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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.
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The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology.
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As a Case Management Coordinator, you will facilitate efficient Care Management services, monitor compliance with assigned responsibilities, complete daily/weekly tasks, and coordinate with patient financial services.
$18.88 - $28.8 an hourFull-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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As a part of the Utilization Management team the Utilization Review RN is a member of the Care Coordination team. Utilization review, prior authorization, Care management, Case management, interqual, ncqa, ncqa standards.
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Manage professional and clerical associates who work with a range of functions, including but not limited to: Access Authorization and pre-certification, utilization review and denial management, Care.
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Through utilization of the nursing process through skilled assessment, education, collaboration and coordination of healthcare and community resources, the RN Care Manager assists patients to gain self-efficacy/management skills, achieve optimum functional health status, and quality of life.
$48.84 - $80.43 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Three years of experience where the primary function of the position was nursing in a hospital or health care agency, one of which must have been at a leadership level, and one year of which must have been in either a hospital, health care agency or managed care company in the area of utilization review, quality assurance, risk management or discharge planning.
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The Director of Utilization Management (UM) provides comprehensive oversight of the Utilization Review process under the Knox Keene license and Department of Health Care Services contract.
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Relevant experience includes previous industry, utilization management/utilization review experience and care coordination. By using Interqual criteria, policies, regulatory guidelines and other standards of care, the Coordinator for Utilization Management (UM) will collaborate with other health care providers to evaluate the appropriateness of utilization and the medical necessity of care, for elective and emergency admissions, surgeries, diagnostic procedures and treatments.
$33.66ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The CM also leads activities directed toward improving appropriate utilization across populations of patients to meet holistic care planning goals and organizational strategic objectives, as well as, developing initiatives within the department or to impact management of patient populations within and across the continuum.
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Key Words: RN Travel, Travel Nurse, Contract Nurse, Agency Nurse, Travel Contract, Travel Nursing, Case Manager, Case Management, Utilization Review, Case Manager RN. The role of the case management nurse (RN) is to coordinate continuity of care for patients often as a liaison between the patients family and healthcare organization.
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Is prepared to conduct PPS meetings maintaining MDS assessments per Medicare schedule and maintain PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management Coordinator.
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Is prepared to conduct PPS meetings maintaining MDS assessments per Medicare schedule and maintains PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management Coordinator.
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Areas of oversight for this position include, but are not limited to, case management, quality management, utilization management (UM), and grievance and appeals and committee participation.
$115.71 - $159.1 an hourExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Preferred 5-7 years of experience in combination of utilization management prior authorization or acute/sub-acute care experience. - Minimum 3-5 years of healthcare experience with general knowledge of Utilization Management and Managed Care.
$27.77 - $40.27 an hourFull-timeExpandApply NowActive JobUpdated Today
care management utilization jobs in Peoria, Arizona
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