Top 44429 Utilization Manager Jobs

RN - Case Manager - AS Utilization Management - Full Time - 8 Hour - Days
John Muir Health —Walnut Creek, CA
- $89.23 - $121.58 an hour
- 8 hour shift
- Nursing
- Microsoft Outlook
- RN License
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
Team Lead, IT Services - Remote - Incidents/Problems Management and Batch Operations
Healthesystems —Tampa, FL
- $90,300 - $124,190 a year
- Weekends as needed
- Remote
- Mid-level
- Office
- 3 years
- Paid holidays
- Disability insurance
Quick Apply
6d
Senior Manager, Utilization Management
1199SEIU Family of Funds —New York, NY
- $125,400 - $156,700 a year
- Full-time
- Nursing
- 6 years
- RN License
Oncology Account Manager - Mid-America (KS, MO, AR)
Immunocore —Remote
- $160,000 - $214,000 a year
- Full-time
- 7 years
- Hospital
- Bachelor of Science
- Health insurance
- Dental insurance
3d
Utilization Review Manager - PRN
Assurance Health System, LLC —Remote
- Part-time
- Remote
- Psychiatry
- RN License
- Mid-level
- Health insurance
- 401(k)
Quick Apply
3d
Oncology Prior Authorization Case Manager, Non-RN - Remote
University of Miami —Miami, FL
- Full-time
- Remote
- Mid-level
- Bachelor's degree
- Experience equivalent to degree accepted
- Health insurance
- Dental insurance
Care Manager, Concurrent Review (Remote)
EmblemHealth —New York, NY
- $68,040 - $118,800 a year
- Remote
- Nursing
- Microsoft Outlook
- RN License
Nurse Manager | Medical Oncology & Medical Specialties
Concord Hospital —Concord, NH
- Full-time
- Acute care
- Nursing
- RN License
- Disability insurance
- Health insurance
Department Manager Diagnostic Imaging
Heritage Medical Associates —Nashville, TN
- Full-time
- Computer literacy
- BLS Certification
- Clinic
- Health savings account
- Health insurance
Quick Apply
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
Market Physician Executive (MPE) - Atlanta, GA
Monogram Health Professional Services —Atlanta, GA
- On call
- Medicine
- Critical & Intensive Care
- Travel
- Health insurance
- Dental insurance
Quick Apply
PACE Medical Director, Jordan Valley Senior Care
Jordan Valley Health —Springfield, MO
- Full-time
- Medicine
- Current TB test
- Computer literacy
- Health savings account
- AD&D insurance
Quick Apply
Market Physician Executive (MPE)
Monogram Health Professional Services —Brunswick, GA
- On call
- Hybrid work
- Medicine
- Critical & Intensive Care
- Travel
- Paid parental leave
- Paid holidays
Quick Apply
Market Physician Executive (MPE)
Monogram Health Professional Services —Valdosta, GA
- On call
- Hybrid work
- Medicine
- Critical & Intensive Care
- Travel
- Paid parental leave
- Paid holidays
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
Rehab Supervisor (Physical Therapist) - Home Health
NEOGREEN Solutions —Los Angeles, CA
- $130,000 a year
- CPR Certification
- Management
- BLS Certification
- Paid holidays
- Health 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
12d
Market Physician Executive (MPE) - Float
Monogram Health Professional Services —Georgia
- On call
- Hybrid work
- Medicine
- Critical & Intensive Care
- Travel
- Paid parental leave
- Paid holidays
Quick Apply
FT Licensed Mental Health Practitioner Chico, CA
Compassion Services —Chico, CA
- $56,230 - $81,780 a year
- Weekends as needed
- LMFT
- Psychiatry
- Licensed Clinical Social Worker
Quick Apply
12d

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

John Muir Health -
Walnut Creek, CA

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Job Details

Full-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.

Fixed Schedule:
Week 1: Sun-Wed
Week 2: Sun-Thurs

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

Utilization Manager jobs

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

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

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Senior Manager, Utilization Management

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Utilization Review Manager - PRN

Oncology Prior Authorization Case Manager, Non-RN - Remote

Care Manager, Concurrent Review (Remote)

Nurse Manager | Medical Oncology & Medical Specialties

Department Manager Diagnostic Imaging

Program Manager - Cardiac Rehabilitation

Market Physician Executive (MPE) - Atlanta, GA

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Market Physician Executive (MPE)

Market Physician Executive (MPE)

Supervising Pharmacist

Rehab Supervisor (Physical Therapist) - Home Health

Nurse Manager - Telemetry

Market Physician Executive (MPE) - Float

FT Licensed Mental Health Practitioner Chico, CA

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