Utilization Management Nurse

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 SummaryThe Utilization Management Nurse II is a key member of the healthcare team at Christus Health, responsible for ensuring the clinical appropriateness of care provided to patients and optimizing hospital resource utilization. This role requires a strong clinical background, excellent communication skills, and the ability to work effectively in a...

Job Title: Utilization Management SpecialistAt St. Tammany Health System, we are committed to delivering world-class healthcare close to home. As a Utilization Management Specialist, you will play a critical role in ensuring that our patients receive the most appropriate and effective care.Job Summary:The Utilization Management Specialist is responsible for...

Job Summary: Manages the day-to-day operations of the Utilization Management Program in the Service Area or a Medical Center. Ensures cost effective and quality patient care by appropriate utilization of resources. Provides direction to staff which may include Outside Utilization, Extended Care, Bed Placement, Discharge Planning, Transportation and others...

Job Title: Utilization ManagerCarolina Therapeutic Services is seeking a highly skilled Utilization Manager to join our team. As a Utilization Manager, you will play a critical role in ensuring the continuity of care and quality of service to our consumers.Key Responsibilities:Develop authorizations with Managed Care Organizations (MCOs) to ensure timely and...

A prestigious 100+ patient bed hospital in Northern California is searching for a highly motivated and experienced Clinical Coordinator to join their dynamic healthcare team. This is an exceptional opportunity to make a significant impact on patient care and contribute to the growth and development of clinical services within the hospital. In this role, the...

Job Summary: Manages the day-to-day operations of the Utilization Management Program in the Service Area or a Medical Center. Ensures cost effective and quality patient care by appropriate utilization of resources. Provides direction to staff which may include Outside Utilization, Extended Care, Bed Placement, Discharge Planning, Transportation and others as...

Job Summary: Manages the day-to-day operations of the Utilization Management Program in the Service Area or a Medical Center. Ensures cost effective and quality patient care by appropriate utilization of resources. Provides direction to staff which may include Outside Utilization, Extended Care, Bed Placement, Discharge Planning, Transportation and others...

Job Summary: Manages the day-to-day operations of the Utilization Management Program in the Service Area or a Medical Center. Ensures cost effective and quality patient care by appropriate utilization of resources. Provides direction to staff which may include Outside Utilization, Extended Care, Bed Placement, Discharge Planning, Transportation and others...

Job Title: Utilization ManagerCarle Foundation Hospital is seeking a skilled Utilization Manager to join our team. As a Utilization Manager, you will play a critical role in ensuring that patients receive the most appropriate level of care while minimizing costs.Key Responsibilities:Collaborate with the interdisciplinary team to facilitate placement of...

Job Title: Utilization Management RepresentativeWe are seeking a highly skilled Utilization Management Representative to join our team at Elevance Health. As a Utilization Management Representative, you will play a critical role in ensuring that our members receive the necessary healthcare services while minimizing unnecessary costs.Key...

Your Role The Utilization Management team reviews the inpatient stays for our members and correctly applies the guidelines for nationally recognized levels of care. The Utilization Management Nurse, Senior will report to the Utilization Management Nurse Manager. In this role you will be assigned a list of inpatient facilities and then review clinical...

Your Role The Utilization Management team reviews the inpatient stays for our members and correctly applies the guidelines for nationally recognized levels of care. The Utilization Management Nurse, Senior will report to the Utilization Management Nurse Manager. In this role you will be assigned a list of inpatient facilities and then review clinical...

Job Title: Utilization Management RepresentativeWe are seeking a highly skilled Utilization Management Representative to join our team at Elevance Health. As a Utilization Management Representative, you will play a critical role in ensuring that our members receive the necessary healthcare services while minimizing unnecessary costs.Key...

Your Role The Utilization Management team reviews the inpatient stays for our members and correctly applies the guidelines for nationally recognized levels of care. The Utilization Management Nurse will report to the Utilization Management Nurse Manager. In this role you will be assigned a list of inpatient facilities and then review clinical information...

Your Role The Utilization Management team reviews the inpatient stays for our members and correctly applies the guidelines for nationally recognized levels of care. The Utilization Management Nurse will report to the Utilization Management Nurse Manager. In this role you will be assigned a list of inpatient facilities and then review clinical information...

Case Manager RN - UTILIZATION REVIEWJob Description Full Time Utilization management is the analysis of the medical necessity, acute care appropriateness, and efficiency of medical services and procedures in the hospital setting. Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This...

Are you an experienced nursing leader ready to take your career to the next level? We have an exciting opportunity for a Med/Surg Nurse Manager at a top-tier acute care hospital nestled along the stunning Southern Connecticut Coast. Imagine working in a location where coastal charm meets cutting-edge healthcare, and your leadership will shape the future of...

Job Summary:Develops, manages and directs the Utilization Management programs in a Service Area or a Medical Center. Develops and manages programs that emphasize appropriate admissions as well as concurrent and retrospective review of care. May also be responsible for other integrated functions such as Discharge Planning, Case Management program, Outside...

Job Title: Utilization Review NurseAlbany Medical Center is seeking a skilled Utilization Review Nurse to join our team. As a Utilization Review Nurse, you will be responsible for reviewing patient admissions and continued stays to ensure that they meet medical necessity and are in compliance with regulatory requirements.Key Responsibilities:Conduct thorough...