CARE MANAGER
Thomasville, GA · On-site
Care Manager - Utilization Review Description: Excellent communication skills Excellent organizational abilities Skills in assessing, planning and managing patient care delivery Utilization ...
CARE MANAGER
Thomasville, GA · On-site
Care Manager - Utilization Review Description: Excellent communication skills Excellent organizational abilities Skills in assessing, planning and managing patient care delivery Utilization ...
CARE MANAGER
Thomasville, GA · On-site
Care Manager - Utilization Review Description: Excellent communication skills Excellent organizational abilities Skills in assessing, planning and managing patient care delivery Utilization ...
CARE MANAGER
Thomasville, GA · On-site
Care Manager - Utilization Review Description: Excellent communication skills Excellent organizational abilities Skills in assessing, planning and managing patient care delivery Utilization ...
... Health Utilization Review (UR) and Utilization Management (UM) processes across two hospital ... Company Name Piedmont Healthcare Corporate
... Health Utilization Review (UR) and Utilization Management (UM) processes across two hospital ... Company Name Piedmont Healthcare Corporate
... Health Utilization Review (UR) and Utilization Management (UM) processes across two hospital ... Company NamePiedmont Healthcare CorporateEmployment Type: FULL_TIME
... Health Utilization Review (UR) and Utilization Management (UM) processes across two hospital ... Company NamePiedmont Healthcare CorporateEmployment Type: FULL_TIME
Provide system-level leadership and operational oversight of the Behavioral Health Utilization ... IQCI Certification Required Piedmont Healthcare Corporate
Provide system-level leadership and operational oversight of the Behavioral Health Utilization ... IQCI Certification Required Piedmont Healthcare Corporate
RN Care Manager
Atlanta, GA · On-site
... utilization * Utilizing your clinical knowledge and deep understanding of key community resources, you'll provide health education and coordinate consults and referrals to support patients and ...
RN Care Manager
Atlanta, GA · On-site
... utilization * Utilizing your clinical knowledge and deep understanding of key community resources, you'll provide health education and coordinate consults and referrals to support patients and ...
Care Manager RN - Inpatient Department:University Hospital | Care Management Services Scope of ... resource utilization. Minimum Qualifications For Hire - Bachelors degree in Nursing, Masters ...
Care Manager RN - Inpatient Department:University Hospital | Care Management Services Scope of ... resource utilization. Minimum Qualifications For Hire - Bachelors degree in Nursing, Masters ...
... Utilization review duties in Care Management. Timely communication of clinical information and updates will be provided to the insurance companies as requested or required by contract or federal and ...
... Utilization review duties in Care Management. Timely communication of clinical information and updates will be provided to the insurance companies as requested or required by contract or federal and ...
... Utilization review duties in Care Management. Timely communication of clinical information and updates will be provided to the insurance companies as requested or required by contract or federal and ...
... Utilization review duties in Care Management. Timely communication of clinical information and updates will be provided to the insurance companies as requested or required by contract or federal and ...
He/she will address utilization of resources for efficient and effective care delivery at the appropriate level of care. The Care Manager collaborates with social work, physicians, nurses and ...
He/she will address utilization of resources for efficient and effective care delivery at the appropriate level of care. The Care Manager collaborates with social work, physicians, nurses and ...
This role monitors that the patient is progressing in their plan of care and meet medical necessity ... Previous experience in Utilization Management and/or Appeals Required * Previous Epic experience or ...
This role monitors that the patient is progressing in their plan of care and meet medical necessity ... Previous experience in Utilization Management and/or Appeals Required * Previous Epic experience or ...
Nurse Case Manager Lead
Atlanta, GA · On-site
Assists with development of utilization/care management policies and procedures, chairs and schedules meetings, as well as presents cases for discussion at Grand Rounds/Care Conferences and ...
Nurse Case Manager Lead
Atlanta, GA · On-site
Assists with development of utilization/care management policies and procedures, chairs and schedules meetings, as well as presents cases for discussion at Grand Rounds/Care Conferences and ...
RN Care Manager
Atlanta, GA · On-site
... utilization * Utilizing your clinical knowledge and deep understanding of key community resources, you'll provide health education and coordinate consults and referrals to support patients and ...
RN Care Manager
Atlanta, GA · On-site
... utilization * Utilizing your clinical knowledge and deep understanding of key community resources, you'll provide health education and coordinate consults and referrals to support patients and ...
