American Traveler is seeking an experienced RN Case Manager for a critical need position at a hospital in Woodland Hills, CA, requiring an active CA RN license and Epic EMR experience. Job Details ...
American Traveler is seeking an experienced RN Case Manager for a critical need position at a hospital in Woodland Hills, CA, requiring an active CA RN license and Epic EMR experience. Job Details ...
Medical Case Manager I
$63K - $95K/yr
As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...
Quick apply
Medical Case Manager I
$63K - $95K/yr
As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...
Medical Case Manager I
Birmingham, AL · On-site
$63K - $95K/yr
As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...
Medical Case Manager I
Birmingham, AL · On-site
$63K - $95K/yr
As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...
Medical Case Manager I
Birmingham, AL · On-site
$63K - $95K/yr
As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...
Medical Case Manager I
Birmingham, AL · On-site
$63K - $95K/yr
As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...
Medical Case Manager I
Troy, AL · On-site
$63K - $95K/yr
As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...
Medical Case Manager I
Troy, AL · On-site
$63K - $95K/yr
As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...
Case Manager Care Coordination
Webb, AL · On-site
MINIMUM QUALIFICATIONS RN: Must possess knowledge of case management or utilization review as ... normally obtained through the completion of a bachelor's degree in case management or health care.
Case Manager Care Coordination
Webb, AL · On-site
MINIMUM QUALIFICATIONS RN: Must possess knowledge of case management or utilization review as ... normally obtained through the completion of a bachelor's degree in case management or health care.
Medical Case Manager I
$63K - $95K/yr
As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...
Quick apply
Medical Case Manager I
$63K - $95K/yr
As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...
Medical Case Manager I
$63K - $95K/yr
As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...
Quick apply
Medical Case Manager I
$63K - $95K/yr
As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...
Medical Case Manager I
$63K - $95K/yr
As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...
Medical Case Manager I
$63K - $95K/yr
As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...
Medical Case Manager I
$63K - $95K/yr
As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...
Medical Case Manager I
$63K - $95K/yr
As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...
Overview The Case Manager is responsible to assist in the development, planning, coordination and administration of the activities of Utilization Review and Discharge Planning. Including but not ...
Overview The Case Manager is responsible to assist in the development, planning, coordination and administration of the activities of Utilization Review and Discharge Planning. Including but not ...
The Case Manager is responsible to assist in the development, planning, coordination and administration of the activities of Utilization Review and Discharge Planning. Including but not limited to ...
The Case Manager is responsible to assist in the development, planning, coordination and administration of the activities of Utilization Review and Discharge Planning. Including but not limited to ...
Overview The Case Manager is responsible to assist in the development, planning, coordination and administration of the activities of Utilization Review and Discharge Planning. Including but not ...
Overview The Case Manager is responsible to assist in the development, planning, coordination and administration of the activities of Utilization Review and Discharge Planning. Including but not ...
This role integrates and coordinates Utilization management, care coordination and discharge planning functions. The Case Manager is accountable for a designated patient caseload and plans ...
This role integrates and coordinates Utilization management, care coordination and discharge planning functions. The Case Manager is accountable for a designated patient caseload and plans ...
This role integrates and coordinates Utilization management, care coordination and discharge planning functions. The Case Manager is accountable for a designated patient caseload and plans ...
This role integrates and coordinates Utilization management, care coordination and discharge planning functions. The Case Manager is accountable for a designated patient caseload and plans ...
Collaborates with the Case Manager to identify referrals to Financial Counselors. * Negotiates ... Utilization Review experience preferred. * Expected to work under minimal management supervision
Collaborates with the Case Manager to identify referrals to Financial Counselors. * Negotiates ... Utilization Review experience preferred. * Expected to work under minimal management supervision
Collaborates with the Case Manager to identify referrals to Financial Counselors. * Negotiates ... Utilization Review experience preferred. * Expected to work under minimal management supervision
Collaborates with the Case Manager to identify referrals to Financial Counselors. * Negotiates ... Utilization Review experience preferred. * Expected to work under minimal management supervision
This role integrates and coordinates Utilization management, care coordination and discharge planning functions. The Case Manager is accountable for a designated patient caseload and plans ...
This role integrates and coordinates Utilization management, care coordination and discharge planning functions. The Case Manager is accountable for a designated patient caseload and plans ...
