible to conduct medical necessity screening and work collaboratively with the interdisciplinary team to provide care coordination for patients under the direction of a Registered Nurse and in compliance with evidence-based practice and regulatory requirements.
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Acentra is currently looking for a Utilization Management Appeals Nurse - LPN/RN to join our growing team. Our Utilization Management Appeals Nurse - LPN/RN will help orchestrate the seamless resolution of appeals in line with health regulations.
$24 - $35 an hourFull-timeExpandApply NowActive JobUpdated 10 days ago
utilization review case manager jobs Company: Unitedhealth Group
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