Top 18 Utilization management nurse Jobs in Charleston, Wv

LPN Case Manager -- Resource Center for Case Mgmt -- General Hospital
CAMC Health System —Charleston, WV
- Overtime
- Hospital
- Customer service
- 5 years
LPN Case Manager -- Resource Center for Case Mgmt -- General Hospital
Mon Health —Charleston, WV
- Overtime
- Hospital
- Customer service
- 5 years
Registered Nurse Case Manager -- Resource Center for Case Mgmt -- General Hospital
CAMC Health System —Charleston, WV
- Overtime
- Nursing
- 7 years
- RN License
Access Coordinator
Mon Health —Charleston, WV
- Overtime
- Nursing
- RN License
- Hospital
1d
Registered Nurse Case Coordination Family Medicine -- Family Medicine Center -- Heart & Vascular Cen
CAMC Health System —Charleston, WV
- Overtime
- Nursing
- RN License
- Customer service
Registered Nurse Case Manager -- Resource Center for Case Mgmt -- General Hospital
Mon Health —Charleston, WV
- Overtime
- Nursing
- 7 years
- RN License
Registered Nurse Case Coordination Family Medicine -- Family Medicine Center -- Heart & Vascular Cen
Mon Health —Charleston, WV
- Overtime
- Nursing
- RN License
- Customer service
Manager of Nursing- Operating Room Evening Shift
THOM Thomas Hospitals —South Charleston, WV
- Full-time
- Nursing
- Surgery
- RN License

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Telephonic Case Manager I
CorVel Corporation —Charleston, WV
URAC recognized Case Management certification (ACM, CCM, CDMS, CMAC, CMC, CRC, CRRN, COHN, COHN-S, RN-BC) required to be obtained within 3 years of hire if no…
$63,739 - $95,264 a year
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Patient Accounts Resolution Specialist -- Patient Accounts -- General Hospital
Mon Health —Charleston, WV
Review assigned work items daily to resolve “at risk, past due, and technical denial” claim issues Work with coding to resolve coding related denials Work with…

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This position maintains awareness of emerging state and national healthcare trends and drives initiatives to enhance care quality and ensure effective resource…
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Clinical Reviewer - Medical Coder & QA
Ohio Living —Westerville, OH
Current unencumbered license for the state of Ohio to practice as a Licenses Practical Nurse (LPN) preferred Certificate for OASIS Specialist-Clinical…
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LPN Case Manager -- Resource Center for Case Mgmt -- General Hospital

CAMC Health System -
Charleston, WV

Apply Now

Job Details

Full-time

Qualifications

BLS Certification
LPN

Full Job Description

Job Summary

Collaborate with and serve as a clinical resource to the health care team to enhance the delivery of patient care services. Efficiently coordinate patient needs to assure high quality patient care, reduce length of stay and resource utilization and ensure reimbursement drawing on a broad clinical and systems management knowledge base.

Responsibilities

Intervenes with physicians and ancillary departments concerning clinical and utilization issues to ensure optimal patient outcomes.
Completes psychosocial assessments
Assist with transfers to other facilities
Provides code 44 documents to Medicare patients when applicable.
Acts as a resource to assist others with patient care management.
Ensures patient rights are sustained and safeguard patient privacy and confidentiality.
Assists with medication prior authorizations when necessary
Responds to referrals for patients and families with complex issues
Coordinates home health, SNF, and other post-acute placements for patients
Participates in MDTR rounds for assigned units
Arranges transportation for patients to ensure timely discharge
Works directly with RN Case Managers and Social Work team to ensure timely discharge
Works with outside resources to ensure patients have support once discharged
Documents all activity timely within the electronic medical record
Participates in hospital/unit committees as requested.

Knowledge, Skills & Abilities

Patient Group Knowledge (Only applies to positions with direct patient contact)

The employee must possess/obtain (by the end of the orientation period) and demonstrate the knowledge and skills necessary to provide developmentally appropriate assessment, treatment or care as defined by the department’s identified patient ages. Specifically the employee must be able to demonstrate competency in: 1) ability to obtain and interpret information in terms of patient needs; 2) knowledge of growth and development; and 3) understanding of the range of treatment needed by the patients.

Competency Statement

Must demonstrate competency through an initial orientation and ongoing competency validation to independently perform tasks and additional duties as specified in the job description and the unit/department specific competency checklist.

Common Duties and Responsibilities
(Essential duties common to all positions)

1. Maintain and document all applicable required education.
2. Demonstrate positive customer service and co-worker relations.
3. Comply with the company's attendance policy.
4. Participate in the continuous, quality improvement activities of the department and institution.
5. Perform work in a cost effective manner.
6. Perform work in accordance with all departmental pay practices and scheduling policies, including but not limited to, overtime, various shift work, and on-call situations.
7. Perform work in alignment with the overall mission and strategic plan of the organization.
8. Follow organizational and departmental policies and procedures, as applicable.
9. Perform related duties as assigned.

Education

Post High School Diploma or Certificate Program (Required) Substitution: minimum of 2 years clinical experience with additional experience in case management, care management, utilization management, home health, skilled nursing, or other post-acute setting to meet minimum 5 years of experience

Credentials

Basic Life Support (Required) Within 30 days of hireWithin 30 days of hire
Licensed Practical Nurse (Required)

Work Schedule: Days

Status: Full Time Regular 1.0

Location: General Hospital

Location of Job: US:WV:Charleston

Talent Acquisition Specialist: Jamie L. Douglas [email protected]

Apply Now

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utilization management nurse jobs in charleston, wv

LPN Case Manager -- Resource Center for Case Mgmt -- General Hospital

LPN Case Manager -- Resource Center for Case Mgmt -- General Hospital

Registered Nurse Case Manager -- Resource Center for Case Mgmt -- General Hospital

Access Coordinator

Registered Nurse Case Coordination Family Medicine -- Family Medicine Center -- Heart & Vascular Cen

Registered Nurse Case Manager -- Resource Center for Case Mgmt -- General Hospital

Registered Nurse Case Coordination Family Medicine -- Family Medicine Center -- Heart & Vascular Cen

Manager of Nursing- Operating Room Evening Shift

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