REMOTE INPATIENT UTILIZATION MANAGEMENT

SummaryJob DescriptionProvides leadership, support, training, and direction to the Inpatient UM teammates. The incumbent will use clinical judgment to provide utilization management review for inpatient during high volume situations. Provide high quality, cost-effective care to enable patients to achieve maximum medical improvement, while receiving care...

Utilization Management Clinical Registered Nurse - The Health Plan - RemoteJob Summary We are searching for a Utilization Management Clinical RN -- someone who works well in a fast-paced setting. In this position, you will provide precertification of inpatient hospitalizations and all outpatient procedures and services requiring authorization. This role...

Utilization Management NurseWhy Choose Jefferson Health Plans? We are an award-winning, not-for-profit health maintenance organization offering Medicaid, Medicare, and Children's Health Insurance Program (CHIP) plans that include special benefits to improve the health and wellness of our members. We are committed to creating a community where everyone...

Job Description:This position will be remote role for Nurses in MichiganShould have a valid MI RN LicenseShould Have utilization management experience.Should have experience completing post-acute reviews for the inpatient rehab, skilled nursing facility settings previously.The candidate should be well versed in coordination of care activities along with...

Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect.Whether remote or on campus, Adventist Health Roseville and shared...

Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute...

Registered Nurse RN Inpatient Case Manager Austin TexasOpportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and...

Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect. Whether remote or on campus, Adventist Health Roseville and shared...

Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect. Whether remote or on campus, Adventist Health Roseville and shared...

The Utilization Management Specialist coordinates communication with admitting financial counselors, case management, patient financial services, and payers to ensure all inpatient services provided by the hospital are authorized by appropriate payer. The Utilization Management Specialist works with case managers to facilitate timely transmission of...

DescriptionHealth Information Management (HIM) Coder Opportunity Location: REMOTE Lifepoint Rehabilitation is a leading provider of acute inpatient rehabilitation services with more than 300 hospital-based rehabilitation units, medical/surgical and outpatient therapy settings and more than 30 joint venture inpatient rehabilitation hospitals across the...

About The RoleBHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs daily medical necessity reviews while working remotely.Primary Responsibilities Perform prospective, concurrent, and retrospective utilization reviews and first level determination approvals for members using evidenced based guidelines,...

JOB SUMMARY:Under direction of the Director or Nurse Manager of Value Based Care, the Inpatient Navigator acts as a liaison between the patient and/or caregiver, the Transitional Care Manager (TCM), community healthcare providers, and external vendors by visiting admitted patients to discuss the hospitalization course, discharge plan, and post discharge...

This position is remote, however, you must reside in the State of New Mexico.This position is a contract for about 6 months. The pay is $40/hour.RN or LPN. No travel. Remote position. Work week is Monday-Saturday, working rotating Saturdays. Looking for clinical knowledge, computer skills, team oriented. Of course, would like local agency if possible for...

Well established local CPA firm is searching for a Tax Manager and Senior to add to their growing staff. Professional, friendly work environment features a great work life balance and the ability to either work fully remote and live anywhere in either PST or MST time zones, or work remotely with some in office or client location work assignments. They offer...

The Utilization Management (UM) LVN performs utilization review activities, including, but not limited to, precertification, ensures appropriate level of care and status (Inpatient, Outpatient, and Observation) throughout admission and performs concurrent reviews/retrospective reviews according to guidelines. In addition, the UM LVN delegates to UM RN...

City/State Norfolk, VA Overview Work Shift Rotating (United States of America) Sentara Norfolk General Hospital is hiring an Inpatient Case Manager RN to work part-time rotating shifts. Generous Sign-on Bonus available for qualified candidates! Responsible and accountable for the provision and facilitation of comprehensive care management, services...

An exciting new opportunity has just become available for an Inpatient Hospital Pharmacist! Join a state of the art Hospital in beautiful Eastern Montana as they are actively interviewing for an Pharmacist to join their Pharmacy Department dedicated Pharmacist, Hospital, Patient, Patient Care, Nurse Practitioner, Behavioral Health, Healthcare, Staffing

Well established local CPA firm is searching for a Tax Manager and Senior to add to their growing staff. Professional, friendly work environment features a great work life balance and the ability to either work fully remote and live anywhere in either PST or MST time zones, or work remotely with some in office or client location work assignments. They offer...

Under general supervision of the Director of Case Management, the Utilization Review Nurse provides a clinical review of cases using medical necessity criteria to determine the medical appropriateness of inpatient and outpatient services. Provides feedback and assistance to other members of the healthcare team regarding the appropriate use of resources and...