Management, the Care Manager is responsible for managing the continuum of care from admission through discharge for assigned... patients. The role reflects appropriate knowledge of RN scope of practice, current state requirements, CMS Conditions...
and providing timely and accurate information to payors. The role integrates and coordinates the functions of utilization management... effectively to meet patient needs, manage the length of stay, and promote efficient utilization of resources. Specific functions...
Management Nurse Specialist RN II facilitates, coordinates, and approves medically necessary referrals that meet established... Required: At least 5 years of varied clinical experience in an acute hospital setting. At least 2 years of Utilization Management/Case...
for Medicare Advantage Utilization Management, you'll provide direct management to a team of UM coordinators and nurses. You'll... in CA required Bachelors of Science, Nursing (BSN) degree required Five or more years of utilization management required Four or more years...
Management Nurse Specialist RN II facilitates, coordinates, and approves medically necessary referrals that meet established... Required: At least 5 years of varied clinical experience in an acute hospital setting. At least 2 years of Utilization Management/Case...
for Medicare Advantage Utilization Management, you'll provide direct management to a team of UM coordinators and nurses. You'll... in CA required Bachelors of Science, Nursing (BSN) degree required Five or more years of utilization management required Four or more years...
Management Nurse to join our team! As a Utilization Management Nurse on the team, you will be responsible for reviewing patient... in either Case Management or Utilization Management. Responsibilities Review patient files and treatment information...
members. Conducting utilization management (UM) activities in accordance with health plan policies and regulatory guidelines... in utilization management, preferably in Medicare Advantage or managed care. Knowledge of Medicare Advantage regulatory guidelines...
clinical and quality outcomes by effectively managing care and resources to reduce unnecessary utilization. The RN Care Manager... development of an individualized care plan with emphasis on promoting patient self -management and family responsibility. The RN...
! As the Manager of Care Management, you will oversee a multidisciplinary team, including RN Care Managers, Care Management... training. Desired Qualifications Direct patient care, care coordination, utilization management, or case/disease management...
Utilization Management Operations Manager and the RN Assistant Director, the ICM Behavioral Coordinator plays a vital role...Description We are seeking for a detail-oriented Intensive Case Management (ICM) Behavioral Coordinator dedicated...
management department operations to ensure optimal efficiency and effectiveness. Reviews performance data and reporting... of education/related experience: Required Master's Degree: Preferred Five years' case management, hospital discharge planning...
utilization. Assures appropriate staff support of Utilization Management and other relevant committees. Supports the... Management will mainly be responsible for the operational component of the Care Management (CM) Department with the main goal...
. Must have a valid RN license in the state where they will be practicing, BLS certification, and Case Management Certification (RN-BC..., ability to effectively communicate Other Requirements: Utilization review and discharge planning experience is necessary...
Management, the Care Manager is responsible for managing the continuum of care from admission through discharge for assigned... patients. The role reflects appropriate knowledge of RN scope of practice, current state requirements, CMS Conditions...
Role Summary Join a dedicated team where your work has a meaningful impact every day. As an RN Case Manager... of Rights. Perform admission, continued stay, and discharge reviews to determine medical necessity and resource utilization...
of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and appropriate... in a clinical discipline per state guidelines (RN, LCSW preferred). Previous experience in Case Management and Discharge Planning...
Nursing staff) CA RN License and BLS certification Recent experience in case management, utilization management.... You will also perform utilization review while assuring the delivery of concurrent and post-hospital care. We're also looking to you to help...
experience in case management, utilization management and discharge planning Minimum of three years of acute hospital experience.... You will also perform utilization review while assuring the delivery of concurrent and post-hospital care. We're also looking to you to help...
, or serves as liaison, for administrative support activities including facilities management, pharmacy, utilization management...). What will you be doing in this role? The Supervisor of Clinical Operations RN supports the physician and clinical staff in the delivery...