Utilization Review Manager - Home Care jobs in North Carolina
Utilization Review Manager - Home Care ensures quality and level of care for patients are up to established standards and comply with federal, state, and local regulations. Investigates and resolves reports of inappropriate care. Being a Utilization Review Manager - Home Care may require a bachelor's degree. Typically reports to a head of a unit/department. To be a Utilization Review Manager - Home Care typically requires 4 to 7 years of related experience. Contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. (Copyright 2024 Salary.com)
Recently Added Utilization Review Manager - Home Care jobs
RN Utilization Review Manager
- Carteret Health Care
-
Morehead, NC
FULL_TIME
-
JOB RELATIONSHIPS
- Position reports to the Director of Quality, Utilization Management, and Disease Specific Programs. . Works closely with Case Management staff, physicians, Vice President of Medical Affairs, and the Business Office.
DEFINITION OF POSITION
- The Utilization Management RN will ensure regulatory compliance with CMS Conditions of Participation with regard to Utilization Management. Individuals will perform Utilization Review according to CMS guidelines, participate in denial/appeal process, and interact with physicians regarding Utilization Management concerns.
QUALIFICATIONS
- Professional
- Associates Degree in Nursing required; BSN preferred.
- NC RN licensure required.
- If ADN prepared must have 5 years’ experience in an acute care hospital; experience with CMS/commercial insurance/case management preferred. If BSN prepared, must have 3-5 years’ experience in an acute care hospital; experience with CMS/commercial insurance/case management preferred.
- A certification in Case Management (i.e. CCM, ACM) can substitute for 1 year of experience.
- 5 Days Ago
Utilization Review Nurse
- HOSPICE & PALLIATIVE CARE CHARLOTTE
-
Pineville, NC
OTHER
- Job Details Job Location: Homecare South - Pineville, NC Position Type: Full Time Salary Range: Undisclosed Travel Percentage: Local Travel Job Shift: Day DescriptionEssential Functions Clinical o Ass...
- 9 Days Ago
RN Quality Review Specialist
- Helms Home Care
-
Denver, NC
PART_TIME
- The Clinical Review Specialist is an integral member of the care planning team and works closely with clinical and coordination staff to support the management and delivery of quality home infusion th...
- 4 Days Ago
Registered Nurse-Utilization Review/Patient Care Coordinator (PRN)
- Ashe Memorial Hospital
-
Jefferson, NC
OTHER
- At Ashe Memorial Hospital, we are driven by our Mission Statement, "To meet the needs of the community by delivering patient-centered, high quality health care." Ashe Memorial Hospital is proud to be ...
- 18 Days Ago
Utilization Review Coordinator
- State of North Carolina
-
Buncombe, NC
FULL_TIME
- This posting has been extended*** SIGN-ON BONUS $10,000 ***for the successful applicant of this posting. See "Eligibility for Sign-On Bonus" below in the Supplemental and Contact Information section f...
- 1 Day Ago
Utilization Review Quality Specialist
- ECU Health
-
Greenville, NC
FULL_TIME
- ECU Health About ECU Health Medical Center ECU Health Medical Center, one of four academic medical centers in North Carolina, is the 974-bed flagship hospital for ECU Health and serves as the primary ...
- 4 Days Ago
Utilization Review Manager - Home Care jobs at Popular Companies
Gas Utilities Manager
- Accenture
-
Austin, TX
- We Are: Our Utility Industry, Transmission & Distribution Practice is powering the progress to a safe, connected, and su...
- 6/10/2024 12:00:00 AM
Director Utilization Management
- Heritage Valley Health System, Inc.
-
Beaver, PA
- Department: Utilization Review. Work Hours: Primarily Monday through Friday, extended hours as needed to support organiz...
- 6/9/2024 12:00:00 AM
Supervisor, Utilization Management
- Centene Corporation
-
Tallahassee, FL
- You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Managem...
- 6/9/2024 12:00:00 AM
Utilization Management Specialist
- Blue Cross and Blue Shield Association
-
Meridian, ID
- Our Utilization Management Rep will coordinate and manage incoming and outgoing correspondence to include referrals, pri...
- 6/9/2024 12:00:00 AM
Director of Utilization Management
- Oceans Healthcare
-
Jackson, MS
- Description The Director Utilization Management is responsible for oversight and management of all utilization review/ca...
- 6/8/2024 12:00:00 AM
Manager, Utilization Management
- Hiring Now!
-
New York, NY
- Creates and upholds policies and procedures for coverage determinations. Serves as subject matter expert for Medicare co...
- 6/8/2024 12:00:00 AM
Director Utilization Management
- Heritage Valley Health System
-
Beaver, PA
- Department: Utilization Review Work Hours: Primarily Monday through Friday, extended hours as needed to support organiza...
- 6/7/2024 12:00:00 AM
Environmental and Utilities Manager
- Leprino Foods
-
Lubbock, TX
- For our future state-of-the art 600+ person Lubbock, TX cheese and whey manufacturing facility, Leprino is seeking an En...
- 6/6/2024 12:00:00 AM
About North Carolina
North Carolina (/ˌkærəˈlaɪnə/ (listen)) is a state in the southeastern region of the United States. It borders South Carolina and Georgia to the south, Tennessee to the west, Virginia to the north, and the Atlantic Ocean to the east. North Carolina is the 28th-most extensive and the 9th-most populous of the U.S. states. The state is divided into 100 counties. The capital is Raleigh, which along with Durham and Chapel Hill is home to the largest research park in the United States (Research Triangle Park). The most populous municipality is Charlotte, which is the second-largest banking center in...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Review Manager - Home Care jobs
$73,519 to $93,725