Top 118 um (utilization management) care coordinator Jobs

RN Case Manager Lead Wesley Long Hospital
Cone Health —Greensboro, NC
- Full-time
- Nursing
- RN License
- Hospital
RN Care Manager Lead
Cone Health —Greensboro, NC
- Full-time
- Nursing
- RN License
- Hospital
20h
Registered Nurse - Utilization and Care Transitions
Neighborhood Healthcare —Riverside, CA
- $50.10 - $75.10 an hour
- Monday to Friday
- CPR Certification
- Nursing
- Skilled nursing facility
- Health insurance
- Dental insurance
Quick Apply
3d
Senior Director, Health Plan Utilization Management - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement))
Denver Health —Denver, CO
- $143,800 - $237,300 a year
- Full-time
- Hybrid work
- Nursing
- Pass drug screening
- Office
- Paid parental leave
- Paid holidays
Care Coordination RN
Clinical Management Consultants —Bronx, NY
- $126,310 - $162,640 a year
- Full-time
- Acute care
- Surgery
- Inpatient
Nurse Manager of Utilization Management UM and Discharge Planning
Clinical Management Consultants —Emeryville, CA
- $201,860 - $250,460 a year
- Full-time
- Nursing
- Hospital
- In-person
- Health insurance
- Dental insurance
Nurse Director Utilization Review and Case Management
Clinical Management Consultants —Berkeley, CA
- $152,580 - $175,960 a year
- Full-time
- Acute care
- Hospital
- Acute care
- Health insurance
- Dental insurance
Clinical Care Manager
Community Behavioral Health. —Philadelphia, PA
- Overtime
- LMFT
- Microsoft Excel
- Customer service
- Wellness program
- Commuter assistance
Quick Apply
2d
Manager Case Management & Social Services RN
Houston Methodist Willowbrook Hospital —Houston, TX
- Full-time
- Acute care
- Nursing
- RN License
Nurse Manager Case Management and Utilization Review
Clinical Management Consultants —Tucson, AZ
- $128,660 - $154,700 a year
- Full-time
- Acute care
- Nursing
- Acute care
- Tuition reimbursement
- Paid time off
Case Manager, RN - Value Based Service Org - Full Time 8 Hour Days (Non-Exempt) (Non-Union)
Keck Medical Center of USC —Los Angeles, CA
- $53.00 - $87.45 an hour
- 8 hour shift
- Background check
- Nursing
- RN License
Case Manager, RN - Value Based Service Org - Full Time 8 Hour Days (Non-Exempt) (Non-Union)
USC —Los Angeles, CA
- $53.00 - $87.45 an hour
- 8 hour shift
- Nursing
- RN License
- Hospital
ABA Behavioral Health Utilization Manager (Outpatient and Non-24 Hour Diversionary Services)
WellSense Health Plan —Remote
- $69,500 - $100,500 a year
- Full-time
- Remote
- LMFT
- Nursing
- Microsoft Excel
- Health insurance
- Dental insurance
8d
Care Coordinator (RN) - Part-Time/Rotating Weekends
3110 Kennestone Hospital, Inc. —Marietta, GA
- Weekends only
- Nursing
- RN License
- Hospital
Care Manager/Readmission Prevention - Per Diem (REMOTE)
Stony Brook Southampton Hospital —Southampton, NY
- $60.87 - $69.93 an hour
- Online Application
- Remote
- Bilingual
- Nursing
- RN License
10d
Utilization Review-Care Management Coordinator PT/Day
Mee Memorial Hospital —King City, CA
- $49.21 - $65.08 an hour
- Part-time
- Spanish
- Nursing
- RN License
10d
Care Coordinator - Clinical Appeals RN
Premera Blue Cross —Remote
- $80,200 - $143,100 a year
- Online Application
- Nursing
- RN License
- Mid-level
- Free parking
- Wellness program
2d
Care Management Specialist II
Southwest Michigan Behavioral Health —Portage, MI
- $63,750 - $86,250 a year
- Full-time
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- Addiction Medicine
- Dental insurance
- Work from home
Quick Apply
Case Manager
Spartanburg Regional Healthcare System —Spartanburg, SC
- Full-time
- Master of Social Work
- Nursing
- RN License
Quick Apply
Behavioral Health Operations Manager
CenCal Health —Santa Barbara, CA
- $103,898 - $161,043 a year
- Online Application
- LMFT
- Inventory management
- Licensed Clinical Social Worker
- Wellness program
- Paid holidays
Quick Apply

