Clinical Utilization Review Case Manager
Torrance-Memorial-Medical-Center
Torrance-Memorial-Medical-Center seeks an experienced Utilization Review Case Manager (RN) to review patient charts and validate appropriate levels of care using InterQual/MCG criteria. The UR CM secures payer authorization and communicates with payers throughout the stay, ensuring compliance with CMS and Joint Commission standards. The role involves collaborating with RN Case managers, physicians, and external case managers, documenting thoroughly, and supporting denial prevention and discharge #J-18808-Ljbffr Torrance-Memorial-Medical-Center
$56.39 - $87.25 per hour
Under general supervision, performs review of patient charts as required by the Hospitals Utilization Management Review Plan. The Utilization Review Case Manager (UR CM) validates the... ...secures authorization for the patient's clinical services through collaboration and...SuggestedContract workNight shift$47.2 - $63.45 per hour
...for the quality and resource management of all patients that are admitted... ...the achievement of quality, clinical and cost-effective outcomes... ...admission and concurrent review of the medical record for the... ...least one year experience in case management, discharge planning...SuggestedFull timePart timeWork experience placementLocal areaShift work- Origin Travel Nurses is seeking a Case Manager responsible for utilization review and case management in a hospital setting. You will perform chart reviews... ...at admission, and document daily. This role requires clinical and case management experience, plus BCLS...Suggested
- ...Case Manager Qualifications for Case Manager: The Case Manager... ...Partners with medical staff, utilizes scientific evidence for best... ...employee performance through the review of completed work assignments... ...CA Registered Nurse Acute clinical experience Experienced in...SuggestedTemporary workShift work
- ...Case Manager This position reports to the Director of Case Management... ...Services. Performs chart reviews and quality assessments on all... ...regarding criteria for Utilization Management. Provides documentation... ..., direct‑hire, and non‑clinical professionals across hospitals...SuggestedLocumImmediate startShift work
- ...and integrity that you truly deserve. Job Description Minimum of recent 2 years combined case management or clinical experience providing direct patient care and utilization review/case management experience in an acute care environment Working knowledge in the use of...Daily paid
- ...Nurse Case Manager Under the general supervision of the CM Director the nurse case manager manages clinical resource utilization and documentation affecting reimbursement, acting as a resource... ...Act. Essential Functions: Reviews clinical information daily on each...Full timeShift workDay shift
- Role Summary The Case Manager is a vital member of the Interdisciplinary Care Team and collaborates... ...with the Primary Care Provider and utilizing clinic resources. Conduct in-clinic, at-home... ...discharges and transitions of care. Review medical test results and collaborate...Immediate startMonday to Friday
- ...Registered Nurse (Case Manager)The case manager performs the primary functions of assessment... ...health care plans and optionsMake clinical decisions for routine patient careAccurately... ...consider 1.5 years)Experience with Utilization Review and Discharge PlanningExperience with...
$34.77 - $36.6 per hour
...medical, dental, vision and retirement benefits Job Summary The Clinical Case Management Team provides clients with the highest levels of acuity and... ...Assigns and monitors case load of the team: Review daily referrals and screenings of potential clients. Designates...Hourly payWork at officeLocal area$34.77 - $36.6 per hour
...vision and retirement benefits JOB SUMMARY AND PURPOSE The Clinical Case Management Team provides clients with the highest levels of acuity and... ...RESPONSIBILITIES Assigns and monitors case load of team: Review daily referrals and screenings of potential clients....Work at officeLocal area$38 - $41 per hour
...placing talented healthcare professionals in clinical and non-clinical positions with some of... ...are aggressively seeking an Ambulatory Case Manager RN to join a large Healthcare... ...prospective, concurrent and retrospective review of active patient care. Coordinates treatment...Private practiceMonday to FridayFlexible hoursShift work$51.19 - $64.92 per hour
...physician and offer 24-hour clinical care seven days a week... ...and ensures optimum utilization of resources, service... ...with external review agencies. Provides ongoing... ...the quality of patient management and satisfaction, to promote... ...of functions of case management, utilization...Full timeWork at office- ...Job Title: RN Case Manager Los Angeles, CA Region Now Hiring: RN Case Manager Los Angeles... ...Responsibilities May assist supervisor/manager in review of reports, staff development.... .... Individuals who conduct initial clinical review possess an active, professional license...Full timeWork at officeLocal areaImmediate start
