Top 5696 Manager Utilization Management Jobs

RN - Case Manager - AS Utilization Management - Part Time - 8 Hour - Days
John Muir Health —Walnut Creek, CA
- $89.23 - $121.58 an hour
- 8 hour shift
- Nursing
- Microsoft Outlook
- RN License
Sr. Manager of Member Engagement
Private Health Management —Remote
- $120,000 - $180,000 a year
- US work authorization
- Senior level
- Leadership
- Health insurance
- Dental insurance
Quick Apply
Utilization Management Manager Full Time
Kindred Hospitals Mountain District Office —Las Vegas, NV
- Full-time
- Nursing
- Microsoft Outlook
- Hospital
Clinical Adjudication Manager (Weekday Evening Shift + Flexible Scheduling (Part Time or Full Time) (Part C)
TMF Health Quality Institute —Remote
- Full-time
- Nursing
- Supervising experience
- Team management
- AD&D insurance
- Disability insurance
Utilization Management Manager
Healthfirst —New York, NY
- $99,700 - $168,810 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- RN License
- Health insurance
- Dental insurance
Utilization Review Manager - Remote - Faulkner
Brigham and Women's Faulkner Hospital, Inc. —Boston, MA
- $41.36 - $100.00 an hour
- Part-time
- Remote
- Nursing
- RN License
- Computer literacy
- Opportunities for advancement
Quick Apply
5d
General Manager, Product Strategy and Management: EviCore
The Cigna Group —Remote
- $223,000 - $371,600 a year
- Online Application
- Remote
- 8 years
- Bachelor's degree
- Continuous improvement
- Paid holidays
- Health insurance
6d
Nurse Manager | Medical Oncology & Medical Specialties
Concord Hospital —Concord, NH
- Full-time
- Acute care
- Nursing
- RN License
- Disability insurance
- Health insurance
Program Manager - Cardiac Rehabilitation
SouthEast Alaska Regional Health Consortium —Juneau, AK
- $36.46 - $51.29 an hour
- Full-time
- Microsoft Excel
- Computer literacy
- BLS Certification
- Paid parental leave
- Disability insurance
Quick Apply
Supervising Pharmacist
Integrea Community Mental Health Systems —Opelika, AL
- Extended hours
- Bachelor of Science
- Residential
- Bachelor's degree
- Dental insurance
- Vision insurance
Quick Apply
Nurse Manager - Telemetry
MountainView Regional Medical Center —Las Cruces, NM
- Full-time
- Acute care
- Nursing
- RN License
- Health insurance
- Dental insurance
Quick Apply
11d
Pharmacy Manager
Weis Markets —Binghamton, NY
- $94,000 - $155,000 a year
- Full-time
- Background check
- Bachelor of Science
- Mid-level
- AD&D insurance
- Disability insurance
Quick Apply
Manager Behavioral Health
CHRISTUS Health (IHE/Hosted) —Longview, TX
- $49,886.84 - $60,078.78 a year
- 8 hour shift
- Nursing
- PALS Certification
- Hospital
- Relocation assistance
Quick Apply
Urgently Hiring - Radiology Manager Position in a Freestanding ER
LONESTAR 24HR ER —New Braunfels, TX
- From $45 an hour
- Urgently hiring
- Background check
- CPR Certification
- BLS Certification
- Continuing education credits
- Paid holidays
Quick Apply
Nurse Supervisor
FAMILY HOSPITAL MANAGEMENT COMPANY —Papillion, NE
- $45 - $50 an hour
- Full-time
- Nursing
- Patient monitoring
- RN License
- AD&D insurance
- Health insurance
Quick Apply
Registered Nurse Manager - NCSH Residential
Health Right 360 —Escondido, CA
- $126,000 - $136,500 a year
- Full-time
- Background check
- Nursing
- Patient monitoring
- Commuter assistance
- Paid holidays
Quick Apply
Respiratory Therapy Manager
Froedtert South, Inc. —Pleasant Prairie, WI
- Full-time
- Acute care
- PALS Certification
- Hospital
- Opportunities for advancement
Quick Apply
13d
Clinical Supervisor – Child & Family Services (Lebanon)
West Central Behavioral Hea —Lebanon, NH
- $68,500.00 - $104,483.09 a year
- Customer service
- Computer literacy
- Mid-level
- 403(b) matching
- Paid holidays
Quick Apply
Clinical Case Manager Master's Level CSDD
Community Mental Health Authority —Lansing, MI
- $60,604 - $68,790 an hour
- Full-time
- Background check
- Clean driving record
- Pass drug screening
- Mileage reimbursement
- Health savings account
Quick Apply
Nurse Manager, Behavioral Health Services
Signet Health Corporation —Greensboro, NC
- $110,000 - $120,000 a year
- Full-time
- Nursing
- Psychiatry
- RN License
- Disability insurance
- Health insurance

