Utilization Management RN: Care Coordination Pro
Santa Barbara Cottage Hospital
Santa Barbara Cottage Hospital is seeking a registered nurse to perform utilization review of inpatient, outpatient, and post-acute services. The role involves determining medical necessity, documenting decisions, and coordinating with the Medical Director and care management teams to ensure appropriate care across the health care continuum. Responsibilities include data entry, interdepartmental communication, and ongoing participation in education initiatives. #J-18808-Ljbffr Santa Barbara Cottage Hospital
- A healthcare organization in New York is seeking a Clinical Coordinator/RN Care Manager responsible for conducting comprehensive assessments upon patient admission. The role involves coordinating care, facilitating discharge planning to prevent readmissions, and collaborating...Suggested
- ...Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from... ...management and benefit coordination, requiring an active RN license and hospital experience. Responsibilities... ...providers, and ensuring timely care while meeting state and federal...SuggestedRemote workWork from home
- ...to educate providers on benefits and networks. The role includes coordinating discharge planning and referrals to care management to support high-quality, cost-effective care. The ideal candidate has an RN license, 3+ years of clinical practice, and experience in...SuggestedRemote jobRotating shift
$45 - $45.5 per hour
...Job Title: Nurse Case Management Senior Analyst Location... ...evaluates appropriate health care services in conjunction... ...treatment plan. Utilizes clinical skills to assess, plan, implement, coordinate, monitor and evaluate options... ...junior team members. RN and current...SuggestedContract workImmediate startRemote workMonday to FridayAfternoon shift$45.22 per hour
...you\'ll do The SANE Program Coordinator RN coordinates the BHN SANE program... ...plan for new examiners Manage an on-call schedule for examiners... ...in order to provide quality care to assigned patients Develops... ...the age of the client served Utilizes and follows national patient...SuggestedReliefLocal area- IntusCare is seeking a Utilization Management (UM) Manager to lead the UM nurse team supporting a PACE... ...criteria across cases to optimize care and efficiency. The role blends hands-... ...staffing, coaching, QA, and cross-functional coordination with clients and the contracted...Remote job
$40 - $45 per hour
...Immediate need for a talented RN Care Management Coordinator . This is a 03 months Contract opportunity with long-term potential and is Remote... ...skills based on advanced medical knowledge to cases, utilizing specified resources and guidelines to make case determination...Contract workLocal areaImmediate startRemote work- University of Miami Health System seeks a full-time Utilization Review Case Manager to work remotely. The role reviews patient charts for... ..., concurrent and retrospective utilization, coordinating with the care team for timely and appropriate care. You will manage...Remote jobFull time
- UnitedHealth Group is a health care and well-being company... ...As a part of the care management team, the Care Coordinator will be the primary care manager... ...to promote appropriate utilization of services and improved quality... ...in one of the below: RN LCSW, LMSW, LSW, LCPC,...Remote jobMinimum wageFull timeWork experience placementLocal area
$118.13k - $155.79k
...Presbyterian Hospital is seeking a Case Manager - RN for Inpatient Units. This full-time... ...involves discharge planning and utilization management for patients in Brooklyn... ...include managing clinical reviews and coordinating post-acute care plans. Candidates should have a Bachelor...Full time$30 - $35 per hour
...Description Job Description Nursing Care Coordinator (RN / LPN) Location: Brooklyn, NY (In-... ...partnership with MedElite Healthcare Management Group empowers us to focus on what... ...care management verticals. Systems Utilization : Maintain proficiency across primary...Hourly payFull timeWork at officeRelocation packageMonday to Friday- ...Sciences University is seeking a full-time TH Utilization Review Quality Assurance Senior Coordinator / RN Case Manager in New York. The role focuses on hospital case... ...discharge planning to ensure smooth transitions of care. The position requires NY RN licensure, a...Full time
- ...licensed practical nurse to join BHPS Utilization Management as a remote reviewer of medical necessity... ...cases using clinical guidelines and coordinate with providers and departments to... ...to work independently in a fast-paced managed care environment. #J-18808-LjbffrRemote work
- ...Health Plan Solutions seeks an experienced Utilization Management Nurse (LPN) to perform medical... ...remotely. You will work within UM processes, coordinate with partners, and ensure timely,... ...Office, and 2+ years in UM within managed care. Prior experience in various reviews...Work at officeRemote work
- ...members access quality, affordable care! PacificSource is an equal... ...ways that fully develop and utilize each person’s talents and... ...non-medical professionals to coordinate delivery of healthcare services... ...available. Provide utilization management (UM) services which promote...