$53 - $75 per hour
...Inpatient Care Manager Salary Range: $53.00 - $75.00 per hour Based on an initial review of member care needs at the time of admission... ...discharge. Apply approved clinical criteria to monitor... ...continuity of care. Presents cases and participates in discussion...Hourly payLocal area$61.98 - $86.73 per hour
...RN, Case Manager III (UR) Title: RN Case Manager III Location: Long Beach Department... ...for education, monitoring, utilization and evaluation of medical outcomes.... ...documentation, including but not limited to the Clinical Pertinence Review Form. The case manager has the...Full timeContract workShift work$120k - $150k
...through exceptional care and meaningful relationships. As our Clinical Director, you'll have the chance to lead with purpose, guiding... ...satisfaction. Qualifications: Experience in leading and managing clinical teams, with a focus on fostering a culture of accountability...$157.21k - $231.13k
...USA The System Director of Case Management is responsible for the overall... ...-quality care that meets clinical, operational, and regulatory... ...management program at Pipeline utilizing a system approach Oversee... ...further information, please review the Know Your Rights notice...Local area- Duties And Responsibilities The Case Manager will assist patients to understand recommendations... ...(billing, medical records, etc.). Review superbill forms. Maintain and... ...as directed by supervisor (Clinic Manager/LVN). Utilization of CAIR, and VFC and other systems as...
$68.65k
Senior Surrogacy Case Manager / Program Coordinator Over The Rainbow Surrogacy Full-Time |... ...postpartum needs. Communicate with IVF clinics, attorneys, escrow companies, insurance... ...the GC clearance process, including: Reviewing prospective GC applications and qualifications...Full timeRemote workMonday to Friday$55 - $60 per hour
...growth opportunities.We're hiring a RN Case Manager – a compassionate and skilled clinician... ...with a Hospice Care LeaderYou lead with clinical expertise, empathy, and strong organizational... ...by Silverado and is available for review upon request to ensure compliance with California...Full timeMonday to FridayShift work- TEEMA Solutions Group invites a dedicated Registered Nurse Case Manager to join our care team in Carson, CA. This hybrid clinic & field-based role concentrates on improving care outcomes for an assigned elder patient panel, collaborating with PCPs and an interdisciplinary...
$55.56 - $85.96 per hour
...in Torrance, California is seeking a Case Management Nurse II to support the interdisciplinary... ...patient caseload, integrate utilization management, and provide discharge planning... ...will have a nursing degree, relevant clinical experience, and a Registered Nurse License...Hourly pay- Volunteers of America Los Angeles is seeking a Lead Clinical Case Manager to supervise a high-acuity caseload and provide coordinated care, counseling, and planning. The role combines administrative duties with field/outreach work to support re-entry and stability for clients...
$60.07 per hour
Position Summary The RN Case Manager is responsible for performing clinical assessment and reassessment of acute care Inpatients for the purpose of performing utilization review, resource management and safe discharge planning. The RN Case Manager prioritizes, plans, organizes...Full timeLocal areaImmediate startRelocation package- Alta Hospital in California seeks an RN Case Manager to assess and reassess acute inpatients for utilization review, resource management, and safe discharge planning. You... ...transitions of care. The role emphasizes clinical competence, timely reviews, and effective communication...
- ...Clinical Care Manager – CA We are seeking a Clinical Care Manager – CA to join our team at Independent... ...in clinical care coordination or case management. Requires knowledge of... ...with insurance providers and case management teams to optimize resource utilization....
$24 - $26 per hour
...Case Manager Long Beach, CA Case Management Services form the core of the services for people who are homeless... ...plan, and conduct comprehensive assessments to be reviewed and updated quarterly. Learn and utilize the project's database software (CHAMP/HMIS/APRICOT...Hourly payPermanent employmentFlexible hoursAfternoon shift- ...or lack thereof through comprehensive case management and integrated social service programs.... ...their individual goals Identify and utilize client strengths to increase self-efficacy... .... St. Joseph center invites you to review the current "EEO is The Law" poster as...Permanent employmentFull timeFlexible hoursAfternoon shiftEarly shift
$150k
...Job Description Position SummaryThe Manager of Case Management is accountable for overseeing... ...to the Facility(s). Attends the Utilization Management Committee. Under the direction... ...and met.Collaborates effectively with clinical and administrative leadership, physicians...Full timeLocal areaImmediate start
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