Utilization Review-Case Management

Work as member of multi-disciplinary treatment team reviewing patient care and treatment options for both inpatient and outpatient services. Proactively monitor and optimize reimbursement for external reviewers/third party payers.Pay Range: $32/hr. to $60/hrResponsibilities:Admissions: Conduct admission reviewsConcurrent/Stay Reviews: Conduct concurrent and...

Job DescriptionJob DescriptionWork as member of multi-disciplinary treatment team reviewing patient care and treatment options for both inpatient and outpatient services. Proactively monitor and optimize reimbursement for external reviewers/third party payers.*Pay Range: $32/hr. to $60/hr.Responsibilities:Admissions: Conduct admission reviewsConcurrent/Stay...

**Sign On Bonus for Eligible External Hires** **Job Summary**: Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the medical necessity for Inpatient hospitalization. Interacts with the family,...

JOB SUMMARY: Case Managers function as liaisons between patients, their families, and internal and external health care personnel to ensure appropriate, efficient, and timely health care service. Their focus includes providing clinical documentation to third party payers to facilitate authorization and reimbursement for inpatient hospital stays,...

PHMC is proud to be a leader in public health. PHMC requires that all employees are fully vaccinated with the Covid-19 vaccine before the first day of employment. JOB DESCRIPTION: Full Time Bi-lingual FIR Case Manager reports to the FIR case management supervisor. This individual works directly with participants that have Forensic Service involvement and may...

Overview:   Utilization Review Supervisor Pay: $27 - $30 per hour   The Utilization Review Supervisor will oversee a Utilization Review team to effectively implement and complete the authorization processes for Embark BH programs. The primary responsibilities for this role include building a cohesively effective UR team to ensure that they are...

[Certified Case Manager (CCM) - Commission for Case Manager Certification; Accredited Case Manager (ACM) - American Case Management Association (ACMA); Bachelor's Degree in Nursing; California Registered Nurse (RN) - CA Board of Registered Nursing; Bachelor's Degree **Hours**: **Shift Start Time**: Variable **Shift End Time**: Variable **AWS Hours...

Job SummaryThe Utilization Review (UR) Nurse has acute knowledge and skills in areas of utilization management (UM), medical necessity, and patient status determination. This individual supports the UM program by developing and/or maintaining effective and efficient processes for determining the appropriate admission status based on the regulatory and...

Overview: Monitors the admissions, continued stay, and discharge of patients following pre-­established criteria.   Assures that patients meet InterQual criteria from admission to discharge including appropriateness of level of care.   Conducts interdisciplinary care management rounds.  Ensures collaboration between multidisciplinary healthcare team...

Overview: Monitors the admissions, continued stay, and discharge of patients following pre-­established criteria.   Assures that patients meet InterQual criteria from admission to discharge including appropriateness of level of care.   Conducts interdisciplinary care management rounds.  Ensures collaboration between multidisciplinary healthcare team...

We are looking for a *Care Review Clinician *to join our growing team. You will be offered a competitive hourly rate of $45.22*/ hour. **Responsibilities of the Care Review Clinician:** Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at...

Overview: Under the general supervision of the case management Director acts as a patient advocate/case manager to hospital clients. An autonomous role that coordinates, negotiates, procures services and resources for, and manages the care of complex patients to facilitate achievement of quality and cost efficient patient outcomes. Looks for opportunities to...

The Case Manager will work under the supervision of the Program Director. The Case Manager will perform client intake, sign all intake documents, and perform group and individual sessions. The Case Manager will perform duties while adhering to the organization's values and principals. EXPERIENCE & EDUCATION: A minimum of a High School diploma or GED is...

Job DescriptionJob DescriptionThe Case Manager will work under the supervision of the Program Director. The Case Manager will perform client intake, sign all intake documents, and perform group and individual sessions. The Case Manager will perform duties while adhering to the organization's values and principals.EXPERIENCE & EDUCATION:A minimum of a...

Overview: Founded in 1910 Dignity Health - Community Hospital of San Bernardino is a 347-bed acute care nonprofit community hospital located in San Bernardino California. Known for its programs in maternity care and pediatrics behavioral health and long-term subacute care for adults and children the hospital also includes inpatient and outpatient surgery....

Overview: Monitors the admissions, continued stay, and discharge of patients following pre-­established criteria.   Assures that patients meet InterQual criteria from admission to discharge including appropriateness of level of care.   Conducts interdisciplinary care management rounds.  Ensures collaboration between multidisciplinary healthcare team...

Overview: Provides case management services and administrative support to Panelists (judges and attorneys) and professional service and support to clients. Administers cases guided by JAMS rules, policies, and best practices. Serves as a business partner to Panelists to assist them in achieving their practice goals. JAMS is committed to diversity and...

Overview: JOB SUMMARY Evaluates the clinical status of patients using evidence based criteria to determine medical necessity for hospitalization, clinical progression and continued acute care needs.  Utilizes information about clinical condition, prior level of functioning and anticipated treatment plan to support a safe, smooth transition to other levels...

Overview: The ED LVN/RN Case Manager uses InterQual criteria to evaluate the appropriateness of admissions, level of care, and readiness for discharge.  Assures correct level of care: critical, telemetry, acute, observation, for all admissions.  Work with physicians to assign/order appropriate designation and medical record documentation.   The incumbent...

**Job Title**: 4-in-1 Public Health Registered Nurse Case Manager Full Time Grant Funded **Reports To**: Behavioral Health Director **Summary**: The Public Health Case Manager functions as an integral member of the medical and behavioral health departments with the aim of improving self-management and clinical outcomes for patients of San Diego American...