Utilization Management Nurse - Patient Case Management in Raleigh, NC for WakeMed Health & Hospitals

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Clinical Denials Management Program Coordinator RN

Cedars Sinai

Los Angeles, California

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Acute Medicine Clinical Nurse - FT Days

BJC HealthCare

Saint Louis, Missouri

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TRANSITIONAL CASE MANAGER PRN - WEEKDAY

Cooper University Health Care

Camden, New Jersey

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Acute Nurse Clinical Nurse - FT Nights

BJC HealthCare

Saint Louis, Missouri

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Care Manager - Case Management

CHRISTUS Health

Santa Fe, New Mexico

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Registered Nurse RN - Inpatient Case Manager

Northeast Georgia Health System

Dahlonega, Georgia

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Acute Medicine Clinical Nurse - FT Nights

BJC HealthCare

Saint Louis, Missouri

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Acute Medicine Team Lead Charge Nurse - FT Nights (6200 MED)

BJC HealthCare

Saint Louis, Missouri

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Registered Nurse, Per Diem Days, 8am - 4pm, Wound Healing Center, Atlantic Health, Chilton Medical Center

Atlantic Health

Pompton Plains, New Jersey

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Manager, Care Management Transition of Care Team - Denver Health Medical Plan

Denver Health

Denver, Colorado

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Social Worker-BSW LBSW

Indiana University Health

Muncie, Indiana

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TRANSITIONAL CASE MANAGER PRN - WEEKDAY

Cooper University Health Care

Camden, New Jersey

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Athletic Trainer II - Institute for Healthy Living - Full Time

CHRISTUS Health

Longview, Texas

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RN Cardiac PCU

Baylor Scott & White Health

Temple, Texas

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Home Health CNA

BJC HealthCare

Glen Carbon, Illinois

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Senior Social Worker (PCMHI)

Veterans Affairs, Veterans Health Administration

Sierra Vista, Arizona

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Senior Social Worker Behavioral Health Interdisciplinary Program (BHIP)

Veterans Affairs, Veterans Health Administration

Millington, Tennessee

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Physical Therapist I: Pelvic Floor; Full Time, Atlantic Health Atlantic Rehab Wayne (OP)

Atlantic Health

Wayne, New Jersey

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Registered Nurse Case Manager PRN - VUH

Vanderbilt Health

Nashville, Tennessee

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LTSS Nursing Facility Service Coordiantor Level 1*

Harris Health

Houston, Texas

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RN Coordinator-Home Infusion

Duke University Health System

Durham, North Carolina

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Registered Nurse - Orthopedic Surgical

Indiana University Health

Indianapolis, Indiana

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Senior Social Worker - Substance Treatment Program Therapist

Veterans Affairs, Veterans Health Administration

Wenatchee, Washington

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RN-Transfer Center

Indiana University Health

Indianapolis, Indiana

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RN Cardiac Care and Telemetry

Baylor Scott & White Health

Temple, Texas

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Utilization Management Nurse - Patient Case Management

OverviewResponsible for performing a comprehensive review of the medical record to assess for accuracy in the assignment of patient class (status) that is congruent with the patient's clinical condition, physician intent, medical necessity and current rules and regulatory requirements. Documents accurate and timely clinical reviews to support medical necessity and obtain payer authorization. Complies with current rules and regulatory requirements pertaining to utilization management. Communicates and collaborates with providers and members of the health care team to promote optimal, appropriate, and cost- effective utilization of resources. Identifies, addresses, and mitigates avoidable days whenever possible. Department Description

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