517 rn utilization manager jobs found

Job Description Description Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve. This Utilization Manager will be supporting the Medicine, Oncology, and Cardiac Services units housed at UNC Medical Center in Chapel Hill. You will work in collaboration with the patient and their families family, interdisciplinary team (including physicians, other care providers, and payors), and assess the patient care progression from acute care episode through post discharge for quality, efficiency, and effectiveness. In addition, you will work collaboratively with other Care Management staff to ensure patient needs are met and care delivery is coordinated across the continuum. This role may require participation in daily unit-based patient progression rounds with the care team. The schedule expectations are Monday-Friday...

Job Description Description Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve. Summary: Works in collaboration with the patient/family, and interdisciplinary team (including physicians, other care providers, and payors), and assesses the patient care progression from acute care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ensure patient needs are met and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and discharge reviews in accordance with federal regulations & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection by reconciling physician orders, bed billing...

Job Description Description Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve. Summary: Works in collaboration with the patient/family, and interdisciplinary team (including physicians, other care providers, and payors), and assesses the patient care progression from acute care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ensure patient needs are met and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and discharge reviews in accordance with federal regulations & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection by reconciling physician orders, bed billing...

Job Description Description Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve. Summary: Works in collaboration with the patient/family, and interdisciplinary team (including physicians, other care providers, and payors), and assesses the patient care progression from acute care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ensure patient needs are met and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and discharge reviews in accordance with federal regulations & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection by reconciling physician orders, bed billing...

Job Description Description Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve. This position will support the Emergency Department & Point of Entry at Hillsborough and provide inpatient unit support at Hillsborough including Acute Inpatient Rehab; along with Chatham Hospital & Advance Care at Home patients. Work hours are 3p-11p Mon-Fri with rotation to weekends/holidays. Summary: Works in collaboration with the patient/family, and interdisciplinary team (including physicians, other care providers, and payors), and assesses the patient care progression from acute care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ensure patient needs are met and care delivery is coordinated across...

Job Description Description Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve. This position will be serving the Medicine, Oncology, Cardiology, and Psych Team at our Medical Center located in Chapel Hill, NC. The individual moving into this role will be completing clinical reviews for the following areas: Inpatient, Observation for Med Surg Units at Main campus, Psych Main and Youth Behavioral Health for medical necessity. This team identifies and submits Medicine Treatment Authorization Requests (patients who are in the medicine floor with psych dx and treatment) and psych retroactive Treatment Authorization Requests for the following UNC affiliated campuses – Main, Hillsborough, Chatham and Youth Behavioral Health. This team assists the weekends and other Utilization Management teams with their reviews....

Job Description Description Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve. Summary: The purpose of this position is to provide ongoing support and expertise through comprehensive assessment, planning, implementation and overall evaluation of individual patient needs. The overall goal of the position is to enhance the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integrating and functions of case management, utilization review and discharge planning. The Care Manager must be highly organized professional with great attention to detail, adaptable to frequent change, and compliant with regulatory and departmental guidelines and policies. Responsibilities: 1. Identify Cases & Prioritize Day - Review work list to prioritize patients and...

Discover Vanderbilt University Medical Center: Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of diverse individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health recognizes that diversity is essential for excellence and innovation. We are committed to an inclusive environment where everyone has the chance to thrive and where your diversity of culture, thinking, learning, and leading is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt’s mission is to advance health and wellness through preeminent programs in patient care, education, and research. Organization: Utilization...

Case Manager (RN) - Georgetown Memorial Hospital (Georgetown, SC) Posted Date 1 day ago (11/20/2023 9:23 AM) Job ID 2023-12986 Type Part Time Location US-SC-Georgetown Shift Varies - Days Responsibilities Position Summary: The Case Manager is primarily responsible for the coordination of resources and services in response to individual patient needs and fiscal realities. As a member of the patient care team, the case manager is responsible for tracking clinical service utilization of specific patients from admitting to discharge. Tracking includes the concurrent collection of data, and analysis for appropriateness and timing of interventions. The Case Manager provides practical interpretation of the analysis for nurses, multi-disciplinary teams, medical staff and managers as the findings and recommendations relate to the individual patient’s outcomes,...

