Top 6255 Rn Utilization Manager Jobs

RN Utilization Management - Nights onsite
CHRISTUS Health (IHE/Hosted) —Corpus Christi, TX
- $31.70 - $47.00 an hour
- Full-time
- Background check
- Master of Social Work
- Nursing
- Health savings account
- Relocation assistance
Quick Apply
Crisis Program Manager
Family Health Psychiatric and Counseling Center —Alma, MI
- $65,000 - $83,000 a year
- Full-time
- Background check
- LMFT
- Nursing
- Health insurance
- Dental insurance
Quick Apply
4d
UM Case Manager
Havenwyck Hospital (UHS) —Auburn Hills, MI
- $60,000 - $69,000 a year
- Full-time
- Background check
- LMFT
- Nursing
- Loan repayment program
- Health insurance
Quick Apply
UM Case Manager/Appeals Coordinator
Havenwyck Hospital (UHS) —Auburn Hills, MI
- $60,000 - $69,000 a year
- Full-time
- Background check
- LMFT
- Nursing
- Loan repayment program
- Health insurance
Quick Apply
Director, Ambulatory Care Operations
HERITAGE PROVIDER NETWORK, INC. —San Bernardino, CA
- $145,000 - $150,000 a year
- Full-time
- Bilingual
- Nursing
- RN License
- Continuing education credits
- Paid holidays
Quick Apply
Case Manager RN Seasonal
Lower Keys Medical Center —Key West, FL
- Part-time
- Nursing
- RN License
- PALS Certification
Quick Apply
Director, Market Operations
Complete Health —Westminster, CO
- 5 years
- Finance
- Bachelor's degree
Quick Apply
RN - Psychiatric Services / Psych Unit
Yale New Haven Health —Boston, MA
- Nursing
- Psychiatry
- RN License
7d
RN Inpatient Case Manager
MedStar Health —Baltimore, MD
- $89,065 - $162,801 a year
- Full-time
- Acute care
- Nursing
- Microsoft Excel
Director of Case Management
Saint Francis Hospital —Memphis, TN
- Full-time
- Master of Social Work
- Nursing
- Surgery
- Health savings account
- Health insurance
RN Utilization Management Full Time
Martin Luther King, Jr. Community Hospital —Los Angeles, CA
- $52.25 - $80.99 an hour
- Full-time
- Background check
- Spanish
- Nursing
- Disability insurance
- Health insurance
Quick Apply
6d
Manager Inpatient Case Management
Clinical Management Consultants —Durango, CO
- $109,560 - $134,690 a year
- Full-time
- Acute care
- Hospital
- Acute care
- Health insurance
RN Case Manager - Medicine ICU
UCLA Health —Los Angeles, CA
- $65.53 - $84.75 an hour
- Nursing
- RN License
- BLS Certification
RN Case Manager - Surgery Services
UCLA Health —Los Angeles, CA
- $65.53 - $84.75 an hour
- Nursing
- Surgery
- RN License
Director Quality RN
Providence Health and Services —Medford, OR
- $70.99 - $112.08 an hour
- Full-time
- Hybrid work
- Background check
- Nursing
- RN License
- Paid parental leave
- Paid holidays
10h
Case Manager | Durbin Park | Full Time
UF Health —Saint Johns, FL
- Full-time
- Master of Social Work
- Nursing
- RN License
8d
RN Utilization Management
MedStar Health —Washington, DC
- $89,065 - $162,801 a year
- Full-time
- Nursing
- Microsoft Excel
- RN License
- Vision insurance
RN Utilization Mgmt
MedStar Health —Washington, DC
- $89,065 - $162,801 a year
- Full-time
- Nursing
- Microsoft Excel
- RN License
- Vision insurance
ED RN Care Manager - Utilization Managment
Christus Health —Corpus Christi, TX
- Full-time
- Master of Social Work
- Nursing
- RN License
Case Manager - Care Management
Legacy Health —Gresham, OR
- $54.37 - $81.21 an hour
- Part-time
- Nursing
- RN License
- Hospital
8d

I want to receive the latest job alert for Rn Utilization Manager

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

Rn Utilization Manager jobs near

Nursing Supervisor jobs in Corpus Christi, TX

Case Manager jobs in Key West, FL

Director Of Case Management jobs in Memphis, TN

Registered Nurse Emergency Room jobs in Corpus Christi, TX

Registered Nurse jobs in Washington, DC

Registered Nurse jobs in Los Angeles, CA

Registered Nurse Manager jobs in Los Angeles, CA

Case Manager jobs in Gresham, OR

Case Manager jobs in Durango, CO

Director Of Operations jobs in Westminster, CO

Psychiatric Nurse jobs in Boston, MA

Case Manager jobs in Auburn Hills, MI

Registered Nurse Case Manager jobs in Baltimore, MD

Director Of Operations jobs in San Bernardino, CA

Phlebotomy Supervisor jobs in Los Angeles, Ca

Nursing Supervisor jobs in Scottsdale, Az

Nursing Supervisor jobs in Palm Beach County, Fl

Nursing Supervisor jobs in Ocala, Fl

Nursing Assistant Cna jobs in Salem, Or

Nursing Supervisor jobs in Lewiston, Id

RN Utilization Management - Nights onsite

CHRISTUS Health (IHE/Hosted)
Corpus Christi, TX

Quick Apply

Job Details

Full-time
$31.70 - $47.00 an hour

Benefits

Health savings account
Relocation assistance
Health insurance
Dental insurance
401(k)
Flexible spending account
Tuition reimbursement
Paid time off
Vision insurance
401(k) matching
Professional development assistance
Life insurance
Referral program

