Top 6007 Utilization manager rn Jobs

RN - Case Manager - AS Utilization Management - Full Time - 8 Hour - Days
John Muir Health —Concord, CA
- $89.23 - $121.58 an hour
- 8 hour shift
- Nursing
- Microsoft Outlook
- RN License
Hybrid, Per-diem Utilization Review RN
Holy Cross Hospital —Fort Lauderdale, FL
- Part-time
- Hybrid work
- Nursing
- Surgery
- RN License
Utilization Management Clinician I
Community Health Plan of Washington —Seattle, WA
- $35.92 - $55.67 an hour
- Full-time
- Mid-level
- Analysis skills
- Critical & Intensive Care
- Paid jury duty
- Health savings account
Quick Apply
Denials & Appeals Administrator (RN)
Boston Medical Center —Remote
- $43.03 - $62.50 an hour
- Full-time
- Remote
- Nursing
- RN License
- 5 years
- Health insurance
- Dental insurance
Claims - Care Manager, RN, Claims
Wellcove —Remote
- Full-time
- Remote
- RN License
- Mid-level
- Geriatrics
Quick Apply
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
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
Manager, Utilization Review
Health Business Solutions LLC —Remote
- Nursing
- RN License
- Mid-level
6d
RN Case Manager
Community LIFE —Homestead, PA
- $72,000 - $85,000 a year
- Full-time
- Nursing
- RN License
- Word processing
- Travel reimbursement
- Mileage reimbursement
Quick Apply
11d
HOME CARE - RN CASE MANAGER
Aultman Health Foundation —Canton, OH
- Weekends as needed
- Nursing
- RN License
- Computer literacy
Nurse Educator (RN)
Wake Robin Corporation —Shelburne, VT
- $36.70 - $44.77 an hour
- Weekends as needed
- Nursing
- RN License
- Mid-level
- 403(b) matching
- Disability insurance
Quick Apply
Patient Care Manager - Floater (RN)
VITAS Healthcare —Lombard, IL
- $0.70 per mile
- Full-time
- Nursing
- RN License
- Mid-level
- Travel reimbursement
- Disability insurance
Quick Apply
RN Unit Manager
Aloha Nursing Rehab Centre —Kaneohe, HI
- From $96,000 a year
- Full-time
- Background check
- CPR Certification
- Nursing
- Free parking
- Paid holidays
Quick Apply
Branch Clinical Manager (RN) Home Health
Adaptive Home Health —Detroit, MI
- Full-time
- RN License
- Home Health
- Senior level
Quick Apply
RN Case Manager
Community LIFE —Wilkinsburg, PA
- $72,000 - $85,000 a year
- Full-time
- Nursing
- RN License
- Word processing
- Travel reimbursement
- Mileage reimbursement
Quick Apply
Registered Nurse Manager (RN)
Pillar of Cedar Valley Nursing and Rehabilitation —Waterloo, IA
- $45 an hour
- Full-time
- CPR Certification
- RN License
- Mid-level
- Health insurance
- Dental 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
5d
RN/LPN Unit Manager
Confidential —Ocean County, NJ
- Full-time
- RN License
- Nursing home
- BLS Certification
- Health insurance
- Dental insurance
Quick Apply
RN-Clinical Team Coordinator Registered Nurse-Advanced Acute Care Medical
Geisinger —Danville, PA
- Full-time
- Acute care
- Nursing
- Customer service
- Wellness program
- Health savings account

I want to receive the latest job alert for utilization manager rn

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

utilization manager rn jobs near

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

John Muir Health -
Concord, CA

Apply Now

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:

Apply Now

Refine Your Search

utilization manager rn jobs

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

Hybrid, Per-diem Utilization Review RN

Utilization Management Clinician I

Denials & Appeals Administrator (RN)

Claims - Care Manager, RN, Claims

Oncology Prior Authorization Case Manager, Non-RN - Remote

Care Manager, Concurrent Review (Remote)

Sr. Manager of Member Engagement

Manager, Utilization Review

RN Case Manager

HOME CARE - RN CASE MANAGER

Nurse Educator (RN)

Patient Care Manager - Floater (RN)

RN Unit Manager

Branch Clinical Manager (RN) Home Health

RN Case Manager

Registered Nurse Manager (RN)

Nurse Manager - Telemetry

RN/LPN Unit Manager

RN-Clinical Team Coordinator Registered Nurse-Advanced Acute Care Medical

I want to receive the latest job alert for utilization manager rn

Related Searches

Explore jobs in more locations

Job Description:

Work Shift:

Scheduled Weekly Hours:

Job Seeker Tools

Employer Tools

Browse

Stay Connected