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RN Case Manager Lead Wesley Long Hospital

Cone Health -
Greensboro, NC

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Job Details

Full-time

Qualifications

Inpatient
RN License
BLS Certification
Managing patients as a nurse case manager
Hospital experience

Full Job Description

The RN Care Management Lead is an advanced-level member of the Case Management team responsible for coordinating care for patients with significant medical and psychosocial needs, high risk for re-admission and/or prolonged hospitalizations. The Lead in collaboration with the Care Management staff will provide targeted support for the hospital's more complex cases and will lead system-level coordination through Complex Case Rounds (Quality Collaborative). The team will act as a bridge between inpatient care and other ambulatory or service-based teams to ensure continuity and prevent avoidable readmissions for the highest-risk patients.

Essential Job Function:
Assessment & Identification Identify patients across the hospital with extended Lengths of Stay and assess Complex Care Needs that may require significant time and coordination from unit Case Management staff.
Work with Cone’s EPIC predictive analytics to identify and manage potential complex patients or those with a predictive difficult to place flag Care Planning Develop and implement comprehensive, patient-centered discharge plans using advanced clinical judgment and creative problem-solving to promote continuity of care and appropriate resource utilization.
Collaboration and Coordination May Co-Lead and facilitate inpatient interdisciplinary Complex Case Rounds (Quality Collaborative), engaging senior level leadership to identify, escalate and resolve barriers to discharge.
Engage with known complex case patients in the ED, by collaborating with ED providers, social workers and case management, to identify alternative care placements that will support optimal outcomes.
Collaborate with ambulatory and community-based teams to ensure seamless transitions, prevent readmissions and secure post-discharge follow-up to ensure successful transition to the next level of care.
Build and maintain strong relationships with post-acute service providers, insurance case managers, primary care provider case managers, and VBC Initiatives to ensure coordinated value-based care delivery.
Collaborate with Cone’s UR / UM division to ensure both patient choice and aligned post-acute partners to ensure appropriate next level of care is optimized Resource Utilization and Advocacy Assist in preparing a cost-benefit analysis for medically and socially complex Long LOS patients and advocate for necessary resources to support discharge.
Educate patients and families about viable care options, post-discharge needs and community resources to support continuity of care.
Monitoring Monitor “avoidable days” and “avoidable delays” within case load to identify system barriers and uncover opportunities for process improvement across hospital operations and community partnerships.
Responsible for the following: New hire orientation, departmental training, subject matter expert and resources for other team members, participate in interviews, on call, make coverage assignments, safety zone resolution, and representation of department for strategic hospital meetings.

Education:
Required: BSN or MSN from an accredited school of nursing.

Experience:
Required: 5 years inpatient case management experience.
Preferred: Experience in people management. ACM-RN or CCM certified with 3 years of inpatient case management experience.

Licensure/Certification/Listing:
Required: Must hold an active, unencumbered NC Nursing License. Current BLS. Willingness to participate and maintain active engagement in Cone’s clinical ladder program.

Apply Now

Refine Your Search

um (utilization management) care coordinator jobs

RN Case Manager Lead Wesley Long Hospital

RN Care Manager Lead

Registered Nurse - Utilization and Care Transitions

Senior Director, Health Plan Utilization Management - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement))

Care Coordination RN

Nurse Manager of Utilization Management UM and Discharge Planning

Nurse Director Utilization Review and Case Management

Clinical Care Manager

Manager Case Management & Social Services RN

Nurse Manager Case Management and Utilization Review

Case Manager, RN - Value Based Service Org - Full Time 8 Hour Days (Non-Exempt) (Non-Union)

Case Manager, RN - Value Based Service Org - Full Time 8 Hour Days (Non-Exempt) (Non-Union)

ABA Behavioral Health Utilization Manager (Outpatient and Non-24 Hour Diversionary Services)

Care Coordinator (RN) - Part-Time/Rotating Weekends

Care Manager/Readmission Prevention - Per Diem (REMOTE)

Utilization Review-Care Management Coordinator PT/Day

Care Coordinator - Clinical Appeals RN

Care Management Specialist II

Case Manager

Behavioral Health Operations Manager

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