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Manager Utilization Management jobs near

RN - Case Manager - AS Utilization Management - Part Time - 8 Hour - Days

John Muir Health -
Walnut Creek, CA

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Job Details

Part-time
$89.23 - $121.58 an hour

Qualifications

RN License
BLS Certification
Bachelor's degree
Bachelor's degree in nursing

Full Job Description

Job Description:

The role of the inpatient case manager is one of patient advocate of appropriate utilization of resources. The inpatient case manager applies the process of assessment, planning, implementation, monitoring, evaluation and coordination of care to meet the patient’s health care needs through hospitalization and transition back to the community and does this in coordination with the interdisciplinary health team.

The RN Case Manager is expected to function within the full scope of the nursing practice with specialized focus on care coordination, compliance, transition management, education, and utilization management.

Education:

Bachelor's Degree Accredited School of Nursing Required

Experience:

3 years Nursing - Medical/Surgical Preferred or
3 years Nursing - Critical Care Preferred
2 years Care Coordination - Case Management Preferred or Equivalent Work Experience

Certifications/Licensures:

RN Registered Nursing - California Board of Nursing Required
BLS Basic Life Support - American Heart Association Required
ACM Accredited Case Manager - ACMA American Case Management Association or
CCM Certified Case Manager - CCMC Commission for Case Manager Certification Strongly Preferred

Skills:

Strong written and verbal communication skills.
Effectively motivates teams.
Strong knowledge of Medicare and Medi-Cal guidelines and benefit resources as applicable to hospitalization and transition planning.
Working know ledge of common diagnoses and procedures and the impact this w ill have to patients/families and their ability to manage their care outside of the hospital. Specialized know ledge may be required for certain areas of practice.
Knowledge of individual and family development over the life span, and the influences of cultural and spiritual values in health care.
General knowledge of commercial coverage plans and usually covered benefits. Strong understanding of various reimbursement models and impact to care delivery, patient management and reimbursements such as ACOs, DRGs, Full Risk, etc.
Strong understanding of the criteria, rules and regulations around Inpatient, Observation and Outpatient levels of patient management.
Strong know ledge of geriatrics and the impact to health and function in the aged as w ell as a working know ledge of chronic/progressive disease states such as CHF, COPD, Diabetes and End Stage Renal Disease, etc.
Clear understanding of the role of the inpatient Social Worker and Palliative Care Resources.
Ability to plan, organize, manage time and prioritize work in collaboration with others.
Ability to work independently and as a part of a multidisciplinary team.
Effective problem solving and conflict resolution skills.
Ability to work respectfully and creatively with clients of diverse functional abilities, social, economic, and cultural backgrounds to support both client autonomy and client safety.
Leadership skills to delegate and provide direction/guidance to staff and hold others accountable.
Able to learn and work in a variety of computer programs, including EPIC, Allscripts, InterQual, and Microsoft Outlook.

work schedule: Sunday-Wednesday

Work Shift:

08.0 - 08:00 - 16:30 No Waive (United States of America)

Pay Range:

$89.23 - $121.58 Hourly

Offer amounts are based on demonstrated/relevant experience and/or licensure.

Pay will be adjusted to the local market if hired outside of the Bay Area.

Note: Positions at JMH which are exempt (not eligible for overtime) under the level of Manager are listed as hourly for compensation purposes on this posting. The work shift will contain the word ‘exempt’ on it.

Scheduled Weekly Hours:

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Refine Your Search

Manager Utilization Management jobs

RN - Case Manager - AS Utilization Management - Part Time - 8 Hour - Days

Sr. Manager of Member Engagement

Utilization Management Manager Full Time

Clinical Adjudication Manager (Weekday Evening Shift + Flexible Scheduling (Part Time or Full Time) (Part C)

Utilization Management Manager

Utilization Review Manager - Remote - Faulkner

General Manager, Product Strategy and Management: EviCore

Nurse Manager | Medical Oncology & Medical Specialties

Program Manager - Cardiac Rehabilitation

Supervising Pharmacist

Nurse Manager - Telemetry

Pharmacy Manager

Manager Behavioral Health

Urgently Hiring - Radiology Manager Position in a Freestanding ER

Nurse Supervisor

Registered Nurse Manager - NCSH Residential

Respiratory Therapy Manager

Clinical Supervisor – Child & Family Services (Lebanon)

Clinical Case Manager Master's Level CSDD

Nurse Manager, Behavioral Health Services

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