1105 rn utilization manager jobs found

Job Description Description Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and discharge review cases for medical necessity, appropriate class and level of care (LOC). This position works collaboratively with an interdisciplinary team (including physicians, other care providers, payers, etc.) to ensure the patient’s needs are met and care delivery is coordinated. The UM completes utilization reviews in accordance with federal regulations and the health system’s Utilization Review Plan. Responsibilities: Uses approved criteria and conducts admission review/class change review as trigger by patient admission to the hospital to ensure appropriateness of the setting and timely implementation of the plan of care. Identifies...

BSMMHPUSR244587EXTERNALENUS Everyone who works with Mercy Health is united under one purpose: to help our patients be well in mind, body and spirit. This drive, along with our history of faith, is a powerful combination. It gives us a shared calling to work toward every day. Join our exceptional team and help us continue to provide the highest quality of health care possible to our communities. Summary of Primary Function In the capacity of a Registered Nurse, the Ambulatory Care Manager will provide clinical care management services to identified eligible patients; coordinating care to obtain desired health outcomes, improve self-care abilities, and decrease unnecessary cost of care. Perform standardized comprehensive needs assessment, identifying and addressing barriers to care and aligning patients with available benefits and resources.  Collaborate with patient, provider and care team to develop and implement a plan of care to ensure medically appropriate cost-effective...

BSMMHPUSR245293EXTERNALENUS Everyone who works with Mercy Health is united under one purpose: to help our patients be well in mind, body and spirit. This drive, along with our history of faith, is a powerful combination. It gives us a shared calling to work toward every day. Join our exceptional team and help us continue to provide the highest quality of health care possible to our communities. Primary Function/General Purpose of Position The RN Care Manager is responsible for providing coordination of care for patients to support safe, seamless, timely transitions across the continuum. This role utilizes a collaborative process, the RN Care Manager identifies (using quantitative and qualitative methods), assesses, plans, implements and evaluates the options and services required to meet an individual’s health and health related needs, including social- determinants that affect ones’ overall wellbeing. The RN Care Manager is responsible for screening, identification, and...

BSMMHPUSR244584EXTERNALENUS Everyone who works with Mercy Health is united under one purpose: to help our patients be well in mind, body and spirit. This drive, along with our history of faith, is a powerful combination. It gives us a shared calling to work toward every day. Join our exceptional team and help us continue to provide the highest quality of health care possible to our communities. Summary of Primary Function In the capacity of a Registered Nurse, the Ambulatory Care Manager will provide clinical care management services to identified eligible patients; coordinating care to obtain desired health outcomes, improve self-care abilities, and decrease unnecessary cost of care. Perform standardized comprehensive needs assessment, identifying and addressing barriers to care and aligning patients with available benefits and resources.  Collaborate with patient, provider and care team to develop and implement a plan of care to ensure medically appropriate cost-effective...

112280 Job Description Overview Join our team as a day shift, PRN, Case Management Acute Care Case Manager Registered Nurse (RN) in Pocatello, ID. Why Join Us? Thrive in a People-First Environment and Make Healthcare Better Thrive: We empower our team with career growth opportunities, tuition assistance, and resources that support your wellness, education, and financial well-being. People-First: We prioritize your well-being with a supportive, inclusive culture where you are valued and cared for. Make Healthcare Better: We use advanced technology to support our team and enhance patient care. Get to Know Your Team: Portneuf Medical Center is a nationally recognized healthcare leader with 205 beds, serving as the region's tertiary care and Level II Trauma Center, housing the Portneuf Heart and Vascular Institute, Portneuf Cancer Center, Portneuf Medical Group, and Portneuf Air Rescue. Responsibilities To assure clinical...

117076 Job Description Overview You may be eligible for a Sign On Bonus of up to $5,000.00! Join our team as a day shift, full time, Case Management Acute Care, Case Manager Registered Nurse in Topeka, Kansas. Why Join Us? Thrive in a People-First Environment and Make Healthcare Better Thrive: We empower our team with career growth opportunities, tuition assistance, and resources that support your wellness, education, and financial well-being. People-First: We prioritize your well-being with paid time off, comprehensive health benefits, and a supportive, inclusive culture where you are valued and cared for. Make Healthcare Better: We use advanced technology to support our team and enhance patient care. Get to Know Your Team: The University of Kansas Health System St. Francis Campus, a part of a rich legacy of compassionate care since 1909, now offers 378 licensed beds, a history of innovation, and strong community...