Case Manager (RN) - Waccamaw Community Hospital (Murrells Inlet, SC) Posted Date 1 day ago (11/20/2023 9:23 AM) Job ID 2023-12976 Type Full Time, Non-Exempt Location US-SC-Myrtle Beach Area Shift Varies - Days Responsibilities Position Summary: The Case Manager is primarily responsible for the coordination of resources and services in response to individual patient needs and fiscal realities. As a member of the patient care team, the case manager is responsible for tracking clinical service utilization of specific patients from admitting to discharge. Tracking includes the concurrent collection of data, and analysis for appropriateness and timing of interventions. The Case Manager provides practical interpretation of the analysis for nurses, multi-disciplinary teams, medical staff and managers as the findings and recommendations relate to the...

Case Manager (RN) - Waccamaw Community Hospital (Murrells Inlet, SC) Posted Date 1 month ago (10/9/2023 10:11 AM) Job ID 2023-12828 Type PRN Location US-SC-Myrtle Beach Area Shift Varies - Days Responsibilities Position Summary: The Case Manager is primarily responsible for the coordination of resources and services in response to individual patient needs and fiscal realities. As a member of the patient care team, the case manager is responsible for tracking clinical service utilization of specific patients from admitting to discharge. Tracking includes the concurrent collection of data, and analysis for appropriateness and timing of interventions. The Case Manager provides practical interpretation of the analysis for nurses, multi-disciplinary teams, medical staff and managers as the findings and recommendations relate to the individual patient’s...

locationsFort Worth, TX time typeFull time posted onPosted 6 Days Ago job requisition idJR-102763 Location: Calmont Operations Building Department: Utilization Shift: First Shift (United States of America) Standard Weekly Hours: 40 Summary: Responsible for the coordination and efficient utilization of health care resources for Cook Children's Health Plan (CCHP) members. Works with the Department Manager and Team Lead to ensure the timely provision of quality care throughout the continuum of care. Additional Information: The RN - Behavioral Health UM Reviewer duties include: Facilitates clinically appropriate and fiscally responsible care through communication with the providers and health plan medical directors. Assesses and identifies the members' clinical information and determines, in conjunction with the Medical Director, the medical necessity and appropriateness of requested services....

locationsFort Worth, TX time typePart time posted onPosted 7 Days Ago job requisition idJR-103120 Location: Medical Center - Fort Worth Department: Case Management Shift: Weekend Shift (United States of America) Standard Weekly Hours: 20 Summary: The RN Case Manager (Nex) uses a collaborative process to plan, assess, implement, monitor and evaluate the options and services required to meet the healthcare needs of the patients using the functions of Utilization Review using Interqual and Milliman Care Guidelines, Discharge Planning and Case Management in order to facilitate: (1) quality of patient care; (2) cost effective utilization and outcome management; (3) communication between patients, families, and members of the health care team; (4) expedition of the movement of patients through appropriate levels of care; and (5) information gathering for Quality & Risk Management utilizing Joint Commission Accreditation of...

locationsFort Worth, TX time typeFull time posted onPosted 4 Days Ago job requisition idJR-101450 Location: Medical Center - Fort Worth Department: CLN-Complex Care & Readmission Prevention Shift: First Shift (United States of America) Standard Weekly Hours: 40 Summary: Utilizing a collaborative process with the Complex Care Coordination (CACO) Social Worker, the RN Case Manager will assess, develop, and implement a plan of care to meet the individual health care needs of children with complex medical problems or special health care needs, who have multiple specialists and who are at risk for frequent healthcare utilization. Using effective communication skills and available resources, the RN Case Manager will provide support and reinforce education across multiple service delivery settings in an effort to meet patients unique needs and access care for quality, cost-effective outcomes. The RN Case Manager in conjunction...