Qualifications

Inpatient
Utilization review
RN License
Managing patients as a nurse case manager
Pre-authorization review for utilization management
Case management
Utilization management
Clinical documentation
Acute care
Care plans
Medical terminology

Full Job Description

Summary:

The Emergency Department (ED) Care Manager is responsible for establishing, coordinating, and maintaining the process to increase patient throughput to the most appropriate level of care while facilitating interdisciplinary care across the continuum for the ED. The Care Manager collaborates with the patient and/or family, multidisciplinary team, physicians, community partners, and payers to ensure the patient’s progress and level of care are appropriately determined. The Care Manager has well-developed knowledge and skill in patient status in the inpatient and outpatient settings and collaborates with other care managers, social workers, Patient Access, physicians, and administrative leadership in the ED to determine the appropriate level of care. The Care Manager also has a robust understanding of services and resources outside of the hospital that would be of benefit to the patient and initiates referrals as indicated. This work includes patient assessment and management, resource management, identifying patients appropriate for admission, observation or outpatient status, care facilitation, discharge planning with referrals to all levels of care, and other duties related to the defined population.

Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
Uses approved criteria to conduct patient assessment and admission clinical review to ensure the appropriateness of setting and timely implementation of the plan of care.
Performs review of anticipated admissions, placements in Observation status, and discharges using evidence-based criteria set for appropriate level of care assignment.
Provides identification of patients for whom standard of care treatments could be safely rendered at home.
Screens appropriateness of admission including observation versus inpatient status.
Educates ED physicians and nurses about medical necessity and admission criteria.
Collaborates with physicians and other members of the treatment team on documentation needs and opportunities.
Utilizes high-risk screening criteria to make appropriate community and post-ED referrals.
Initiates prior authorization process when indicated for post-ED referrals and services.
Escalates to physician advisor when unable to resolve discrepancies with the attending physician.
Manages high-use patients and works to find alternatives for care to frequent ED visits.
Plans for discharges from the ED for patients who do not require admission to include arranging for Home Health, DME, placement, and community resources as they relate to social determinants of health.
Provides patient and family education and counseling about existing health problem-related care.
Anticipates barriers/variances to the delivery of care and intervenes as necessary.
Intervenes with physicians and ancillary departments concerning clinical and utilization issues to ensure optimal patient outcomes.
Coordinates and facilitates patient progression throughout the continuum.
Collaborates with all members of the interdisciplinary team to facilitate appropriate care coordination and care delivery.
Able to analyze clinical information and accurately apply clinical criteria.

Education/Skills

Graduate of an accredited school of nursing (BSN preferred) or Master’s degree in Social Work (MSW) required

Experience

3+ years of relevant clinical case/care management experience in the acute care setting required
Familiarity with evidence-based medical necessity criteria sets required
Competency in prior authorization functions and software, including the application of criteria and timelines required
Proficiency in medical and managed care terminology required

Licenses, Registrations, or Certifications

RN license in the state of employment is required
Case Manager certification preferred
BLS preferred

Job Type: Full-time

Pay: $31.70 - $47.00 per hour

Benefits:

401(k)
401(k) matching
Dental insurance
Flexible spending account
Health insurance
Health savings account
Life insurance
Paid time off
Professional development assistance
Referral program
Relocation assistance
Tuition reimbursement
Vision insurance

Experience:

Utilization review: 1 year (Required)

License/Certification:

RN License (Required)

Work Location: In person

Quick Apply

Refine Your Search

Rn Utilization Manager jobs

RN Utilization Management - Nights onsite

Crisis Program Manager

UM Case Manager

UM Case Manager/Appeals Coordinator

Director, Ambulatory Care Operations

Case Manager RN Seasonal

Director, Market Operations

RN - Psychiatric Services / Psych Unit

RN Inpatient Case Manager

Director of Case Management

RN Utilization Management Full Time

Manager Inpatient Case Management

RN Case Manager - Medicine ICU

RN Case Manager - Surgery Services

Director Quality RN

Case Manager | Durbin Park | Full Time

RN Utilization Management

RN Utilization Mgmt

ED RN Care Manager - Utilization Managment

Case Manager - Care Management

I want to receive the latest job alert for Rn Utilization Manager

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected