Utilization Management Nurse

Job SummaryThe Utilization Management Nurse is responsible for the appeal process for the inpatient adult population and is an active participant of the Medicare one day stays process. The incumbent works in a collaborative relationship with admitting, patient financial services, physicians, nurses, case managers and social workers of the interdisciplinary...

Job SummaryAs a Utilization Management Nurse, RN, you will play a critical role in ensuring that our Members receive the necessary care and services to achieve optimal health outcomes. This position requires a strong understanding of healthcare regulations, policies, and procedures, as well as excellent communication and analytical skills.Key...

Job Title: Utility EngineerJoin our team as a Utility Engineer and play a key role in maintaining the infrastructure of our facilities. As a hands-on team member, you will design, review, and implement improvements for our program on Alcatraz Island in San Francisco.Key Responsibilities:Lead and perform all diesel engine repairs across a wide array of...

Job SummaryThe Utilization Management Nurse Case Manager is responsible for the appeal process for the inpatient adult population. This role involves working with admitting, patient financial services, physicians, nurses, and case managers to ensure that patients receive the necessary treatments and services.Key ResponsibilitiesReview admission reviews and...

About MarinHealth Medical CenterMarinHealth Medical Center is a leading healthcare provider in the North Bay area, offering a comprehensive range of services to meet the diverse needs of our community. We are seeking a highly skilled Utilization Review Nurse to join our team of dedicated healthcare professionals.Job Summary:The Utilization Review Nurse will...

Job SummaryAs a Clinical Services Manager - RN, you will play a critical role in ensuring optimum recovery on every claim while establishing trust, providing education, delivering information, and care. You will provide case direction to field case managers when on-site intervention is required.Key ResponsibilitiesPerform within the professional practice...

Job Title: Utilities Business ManagerAbout the Role:The City of Gilroy is seeking a highly skilled Utilities Business Manager to join our team. As a key member of our Utilities Department, you will be responsible for managing the financial health and operational efficiency of our utility enterprise funds.Key Responsibilities:Manage and oversee multiple funds...

About the PositionThe City of Gilroy is seeking a highly skilled Utilities Business Manager to join our team. As a key member of our Utilities Department, you will be responsible for managing and overseeing the financial health and operational efficiency of our utility enterprise funds.Key Responsibilities:Develop and manage budgets related to utilities...

Job SummaryThe Pre-Admission Utilization Management Nurse is responsible for applying utilization management principles and techniques, as well as clinical nursing background and expertise, for the assessment of patients' admissions prior to their entry into the inpatient hospital setting.The incumbent works in a collaborative relationship with admitting,...

Job SummaryThe Utilization Management Nurse Specialist is responsible for the appeal process for the inpatient adult population and is an active participant of the Medicare one day stays process. The incumbent works in a collaborative relationship with admitting, patient financial services, physicians, nurses, case managers and social workers of the...

Job SummaryAs a Clinical Services Manager - RN Telephonic Case Management, you will play a pivotal role in ensuring optimal recovery outcomes for every claimant while fostering trust, providing education, and delivering personalized care. You will collaborate with field case managers to provide case direction when on-site intervention is required.Key...

Job DescriptionMedRisk is seeking a skilled Clinical Reviewer to join our team in the utilization review program. As a Clinical Reviewer, you will play a critical role in promoting quality outcomes and enhancing the physical, psychosocial, and vocational health of individuals.Key Responsibilities:Evaluate medical data for utilization review requests and...

pbJob Summary/b/ppThe San Francisco Department of Public Health is seeking a highly skilled and experienced bSenior Psychiatrist - Utilization Management/b to join our team. As a key member of our Behavioral Health Services team, you will provide clinical leadership and guidance to our team, working in partnership with the UM Unit Manager as Co-Chair of the...

Job Summary: We are seeking a highly skilled and experienced Senior Psychiatrist and Medical Director to lead our Utilization Management team. The ideal candidate will have a strong background in clinical leadership, with expertise in psychiatric medicine and utilization management.Key Responsibilities:Provide clinical leadership and guidance to the...

**Job Summary:**We are seeking a highly skilled Utilization Management Director to oversee the day-to-day operations of the Utilization Management Program in the Service Area or a Medical Center. As a key member of our team, you will be responsible for ensuring cost-effective and quality patient care by optimizing resource utilization.**Key...

Job SummaryWe are seeking a highly skilled Utilization Manager to join our team at Sharp HealthCare. As a Utilization Manager, you will play a critical role in ensuring the efficient and effective management of patient care and resources.Key ResponsibilitiesCollaborate with the Centralized Patient Placement Center (CPPC) team to review external and internal...

Job SummaryWe are seeking a highly skilled Utilization Manager - Transfer and Admission to join our team at Sharp HealthCare. As a key member of our System Integrated Care Management team, you will play a critical role in ensuring the efficient and effective transfer and admission of patients across our healthcare system.Key ResponsibilitiesPartner with the...

Job Summary:The Transfer and Admissions Utilization Manager plays a critical role in the System Integrated Care Management team, partnering with the Centralized Patient Placement Center (CPPC) RNs to review external and internal transfer requests and direct admission requests. This position supports utilization review functions to ensure appropriate patient...

Job SummaryWe are seeking a highly skilled Utilization Manager - Transfer and Admission to join our team at Sharp HealthCare. This role will be responsible for reviewing external and internal transfer requests and direct admission requests, ensuring medical necessity and payer considerations are reviewed.The ideal candidate will have a strong background in...

Job SummaryThis is a newly formed unit that will operate under the direction of the Director of BHS Managed Care and the UM Unit Manager. The desired candidate will provide clinical leadership, guidance and support for the team and work in partnership with the UM Unit Manager as Co-Chair of the UM Committee. This position is currently 0.6 FTE. As the unit...