108853 Job Description Overview Join our team as a day shift, part-time, Case Management Acute Care, Case Manager Registered Nurse in Topeka, Kansas. Why Join Us? Thrive in a People-First Environment and Make Healthcare Better Thrive: We empower our team with career growth opportunities, tuition assistance, and resources that support your wellness, education, and financial well-being. People-First: We prioritize your well-being with paid time off, comprehensive health benefits, and a supportive, inclusive culture where you are valued and cared for. Make Healthcare Better: We use advanced technology to support our team and enhance patient care. Get to Know Your Team: The University of Kansas Health System St. Francis Campus, a part of a rich legacy of compassionate care since 1909, now offers 378 licensed beds, a history of innovation, and strong community support. Responsibilities The Case Manager coordinates care...

118361 Job Description Overview Join our team as a day shift, full-time, Case Management Acute Care Clinical Case Manager (RN) in Albuquerque, NM. You may be eligible for a sign on bonus for up to $10,000. Why Join Us? Thrive in a People-First Environment and Make Healthcare Better Thrive: We empower our team with career growth opportunities, tuition assistance, and resources that support your wellness, education, and financial well-being. People-First: We prioritize your well-being with paid time off, comprehensive health benefits, and a supportive, inclusive culture where you are valued and cared for. Make Healthcare Better: We use advanced technology to support our team and enhance patient care. Get to Know Your Team: Lovelace Medical Center is an acute care hospital with 263 licensed beds, providing comprehensive care, including around-the-clock emergency care, surgical services, non-invasive robotic spine...

116454 Job Description Overview Join our team as a day shift, PRN, Case Management Acute Care, Case Manager Registered Nurse in Topeka, Kansas. Why Join Us? Thrive in a People-First Environment and Make Healthcare Better Thrive: We empower our team with career growth opportunities and resources that support your wellness, education, and financial well-being. People-First: We prioritize your well-being with a supportive, inclusive culture where you are valued and cared for. Make Healthcare Better: We use advanced technology to support our team and enhance patient care. Get to Know Your Team: The University of Kansas Health System St. Francis Campus, a part of a rich legacy of compassionate care since 1909, now offers 378 licensed beds, a history of innovation, and strong community support. Responsibilities The Case Manager RN is responsible for assessing and coordinating patient care across the continuum, utilizing...

115126 Job Description Overview Join our team as a day shift, full-time, Case Management Acute Care Registered Nurse in Roswell, NM. Why Join Us? Thrive in a People-First Environment and Make Healthcare Better Thrive: We empower our team with career growth opportunities, tuition assistance, and resources that support your wellness, education, and financial well-being. People-First: We prioritize your well-being with paid time off, comprehensive health benefits, and a supportive, inclusive culture where you are valued and cared for. Make Healthcare Better: We use advanced technology to support our team and enhance patient care. Get to Know Your Team: Lovelace Regional Hospital includes 24/7 emergency services, intensive care, inpatient and outpatient rehabilitation, surgical and birthing services for Roswell and the surrounding community. Responsibilities The Case Manager RN is responsible for assessing and...

Job Id R1114880 Inspire health. Serve with compassion. Be the difference. Job Summary Provides clinical direction for all aspects of patient care in an acute inpatient setting, fostering patient/family centered care. Demonstrates clinical competency utilizing evidence-based practices/research in all areas of the nursing process: assessment, planning, implementation, evaluation and outcomes. Incorporates knowledge of safety protocols, cost containment and quality improvement throughout the nursing process. Identifies patient, unit and organizational priorities and incorporates into the nursing process. Adheres to all compliance and policy/procedures of the organization including, but not limited to licensure renewal, assigned training, employee health screenings, time and attendance policy, dress code policy, patient confidentiality, infection control, medication administration. Demonstrates knowledge of regulatory agency requirements (TJC, SC DPH, CMS). Provides...

Job Id R1118780 Inspire health. Serve with compassion. Be the difference. Job Summary Provides clinical direction for all aspects of patient care in an acute inpatient setting, fostering patient/family centered care. Demonstrates clinical competency utilizing evidence-based practices/research in all areas of the nursing process: assessment, planning, implementation, evaluation and outcomes. Incorporates knowledge of safety protocols, cost containment and quality improvement throughout the nursing process. Identifies patient, unit and organizational priorities and incorporates into the nursing process. Adheres to all compliance and policy/procedures of the organization including, but not limited to licensure renewal, assigned training, employee health screenings, time and attendance policy, dress code policy, patient confidentiality, infection control, medication administration. Demonstrates knowledge of regulatory agency requirements (TJC, SC DPH, CMS). Provides...

