676 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: 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 type, and...

Job Description Description Areas of focus include Surgery, Women's, and Children's at UNCMC. The team: Completes clinical reviews for all areas: pediatric, adult surgical, and postpartum patients Ensures compliance in accordance to government's federal rules and regulations related to patient care and reimbursement Interacts with the Interdisciplinary Team for patient care progression Protects hospital revenue by working with payors for insurance authorizations, denials, and appeals Delivers mandated federal notices to patients/ patient representatives related to their payer source Preferences given to candidates with Medical Surgical bedside experience. 40 hrs/week with flexible schedule options available Primarily on-site with option to work remotely twice monthly Holiday rotation No Nights No on-call Become part of an inclusive organization with over 40,000 teammates, whose mission is to...

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...

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...

339935 Responsibilities The Valley Health System has expanded into an integrated health network that serves more than two million people in Southern Nevada. Starting with Valley Hospital Medical Center in 1979, the Valley Health System has grown to include Centennial Hills Hospital Medical Center , Spring Valley Hospital Medical Center , Summerlin Hospital Medical Center, Henderson Hospital, Valley Health Specialty Hospital, and West Henderson Hospital. Benefit Highlights: Comprehensive education and training center Competitive Compensation & Generous Paid Time Off Excellent Medical, Dental, Vision and Prescription Drug Plans 401(K) with company match and discounted stock plan Career opportunities within VHS and UHS Subsidies Challenging and rewarding work environment Job Description: To achieve quality healthcare outcomes by establishing a safe, individualized discharge and providing proficient...

RN Case Manager RN Case Manager Apply! Apply! Position Details Department: PCH-MAIN | Case Management Location: Phoenix Shift: Mon-Fri, Sat, Sun, (Days Vary), Days, 8am-5pm...

337358 Responsibilities The Valley Health System has expanded into an integrated health network that serves more than two million people in Southern Nevada. Starting with Valley Hospital Medical Center in 1979, the Valley Health System has grown to include Centennial Hills Hospital Medical Center , Spring Valley Hospital Medical Center , Summerlin Hospital Medical Center Henderson Hospital, Valley Health Specialty Hospital, and West Henderson Hospital. Benefit Highlights: Competitive Compensation & Generous Paid Time Off Excellent Medical, Dental, Vision and Prescription Drug Plans 401(K) with company match and discounted stock plan Career opportunities within VHS and UHS Subsidies Challenging and rewarding work environment Comprehensive education and training center Job Description: Under the supervision of the Regional Manager CDI manages day-to-day workflow, specifically the operations of the Clinical...

locationsCobb Hospital time typeFull time posted onPosted 2 Days Ago job requisition idJR-61614 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Night (United States of America) Job Summary: The RN Clinical Charge Nurse is responsible for directing and overseeing the daily activities of the unit on an assigned shift to assure successful safe delivery of care. The Charge Nurse is a caregiver and often takes modified patient care assignment. They practice in a clinical environment that is administered by...

locations1800 Parkway Place time typeFull time posted onPosted 5 Days Ago job requisition idJR-60389 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Day (United States of America) Job Summary: The nurse manager of the home care program is a registered professional nurse who provides leadership and management of the home care unit through the effective use of home health knowledge and home care nursing skills to create a center of excellence that promotes the mission and vision of WellStar Home Health....

locationsWellstar East Paulding Primary Care time typeFull time posted onPosted Today job requisition idJR-59752 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Day (United States of America) Job Summary: As a member of the Population Health Management (PHM) Team, the Outpatient Case Manager works with members, providers and caregivers to provide intensive, comprehensive case management and increase efficient utilization of services for patient with complex needs; identifies chronic, complex and or...

locationsWellstar MCG Health time typeFull time posted onPosted Today job requisition idJR-60384 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Various (United States of America) Job Summary: The Clinical Outcomes Manager (COM) is an advanced degree nurse with expert knowledge and clinical skills, instrumental in driving safe, high-quality care. Partnering with nursing executives, department, and physician leaders, the COM champions unit- and system-level improvements. This self-directed leader...

remote typeHybrid locationsWCO - Wellstar Corporate Office time typeFull time posted onPosted 3 Days Ago job requisition idJR-57874 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Day (United States of America) Job Summary: This position will support GI and Endoscopy programs system wide. The Clinical Nurse Professional Development Educator Advanced works collaboratively to assess, identify, plan, implement, coordinate, facilitate, and evaluate educational activities through a systems...

locationsWindy Hill Hospital time typeFull time posted onPosted 3 Days Ago job requisition idJR-60217 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Job Summary: The Clinical Nurse Professional Development Educator Advanced works collaboratively to assess, identify, plan, implement, coordinate, facilitate, and evaluate educational activities through a systems model. This includes the tools, theories, skills, and knowledge of the specialty to improve healthcare practice of learners based on the...