locations Kansas City, KS time type Full time posted on Posted 6 Days Ago job requisition id R-27283 Position Title Clinic Rn Care Coor - Cardiology; State Avenue KCKS Clinic Days - Full Time Cardiovascular - State Ave COVID-19 and flu vaccines are required for all health system employees. Learn more. Position Summary / Career Interest: The Ambulatory Clinic RN Care Coordinator is a licensed registered professional nurse who is a clinical expert who provides ethical, evidence-based, safe and compassionate nursing care.   The Ambulatory Clinic RN Care Coordinator focuses on patient safety and the quality of nursing care by identifying and clarifying patient needs, performing clinic related patient care, conducting health education, promoting patient advocacy, coordinating healthcare services, and evaluating patient outcomes. The RN Care Coordinator will provide support to their assigned physicians by communicating with the patient/family/caregiver and relaying the information...

locations Kansas City, KS time type Part time posted on Posted 8 Days Ago job requisition id R-25333 Position Title PRN; Clinic RN Care Coor- Cardiovascular Medicine; Heart Rhythm Management Clinic Days - PRN Bell Hospital COVID-19 and flu vaccines are required for all health system employees. Learn more. Position Summary / Career Interest: The PRN Ambulatory Clinic RN Care Coordinator is a licensed registered professional nurse who is a clinical expert who provides ethical, evidence-based, safe and compassionate nursing care.   The PRN Ambulatory Clinic RN Care Coordinator focuses on patient safety and the quality of nursing care by identifying and clarifying patient needs, conducting health education, promoting patient advocacy, coordinating healthcare services, and evaluating patient outcomes. The RN Care Coordinator will provide support to their assigned physicians by communicating with the patient/family/caregiver and relaying the information to the physician. They will...

locations Kansas City, KS time type Full time posted on Posted 30+ Days Ago job requisition id R-26181 Position Title Clinic RN Care Coord - Clinic Float Pool Medical Pavilion COVID-19 and flu vaccines are required for all health system employees. Learn more. Position Summary / Career Interest: The Ambulatory Clinic RN Care Coordinator is a licensed registered professional nurse who is a clinical expert who provides ethical, evidence-based, safe and compassionate nursing care. The Ambulatory Clinic RN Care Coordinator focuses on patient safety and the quality of nursing care by identifying and clarifying patient needs, performing clinic related patient care, conducting health education, promoting patient advocacy, coordinating healthcare services, and evaluating patient outcomes. The RN Care Coordinator will provide support to their assigned physicians by communicating with the patient/family/caregiver and relaying the information to the physician. They will provide support...

locations Kansas City, KS time type Full time posted on Posted Yesterday job requisition id R-27852 Position Title Clinic RN Care Coordinator - Float Pool Medical Pavilion COVID-19 and flu vaccines are required for all health system employees. Learn more. Position Summary / Career Interest: The Ambulatory Clinic RN Care Coordinator is a licensed registered professional nurse who is a clinical expert who provides ethical, evidence-based, safe and compassionate nursing care. The Ambulatory Clinic RN Care Coordinator focuses on patient safety and the quality of nursing care by identifying and clarifying patient needs, performing clinic related patient care, conducting health education, promoting patient advocacy, coordinating healthcare services, and evaluating patient outcomes. The RN Care Coordinator will provide support to their assigned physicians by communicating with the patient/family/caregiver and relaying the information to the physician. They will provide support and...

locations Westwood, KS time type Part time posted on Posted Yesterday job requisition id R-29483 Position Title PRN Ambulatory Clinic RN Care Coordinator Days - PRN Westwood Medical Pavilion - West Position Summary / Career Interest: The PRN Ambulatory Clinic RN Care Coordinator is a licensed registered professional nurse who is a clinical expert who provides ethical, evidence-based, safe and compassionate nursing care.   The PRN Ambulatory Clinic RN Care Coordinator focuses on patient safety and the quality of nursing care by identifying and clarifying patient needs, conducting health education, promoting patient advocacy, coordinating healthcare services, and evaluating patient outcomes. The RN Care Coordinator will provide support to their assigned physicians by communicating with the patient/family/caregiver and relaying the information to the physician. They will provide support during the physician’s clinic sessions and ensuring the patient/family/caregiver understands...