RN Care Manager
Atlanta, GA · On-site
... utilization * Utilizing your clinical knowledge and deep understanding of key community resources, you'll provide health education and coordinate consults and referrals to support patients and ...
RN Care Manager
Atlanta, GA · On-site
... utilization * Utilizing your clinical knowledge and deep understanding of key community resources, you'll provide health education and coordinate consults and referrals to support patients and ...
... utilization * Utilizing your clinical knowledge and deep understanding of key community resources, you'll provide health education and coordinate consults and referrals to support patients and ...
... utilization * Utilizing your clinical knowledge and deep understanding of key community resources, you'll provide health education and coordinate consults and referrals to support patients and ...
RN Care Manager
Atlanta, GA · On-site
... utilization * Utilizing your clinical knowledge and deep understanding of key community resources, you'll provide health education and coordinate consults and referrals to support patients and ...
RN Care Manager
Atlanta, GA · On-site
... utilization * Utilizing your clinical knowledge and deep understanding of key community resources, you'll provide health education and coordinate consults and referrals to support patients and ...
... Utilization review duties in Care Management. Timely communication of clinical information and updates will be provided to the insurance companies as requested or required by contract or federal and ...
... Utilization review duties in Care Management. Timely communication of clinical information and updates will be provided to the insurance companies as requested or required by contract or federal and ...
Nurse Case Manager Lead
Atlanta, GA · On-site
Assists with development of utilization/care management policies and procedures, chairs and schedules meetings, as well as presents cases for discussion at Grand Rounds/Care Conferences and ...
Nurse Case Manager Lead
Atlanta, GA · On-site
Assists with development of utilization/care management policies and procedures, chairs and schedules meetings, as well as presents cases for discussion at Grand Rounds/Care Conferences and ...
... Utilization review duties in Care Management. Timely communication of clinical information and updates will be provided to the insurance companies as requested or required by contract or federal and ...
... Utilization review duties in Care Management. Timely communication of clinical information and updates will be provided to the insurance companies as requested or required by contract or federal and ...
This role monitors that the patient is progressing in their plan of care and meet medical necessity ... Previous experience in Utilization Management and/or Appeals Required * Previous Epic experience or ...
This role monitors that the patient is progressing in their plan of care and meet medical necessity ... Previous experience in Utilization Management and/or Appeals Required * Previous Epic experience or ...
Utilization Care Manager information
What is a utilization care manager?
Utilization Care Managers are healthcare professionals responsible for evaluating the necessity, appropriateness, and efficiency of medical services provided to patients. They work to ensure that patients receive the right care at the right time, while also helping healthcare organizations manage costs and comply with regulations. Utilization Care Managers often review patient cases, coordinate with medical staff, and interact with insurance companies to authorize or deny services. Their goal is to optimize healthcare delivery, reduce unnecessary procedures, and improve patient outcomes.
How does a utilization care manager collaborate with medical and administrative teams to ensure effective patient care?
Utilization Care Managers work closely with physicians, nursing staff, and administrative teams to review patient cases, determine medical necessity, and coordinate appropriate care plans. They frequently participate in interdisciplinary meetings, communicate with insurance providers regarding authorizations, and ensure compliance with regulatory guidelines. This collaborative approach helps to optimize resource utilization, improve patient outcomes, and support smooth transitions of care. Being proactive in communication and documentation is key to success in this role.
What are the key skills and qualifications needed to thrive as a utilization care manager, and why are they important?
To thrive as a Utilization Care Manager, you need a background in healthcare, typically as a registered nurse or social worker, with expertise in care coordination and utilization review. Familiarity with utilization management software, medical necessity guidelines (such as Milliman or InterQual), and knowledge of insurance regulations are important. Strong analytical thinking, attention to detail, and effective communication skills help you advocate for patients while working with healthcare teams and payers. These skills ensure appropriate resource use, quality patient outcomes, and compliance with regulatory standards.
What is the difference between Utilization Care Manager vs Utilization Review Nurse?
| Aspect | Utilization Care Manager | Utilization Review Nurse |
|---|---|---|
| Credentials | RN, case management certification | RN, certification in utilization review |
| Work Environment | Healthcare facilities, insurance companies | Hospitals, insurance companies, outpatient clinics |
| Primary Focus | Coordinating patient care, managing resources | Reviewing medical necessity, approving treatments |
Utilization Care Managers focus on coordinating patient care and managing resources, while Utilization Review Nurses primarily evaluate medical necessity for treatments. Both roles require nursing credentials and work within healthcare or insurance settings, but their core responsibilities differ in scope and focus.