Job Id R1117792 Inspire health. Serve with compassion. Be the difference. Job Summary Provides clinical direction for all aspects of patient care in an acute inpatient setting, fostering patient/family centered care. Demonstrates clinical competency utilizing evidence-based practices/research in all areas of the nursing process: assessment, planning, implementation, evaluation and outcomes. Incorporates knowledge of safety protocols, cost containment and quality improvement throughout the nursing process. Identifies patient, unit and organizational priorities and incorporates into the nursing process. Adheres to all compliance and policy/procedures of the organization including, but not limited to licensure renewal, assigned training, employee health screenings, time and attendance policy, dress code policy, patient confidentiality, infection control, medication administration. Demonstrates knowledge of regulatory agency requirements (TJC, SC DPH, CMS). Provides...

Job Id R1118102 Inspire health. Serve with compassion. Be the difference. Job Summary Working for the Facility Resource Pool, provides clinical direction for all aspects of patient care in an acute inpatient setting, fostering patient/family centered care. Demonstrates clinical competency utilizing evidence-based practices/research in all areas of the nursing process: assessment, planning, implementation, evaluation and outcomes. Incorporates knowledge of safety protocols, cost containment and quality improvement throughout the nursing process. Identifies patient, unit and organizational priorities and incorporates into the nursing process. Adheres to all compliance and policy/procedures of the organization including, but not limited to licensure renewal, assigned training, employee health screenings, time and attendance policy, dress code policy, patient confidentiality, infection control, medication administration. Demonstrates knowledge of regulatory agency...

Job Id R1115412 Inspire health. Serve with compassion. Be the difference. Job Summary Provides clinical direction for all aspects of patient care in an acute inpatient setting, fostering patient/family centered care. Demonstrates clinical competency utilizing evidence-based practices/research in all areas of the nursing process: assessment, planning, implementation, evaluation and outcomes. Incorporates knowledge of safety protocols, cost containment and quality improvement throughout the nursing process. Identifies patient, unit and organizational priorities and incorporates into the nursing process. Adheres to all compliance and policy/procedures of the organization including, but not limited to licensure renewal, assigned training, employee health screenings, time and attendance policy, dress code policy, patient confidentiality, infection control, medication administration. Demonstrates knowledge of regulatory agency requirements (TJC, SC DPH, CMS). Provides...

Job Id R1118413 Inspire health. Serve with compassion. Be the difference. Job Summary Provides clinical direction for all aspects of patient care in an acute inpatient setting, fostering patient/family centered care. Demonstrates clinical competency utilizing evidence-based practices/research in all areas of the nursing process: assessment, planning, implementation, evaluation and outcomes. Incorporates knowledge of safety protocols, cost containment and quality improvement throughout the nursing process. Identifies patient, unit and organizational priorities and incorporates into the nursing process. Adheres to all compliance and policy/procedures of the organization including, but not limited to licensure renewal, assigned training, employee health screenings, time and attendance policy, dress code policy, patient confidentiality, infection control, medication administration. Demonstrates knowledge of regulatory agency requirements (TJC, SC DPH, CMS). Provides...

Job Id R1117336 Inspire health. Serve with compassion. Be the difference. Job Summary Provides clinical direction for all aspects of patient care in an acute inpatient setting, fostering patient/family centered care. Demonstrates clinical competency utilizing evidence-based practices/research in all areas of the nursing process: assessment, planning, implementation, evaluation and outcomes. Incorporates knowledge of safety protocols, cost containment and quality improvement throughout the nursing process. Identifies patient, unit and organizational priorities and incorporates into the nursing process. Adheres to all compliance and policy/procedures of the organization including, but not limited to licensure renewal, assigned training, employee health screenings, time and attendance policy, dress code policy, patient confidentiality, infection control, medication administration. Demonstrates knowledge of regulatory agency requirements (TJC, SC DPH, CMS). Provides...

Job Id R1118567 Inspire health. Serve with compassion. Be the difference. Job Summary The Hospital Case Manager (HCM) provides case management service for hospital patients, including, but not limited to, utilization management to ensure efficient, cost-effective patient progression through the continuum of care and discharge to an appropriate level of care. In collaboration with physicians, leads the multidisciplinary team including clinical staff and payors to ensure efficient delivery of quality, cost-effective care. Accountabilities Participates in discharge planning activities for patients with complex medical issues, in order to ensure a timely discharge and to provide appropriate linkage with post-acute care providers. Accountable for appropriate levels of care and length of stay focus - 10% Consults with interdisciplinary team, Physician Advisor and administrative leadership as necessary to resolve barriers regarding progression of care. Collaborates...