locations Kansas City, KS Overland Park, KS time type Full time posted on Posted 2 Days Ago job requisition id R-29224 Position Title Clinic RN Care Coordinator - Urology Clinic Days - Full Time Indian Creek Main, Medical Pavilion Position Summary / Career Interest: The Ambulatory Clinic RN Care Coordinator is a licensed registered professional nurse who is a clinical expert who provides ethical, evidence-based, safe and compassionate nursing care.   The Ambulatory Clinic RN Care Coordinator focuses on patient safety and the quality of nursing care by identifying and clarifying patient needs, performing clinic related patient care, conducting health education, promoting patient advocacy, coordinating healthcare services, and evaluating patient outcomes. The RN Care Coordinator will provide support to their assigned physicians by communicating with the patient/family/caregiver and relaying the information to the physician. They will provide support and nursing care services...

locations Westwood, KS time type Full time posted on Posted Today job requisition id R-30214 Position Title Ambulatory Clinic RN Care Coordinator-Myeloma/Hematology Days - Full Time Westwood Medical Pavilion - West Position Summary / Career Interest: The Ambulatory Clinic RN Care Coordinator is a licensed registered professional nurse who is a clinical expert who provides ethical, evidence-based, safe and compassionate nursing care.   The Ambulatory Clinic RN Care Coordinator focuses on patient safety and the quality of nursing care by identifying and clarifying patient needs, performing clinic related patient care, conducting health education, promoting patient advocacy, coordinating healthcare services, and evaluating patient outcomes. The RN Care Coordinator will provide support to their assigned physicians by communicating with the patient/family/caregiver and relaying the information to the physician. They will provide support and nursing care services during the...

locations Kansas City, KS time type Full time posted on Posted Yesterday job requisition id R-30157 Position Title Clinic RN Care Coordinator - Comprehensive Epilepsy Department Sutherland Institute Position Summary / Career Interest: The Ambulatory Clinic RN Care Coordinator is a licensed registered professional nurse who is a clinical expert who provides ethical, evidence-based, safe and compassionate nursing care.   The Ambulatory Clinic RN Care Coordinator focuses on patient safety and the quality of nursing care by identifying and clarifying patient needs, performing clinic related patient care, conducting health education, promoting patient advocacy, coordinating healthcare services, and evaluating patient outcomes. The RN Care Coordinator will provide support to their assigned physicians by communicating with the patient/family/caregiver and relaying the information to the physician. They will provide support and nursing care services during the physician’s clinic...

locations North Kansas City, MO Kansas City, MO time type Part time posted on Posted 5 Days Ago job requisition id R-30149 Position Title PRN-Ambulatory Clinic RN Care Coordinator Days - PRN KUCC - North, KUCC - North Kansas City Position Summary / Career Interest: The PRN Ambulatory Clinic RN Care Coordinator is a licensed registered professional nurse who is a clinical expert who provides ethical, evidence-based, safe and compassionate nursing care.   The PRN Ambulatory Clinic RN Care Coordinator focuses on patient safety and the quality of nursing care by identifying and clarifying patient needs, conducting health education, promoting patient advocacy, coordinating healthcare services, and evaluating patient outcomes. The RN Care Coordinator will provide support to their assigned physicians by communicating with the patient/family/caregiver and relaying the information to the physician. They will provide support during the physician’s clinic sessions and ensuring the...

locations Kansas City, KS time type Full time posted on Posted 3 Days Ago job requisition id R-29907 Position Title RN Care Coordinator - Float Pool (Clinics) Olathe Pavilion Position Summary / Career Interest: The Ambulatory Clinic RN Care Coordinator is a licensed registered professional nurse who is a clinical expert who provides ethical, evidence-based, safe and compassionate nursing care. The Ambulatory Clinic RN Care Coordinator focuses on patient safety and the quality of nursing care by identifying and clarifying patient needs, performing clinic related patient care, conducting health education, promoting patient advocacy, coordinating healthcare services, and evaluating patient outcomes. The RN Care Coordinator will provide support to their assigned physicians by communicating with the patient/family/caregiver and relaying the information to the physician. They will provide support and nursing care services during the physician’s clinic sessions and ensuring the...