What does a utilization care manager do in healthcare?
A utilization care manager in healthcare reviews patient cases to ensure appropriate use of medical services and resources, coordinating care plans to optimize patient outcomes and reduce unnecessary costs. They often work with healthcare providers, insurance companies, and patients, using data and clinical guidelines to make informed decisions about treatment and service utilization.
What are popular job titles related to Utilization Care Manager jobs in Georgia?
For Utilization Care Manager jobs in Georgia, the most frequently searched job titles are:
- Independent Contractor Remote Utilization Management Nurse
- Insurance Review Nurse
- Flexible Utilization Review Nurse
- Behavioral Health Utilization Review Nurse
- Utilization Management Per Diem
- Permanent Remote Pain Management Nurse
- Remote Utilization Management Nurse
- Manager Utilization Management
- Optum Health Utilization Review
- Full Time Remote Behavioral Health Utilization Review
What job categories do people searching Utilization Care Manager jobs in Georgia look for?
The top searched job categories for Utilization Care Manager jobs in Georgia are:
- Remote International Utilization Review Nurse
- Utilization Review
- Internship Rn Utilization Review Nurse
- Behavioral Utilization Review
- From Home International Utilization Review Nurse
- From Home Anthem Utilization Review Nurse
- Full Time Lapc
- Online Utilization Review
- Authorization Utilization Review
- Manager Optum Utilization Review
What cities in Georgia are hiring for Utilization Care Manager jobs?
Cities in Georgia with the most Utilization Care Manager job openings:
Full-time
Medical, Dental, Life, Retirement, PTO
Re-posted 4 days ago
Job description
Care Manager - Utilization Review
Description:
Excellent communication skills
Excellent organizational abilities
Skills in assessing, planning and managing patient care delivery
Utilization Management
Resource Management
Discharge Planning
Outcomes Management
Professional Development
Accountability
Experience/Education:
Registered nurse
Maintains current Georgia Nursing license
Minimum of three years experience as a registered nurse on a nursing unit
Perks/Benefits:
(for eligible employees):
Have optimal opportunity for career growth within our growing organization
Medical / Dental
Retirement Plan
PTO and paid life insurance
What Sets Us Apart
Archbold Medical Center is a four-hospital, four-nursing-home health system with 540 patient beds. We employ more than 2,500 people and boast an outstanding medical staff of nearly 200 qualified physician specialists. Our flagship hospital, Archbold Memorial Hospital, is a 264-bed hospital located in Thomasville, Georgia. Our system hospitals, also in Georgia, are Archbold Brooks Hospital in Quitman, Archbold Grady Hospital in Cairo, and Archbold Mitchell Hospital in Camilla.
For nearly 100 years, Archbold has been synonymous with high-quality, compassionate medical care. While our exemplary facilities have helped us maintain an excellent reputation, our team members are what makes Archbold special.
You are unique. You have skills and a strong passion for helping people. You also have personal goals, and Archbold wants to help you achieve them. We are a diverse healthcare system that promotes teamwork, continuing education, and leadership, and we are committed to recruiting and retaining the best healthcare professionals to join our Archbold team.
What we offer:
We know that your time and expertise are valuable, and to help our employees be at their best and make the most of their employment experience, we offer a comprehensive and generous benefits package that helps our employees and their families meet the challenges of everyday living.
We strive to be a workplace of choice, and from high-quality medical and dental care benefits to retirement benefits that help build wealth for your future, Archbold is proud to offer our employees one of the best benefits packages in the area.
Below are a few of the benefits Archbold Medical Center offers to employees:
- Work/Life Balance
- Planning for the Future
- Low-Cost Prescriptions
- Health & Wellness Benefits
- Planning for Life’s Unexpected Moments
- Helping You to Advance Your Career
Mission
To provide safe, innovative and compassionate care for our communities.
Vision
A healthier region, stronger communities, meaningful work, and trusted care
About Archbold medical group
Sourced by ZipRecruiter
Industry
Hospitals
Company size
1,001 - 5,000 Employees
Headquarters location
Thomasville, GA, US
Year founded
1925