Job Id R1118493 Inspire health. Serve with compassion. Be the difference. Job Summary Provides clinical direction for all aspects of patient care in an acute inpatient setting, fostering patient/family centered care. Demonstrates clinical competency utilizing evidence based practices/research in all areas of the nursing process: assessment, planning, implementation, evaluation and outcomes. Consults with clinical advisor and/or peers as appropriate. Adheres to all compliance and policy/procedures of the organization including, but not limited to: licensure renewal, assigned training, employee health screenings, time and attendance policy, dress code policy, patient confidentiality, infection control, medication administration. Demonstrates knowledge of regulatory agency requirements (JCAHO, DHEC, CMS). Provides care within the scope of the South Carolina Nurse Practice Act. The acute inpatient setting usually requires staff to be scheduled for a significant amount...

Job Id R1118680 Inspire health. Serve with compassion. Be the difference. Job Summary Provides clinical direction for all aspects of patient care in an acute inpatient setting, fostering patient/family centered care. Demonstrates clinical competency utilizing evidence-based practices/research in all areas of the nursing process: assessment, planning, implementation, evaluation and outcomes. Incorporates knowledge of safety protocols, cost containment and quality improvement throughout the nursing process. Identifies patient, unit and organizational priorities and incorporates into the nursing process. Adheres to all compliance and policy/procedures of the organization including, but not limited to licensure renewal, assigned training, employee health screenings, time and attendance policy, dress code policy, patient confidentiality, infection control, medication administration. Demonstrates knowledge of regulatory agency requirements (TJC, SC DPH, CMS). Provides...

Job Id R1118496 Inspire health. Serve with compassion. Be the difference. Job Summary Provides clinical direction for all aspects of patient care in an acute inpatient setting, fostering patient/family centered care. Demonstrates clinical competency utilizing evidence-based practices/research in all areas of the nursing process: assessment, planning, implementation, evaluation and outcomes. Incorporates knowledge of safety protocols, cost containment and quality improvement throughout the nursing process. Identifies patient, unit and organizational priorities and incorporates into the nursing process. Adheres to all compliance and policy/procedures of the organization including, but not limited to licensure renewal, assigned training, employee health screenings, time and attendance policy, dress code policy, patient confidentiality, infection control, medication administration. Demonstrates knowledge of regulatory agency requirements (TJC, SC DPH, CMS). Provides...

Job Id R1112256 Inspire health. Serve with compassion. Be the difference. Job Summary Provides clinical direction for all aspects of patient care in an acute inpatient setting, fostering patient/family centered care. Demonstrates clinical competency utilizing evidence-based practices/research in all areas of the nursing process: assessment, planning, implementation, evaluation and outcomes. Incorporates knowledge of safety protocols, cost containment and quality improvement throughout the nursing process. Identifies patient, unit and organizational priorities and incorporates into the nursing process. Adheres to all compliance and policy/procedures of the organization including, but not limited to licensure renewal, assigned training, employee health screenings, time and attendance policy, dress code policy, patient confidentiality, infection control, medication administration. Demonstrates knowledge of regulatory agency requirements (TJC, SC DPH, CMS). Provides...

Job Id R1106492 Inspire health. Serve with compassion. Be the difference. Job Summary Provides clinical direction for all aspects of patient care in an acute inpatient setting, fostering patient/family centered care. Demonstrates clinical competency utilizing evidence-based practices/research in all areas of the nursing process: assessment, planning, implementation, evaluation and outcomes. Incorporates knowledge of safety protocols, cost containment and quality improvement throughout the nursing process. Identifies patient, unit and organizational priorities and incorporates into the nursing process. Adheres to all compliance and policy/procedures of the organization including, but not limited to licensure renewal, assigned training, employee health screenings, time and attendance policy, dress code policy, patient confidentiality, infection control, medication administration. Demonstrates knowledge of regulatory agency requirements (TJC, SC DPH, CMS). Provides...

Job Id R1104929 Inspire health. Serve with compassion. Be the difference. Job Summary Working for the Facility Resource Pool, provides clinical direction for all aspects of patient care in an acute inpatient setting, fostering patient/family centered care. Demonstrates clinical competency utilizing evidence-based practices/research in all areas of the nursing process: assessment, planning, implementation, evaluation and outcomes. Incorporates knowledge of safety protocols, cost containment and quality improvement throughout the nursing process. Identifies patient, unit and organizational priorities and incorporates into the nursing process. Adheres to all compliance and policy/procedures of the organization including, but not limited to licensure renewal, assigned training, employee health screenings, time and attendance policy, dress code policy, patient confidentiality, infection control, medication administration. Demonstrates knowledge of regulatory agency...