Collaborates with the Case Manager to identify referrals to Financial Counselors. * Negotiates ... Utilization Review experience preferred. * Expected to work under minimal management supervision
Collaborates with the Case Manager to identify referrals to Financial Counselors. * Negotiates ... Utilization Review experience preferred. * Expected to work under minimal management supervision
This role integrates and coordinates Utilization management, care coordination and discharge planning functions. The Case Manager is accountable for a designated patient caseload and plans ...
This role integrates and coordinates Utilization management, care coordination and discharge planning functions. The Case Manager is accountable for a designated patient caseload and plans ...
Utilization Case Manager information
What is a utilization case manager?
A Utilization Case Manager is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical services provided to patients. They review patient cases, coordinate with healthcare providers, and ensure that treatments are in line with established guidelines and insurance requirements. Their goal is to optimize patient outcomes while managing costs and ensuring compliance with regulations. Utilization Case Managers often work in hospitals, insurance companies, or managed care organizations.
How does a utilization case manager typically collaborate with healthcare providers and insurance companies?
Utilization Case Managers play a key role in coordinating care between healthcare providers and insurance companies. They review patient cases to ensure that the recommended treatments are medically necessary and align with insurance policies. This often involves regular communication with doctors, nurses, and insurance representatives to gather information, clarify treatment plans, and advocate for appropriate patient care. Strong collaboration skills are essential, as Utilization Case Managers must balance the needs of patients with organizational guidelines while maintaining positive professional relationships.
What degree do I need for utilization review?
Utilization case managers typically need at least a bachelor's degree in healthcare, nursing, social work, or a related field. Some positions may require a master's degree or professional certification, such as a Certified Case Manager (CCM) or Certified Professional in Healthcare Quality (CPHQ), to advance in the role or handle complex cases.
What are the key skills and qualifications needed to thrive as a utilization case manager?
To thrive as a Utilization Case Manager, you need a background in nursing or social work, strong analytical skills, and a solid understanding of healthcare regulations and insurance processes, often supported by RN licensure or certification in case management (e.g., CCM). Familiarity with utilization management software, electronic health records (EHRs), and payer authorization systems is essential. Excellent communication, critical thinking, and negotiation skills help facilitate collaboration among patients, providers, and payers. These skills ensure appropriate care delivery, cost management, and compliance with healthcare standards.
What is the difference between Utilization Case Manager vs Utilization Review Nurse?
| Aspect | Utilization Case Manager | Utilization Review Nurse |
|---|---|---|
| Credentials | RN license, case management certification | RN license, certification in utilization review |
| Work Environment | Case management teams, hospitals, insurance companies | Utilization review departments, hospitals, insurance providers |
| Primary Focus | Coordinating patient care, discharge planning, resource allocation | Assessing medical necessity, reviewing patient records for appropriateness |
| Common Usage | Broader case management roles, patient advocacy | Specific review of medical necessity and insurance claims |
While both roles require RN licensure and focus on patient care, the Utilization Case Manager primarily coordinates overall patient services and discharge planning, whereas the Utilization Review Nurse concentrates on evaluating the medical necessity of treatments for insurance purposes. Understanding these distinctions helps in choosing the right career path or job search focus.
What are popular job titles related to Utilization Case Manager jobs in Alabama? For Utilization Case Manager jobs in Alabama, the most frequently searched job titles are:
What job categories do people searching Utilization Case Manager jobs in Alabama look for? The top searched job categories for Utilization Case Manager jobs in Alabama are:
What cities in Alabama are hiring for Utilization Case Manager jobs? Cities in Alabama with the most Utilization Case Manager job openings:
Travel RN - Case Management/Utilization Review - Case Management
Woodland, AL • On-site
Other
Posted 4 days ago
Job description
American Traveler is seeking an experienced RN Case Manager for a critical need position at a hospital in Woodland Hills, CA, requiring an active CA RN license and Epic EMR experience.
Job Details
• Day shift position, 8 hours per day, 40 hours per week (8:00 AM - 4:30 PM),
• 31-week contract assignment,
• Epic EMR used at this facility,
Job Requirements
• Active CA RN license required at time of consideration (pending licensure not accepted),
• Active certifications required at time of consideration (no pending certifications accepted),
• Case management experience required,
• Epic EMR experience required,
• Last 4 digits of SSN and date of birth required for consideration,
Additional Information
• Local candidates are accepted and eligible for the same rate as travel candidates,
• Per Kaiser Permanente's HR Tenure Policy, contingent workers who have worked on assignment for two cumulative years (with any gaps of less than 3 months not resetting the clock) must take a minimum 90-day break before returning to assignment