Recent Searches: hudson oh usaatrium windows doorsuniversity waterloosummervillephoenix az

Manager-Utilization Management

Carolina House, an established and evidence-based eating disorders treatment facility with multiple levels of care for patients 17 years old and up, is seeking a Utilization Reviewer / Utilization Review Nurse.

The successful candidate in this key position will be responsible for determining if treatments which are underway or sought for authorization fall within the coverage parameters of a patient's insurance.

Also, the assessment, diagnosis, and treatment of assigned patients. We have two Residential Facilities located in Durham, NC for all gender inclusive treatment needing 24 hour care, as well as a Partial Hospitalization and Intensive Outpatient Program in Raleigh, NC that treats all gender inclusive struggling with eating disorders.

  • Participates in pre-certifications for admissions with third party payers
  • Conducts admission review activities
  • Conducts continued stay review activities
  • Coordinates third party physician peer-to-peer reviews
  • Conducts discharge review activities
  • Notifies third party payers of discharge
  • Maintains accurate UR information and retrieves date for reports
  • Communicates results of third party reviews to appropriate staff for length of stay coordination and discharge planning
  • Establishes and maintains rapport with physicians to ensure adequate, accurate documentation of patient's care.
  • Education Experience

    BA or BS degree preferred

  • Previous experience in the eating disorders or nursing field
  • CPR, CPI and First Aid required
  • Ability to work with all gender inclusive eating disorders population
  • Excellent interpersonal and writing skills
  • Strong problem solving and critical thinking skills
  • Carolina House offers competitive compensation and benefits package including medical, dental, vision, leave benefits, life insurance and 401K plan.

    We are a proud member of Acadia Healthcare-a provider of behavioral healthcare services. Visit the Acadia Website at www.

    acadiahealthcare.com or www.carolinaeatingdisorders.com

    Equal Opportunity Employer / Protected Veterans / Individuals with Disabilities

    The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant.

    However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)

    OpenOctober 21, 2020

    CloseNovember 20, 2020

    Html. body. p. strong. span style "font size. 12pt " Utilization Review Case Manager Nurse. span. strong... u. br. br. u. strong McCall and Lee has been brought on to find a Registered Nurse of Utilization Review...

    See Details

    Identifies quality, risk, or utilization issues to appropriate MedStar personnel.Initiates contact with providers to obtain clinical information to facilitate care or pending of pre...

    See Details

    Description. SHIFT. PRNSCHEDULE. PRN Per Diem. RN Case Manager. PRNSt. Mark's HospitalDo you want to be... Certification in case management or utilization review preferred.InterQual experience preferred.Notice...

    See Details

    Description. SHIFT. PRNSCHEDULE. PRN Per DiemRN Case Manager. PRNTimpanogos Regional HospitalDo you want... or utilization review preferred.InterQual experience preferred.Notice. Our Company's recruiters are here...

    See Details

    0,000 Retention Bonus (External Candidates only) POSITION OVERVIEW. The Case Manager Utilization Review... The UR Case Manager is responsible for overseeing utilization of services, reviewing medical necessity...

    See Details

    Employment Type Part timeShift Day ShiftDescription RN Case Manager. Casual PRN at Mount Carmel Grove... This is done with the intentions of cost effective utilization of hospital resources, minimizing out of...

    See Details

    Description. SHIFT. PRNSCHEDULE. PRN Per DiemRN Case Manager. PRNAlaska Regional HospitalDo you want to... Certification in case management or utilization review preferred. InterQual experience preferred.Notice...

    See Details

    The role of the inpatient case manager is one of patient advocate of appropriate utilization of... The inpatient case manager applies the process of assessment, planning, implementation, monitoring...

    See Details

    Job Summary Serves as departmental Leader for the development, implementation and evaluation of care coordination, transitions in care and utilization review. Works in collaboration with...

    See Details

    The Utilization ManagementProgram Manager is responsible for CountyCare Health Plan's UtilizationManagement (UM) program and vendor contract oversight for medical, behavioral,Long Term Services...

    See Details

    Provides oversight and guidance for the day to day operations of the utilization review management... The Regional Manager of Utilization Management is a registered nurse, who works under the direction of...

    See Details

    Occ Summary Dual role working in both Utilization Management and Case Management Assesses for accuracy... Ongoing collaboration with Case Manager to ensure that patient's condition meets medical necessity...

    See Details

    Will take a traveler but ideally looking for temp to perm or perm.Case Manager Utilization Review... The Case manager Utilization Review Nurse promotes cost effective allocation of the GFCH resources while...

    See Details

    Southwestern Health Resources is seeking to hire a Utilization Manager Licensed Vocational Nurse to... effect on utilization and outcomes of the different methods of reimbursement. Demonstrates participation...

    See Details

    Job DescriptionUtilization Review Case Manager NurseFull Time. 10K SIGN ON BONUS. McCall and Lee has... POSITION OVERVIEW. The Case Manager Utilization Review Nurse promotes cost effective allocation of the...

    See Details

    LSW or LCSW license to qualify for the role.management,Collaboration, Communication, Compliance, Business,Nurse,Utilization Management,Case Management,Utilization...

    See Details

    Job DescriptionCurrently recruiting a Registered Nurse (RN) Utilization Manager near Portsmouth... Sat between 7AM. 7PM. DUTIES OF THE REGISTERED NURSE UTILIZATION MANAGER (RN). Perform a full range of...

    See Details

    The CM Service is comprised of three departments. Case Management, Utilization Management, and Social... Performs and provides consultation regarding Utilization Management and Performance Improvement programs...

    See Details

    Education. Registered Nurse is required. BSN in Nursing is preferredExperience. At least five (5) years of relevant clinical experience. Acute care or managed care utilization review is...

    See Details

    Responsibilities. Responsible for the quality and resource management of all patients that are admitted to the facility from the point of their admission and across the continuum o...

    See Details

    Main Purpose of Job This position serves as the Director for Quality and Utilization Control, under the... ..services administrative experience, including 3 years of supervisory or managerial experience...

    See Details

    Master's degree with 2 years of experience preferred or. Certified Case Manager with 2 years of... Prior Case Management Utilization review experience requiredCertifications. CPRCurrent Level 1...

    See Details

    You Belong Here. Utilization Manager Reviewer Registered Nurse. SWHR CIN. Sunday. Thursday. Fort Worth... Fort Worth. Southwestern Health Resources is seeking to hire a Utilization Manager Reviewer Registered...

    See Details

    Like you. Join us on our mission to heal humanity, one child and family at a time.Case Managers are... performing utilization review activities, including review of patient charts for timeliness of services...

    See Details

    Brings known or suspected problems of under , over , or inappropriate utilization of resources to the attention of the appropriate manager(s). Prepares and maintains appropriate documentation as...

    See Details

    Description Providence is calling a Case Manager (RN). Utilization Care Management Office (Per Diem Day... Please upload current resume We are seeking a Case Manager (RN). Utilization Care Management Office who...

    See Details