locationsVinings Health Park time typeFull time posted onPosted Today job requisition idJR-62656 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Day (United States of America) Job Summary: The RN Charge Nurse, Urgent Care is responsible for directing and overseeing the daily activities of the Urgent Care Center on an assigned shift to assure the delivery of efficient, safe and quality patient care. The RN Charge Nurse is a caregiver who takes a patient care assignment. They practice in a clinical...

locationsVinings Health Park time typeFull time posted onPosted Today job requisition idJR-62726 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Various (United States of America) Job Summary: The RN Charge Nurse, Urgent Care is responsible for directing and overseeing the daily activities of the Urgent Care Center on an assigned shift to assure the delivery of efficient, safe and quality patient care. The RN Charge Nurse is a caregiver who takes a patient care assignment. They practice in a clinical...

locationsPaulding Hospital time typePart time posted onPosted Yesterday job requisition idJR-55962 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Job Summary: PRN/Supplemental as needed Care Coordinator ( Discharge Planner ) for Inpatient Care Acute Care Wellstar Paulding Inpatient Discharge Planning Magnet Designated growing Paulding campus committed to exceptional care and patient experience. 3 STAR CMS scores for Patient Satisfaction. Strong customer service/positivity and empathy...

locationsCobb Hospital time typeFull time posted onPosted 4 Days Ago job requisition idJR-59616 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Day (United States of America) Job Summary: Functions under the direction of the Site Manager. He/she is responsible for performing a wide variety of clinical procedures requiring independent judgement, ingenuity and initiative in the utilization of the equipment for the diagnosis and/or treatment Core Responsibilities and Essential Functions: Builds a...

locationsWAB - Wellstar Administrative Building time typeFull time posted onPosted 30+ Days Ago job requisition idJR-16620 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Job Summary: As a member of the Population Health Management (PHM) Team, the Outpatient Case Manager works with members, providers and caregivers to provide intensive, comprehensive case management and increase efficient utilization of services for patient with complex needs; identifies chronic, complex and or catastrophic cases through the case...

locationsWellstar MCG Health time typeFull time posted onPosted 4 Days Ago job requisition idJR-46848 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Night (United States of America) Job Summary: The RN Resident is expected to successfully complete the 12-month Nurse Residency Program (NRP). The Wellstar program is designed to facilitate and provide support for a successful transition into professional practice for the new graduate RN with less than 6 months of experience as a Professional Registered...

locationsKennestone Hospital time typeFull time posted onPosted 3 Days Ago job requisition idJR-49926 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Day (United States of America) Job Summary: The Manager, Critical Care Clinical Support Programs supports Wellstar ECMO services in the community by overseeing the clinical and operational components of the ECMO program and team. This position will assist in the planning, development, and implementation of the ECMO Program as it expands to offer complex...

locationsPaulding Hospital time typeFull time posted onPosted 6 Days Ago job requisition idJR-52600 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Day (United States of America) Registered Nurse Oncology Infusion Float-Paulding Shift: FT Day **Sign on Bonus Eligible** The RN Oncology Infusion Therapy Clinician functions under the direction of the Manager Infusion Therapy or other designated leader. The RN Oncology Infusion Therapy Clinician demonstrates knowledge, competency, and clinical...

remote typeOnsite locationsNorth Fulton Hospital time typePart time posted onPosted 30+ Days Ago job requisition idJR-35690 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Job Summary: Wellstar North Fulton Hospital has an opportunity for a Senior Registered Nurse (RN) Care Coordinator - PRN Day Shift The Care Coordinator RN Sr. (RN Sr) is responsible for assessing transitional care needs, coordinating care across the continuum, and engaging with patient and family to assure care needs are met the most...

locationsCobb Hospital time typeFull time posted onPosted 3 Days Ago job requisition idJR-45148 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Day (United States of America) Hours: 7AM-5:30PM-Monday-Friday-4/10's Call Required within 30 minute Holiday Call Required-Weekends Included when on Call Job Summary: Functions under the direction of the Site Manager. He/she is responsible for performing a wide variety of clinical procedures requiring independent judgement, ingenuity and initiative in...

locationsNorth Fulton Physicians Building time typeFull time posted onPosted Today job requisition idJR-53412 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Day (United States of America) Job Summary: The Registered Nurse Specialty functions under the direction of the Office Manager and/or Physician and is responsible for implementing the nursing process based on expanded knowledge and experience. The nurse is responsible for coordinating and providing safe patient care with an understanding and...