- ...thread” of compassionate care that connects staff... ...Responsibilities As our Utilization Management Nurse, you will be a... ...reviews per the Care Coordination Utilization Review guidelines... ...Review Organization (PRO), Joint Commission,... ...with facility RN Care Coordinators to ensure...
- ...a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our growing healthcare team... ...while supporting transitions of care and ensuring patients receive appropriate... ...interdisciplinary teams to ensure coordinated and effective care delivery....Remote work
$100k - $119k
ONSITE Clinical Care Coordinator RN role offering 4 day work week, 15K Sign on Bonus, PENSION &... ...is used in eligibility determinations, utilizing the Hospice Conditions of Participation... .... Coordinates effective symptom management for patients awaiting hospital discharge...Temporary workLocal areaRelocation packageFlexible hours- ...Morningside is seeking an experienced RN Case Manager for Case Management (ED) on... ...outcomes. The role involves coordinating UR activities, discharge planning, and the continuum of care, with a focus on efficiency, quality, and resource utilization. A NYS RN license and related...Night shift
$26.01 - $56.14 per hour
...URAC-accredited medical management organization founded... ...flexible, cost-effective care management solutions... ...journeys. As a Utilization Management (UM) Nurse... ...process to implement, coordinate, monitor and evaluate... ...Active, unrestricted RN license in your state...Hourly payFull timeTemporary workLocal areaRemote workMonday to FridayFlexible hoursShift work- ...CVS Health is seeking an experienced Utilization Management (UM) Nurse Consultant for a 100% remote... ...candidates in the EST or CST zones. You will coordinate, document, and communicate utilization... ...activities to ensure appropriate care while complying with state and federal...Full timeRemote work
- Empower. Unite. Care. MetroPlus Health is committed... ...York State Medicaid Managed Care, Medicare, Child... ...expenses, through the coordination of services, both outpatient... ...MetroPlusHealth Utilization Management policies, procedures... ...Professional Nurse (RN), License Practical...Shift work
- Texas Health Resources is seeking an Utilization Management RN - Clinical Review to support remote admissions reviews across THR facilities. You... ...requires an RN with an Associate's degree and inpatient acute care experience, plus Utilization Management exposure. #J-18808...Remote job
$42 per hour
...help Programs of All-Inclusive Care for the Elderly (PACE)... ...purpose-built solutions for care coordination, risk adjustment, population health, and utilization management. IntusCare empowers teams to take... ...management experience. Current RN license Proven experience...Contract workRemote work$87.36k - $91.52k
...Job Description Job Description Pulmonary Program Coordinator (RN) Salary: $87,360- $91,520 annually (depending on experience) Hourly... ...'ll provide clinical leadership, coordinate pulmonary-focused care, and collaborate with the interdisciplinary team to support...Hourly payWeekly payDaily paidFull timePart timeShift work- Job Title RN Magnet Program Coordinator, York, PA Job Description Provides oversight of the Magnet Program... ...practices that improve patient care delivery. Responsibilities Coordinates... ...Coordinates and facilitates Magnet Councils. Manages performance requirements on an...Work at office
- Appworkshub is seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our remote healthcare team. In this role, you... ...utilization reviews, support transitions of care, and ensure compliance with Medicare Advantage regulations...Remote job
- ...Registered Nurse to join our interdisciplinary team across inpatient, outpatient, and community settings. You will lead the care planning process, coordinate the interdisciplinary plan of care, and ensure alignment with the medical treatment plan while delivering culturally...
- Currently seeking a Utilization Management RN . Please see details and qualifications below: Position... ...to review medical records, validate care plans, and authorize services that meet... ...with providers, support care coordination, ensure regulatory compliance, and advocate...Immediate startRemote workWeekend workDay shift
- ...A healthcare provider in New Jersey is seeking a dedicated perioperative nurse responsible for coordinating and delivering care in the operating room. The role involves supervising surgical team members and ensuring efficient operations while addressing the needs of patients...
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