Find clinical, allied health, care team, and healthcare operations openings using one smart search field across cities, regions, and employers.
Mount Sinai Health System
Overview
The role involves coordinating clinical information requests from third-party payers and supporting utilization management for patient admissions and stays. It also includes tracking concurrent adverse determinations and collaborating with the Appeals Management Department to handle retrospective denials.
Quick view →
Compensation
Salary not listed
Posted
24 days ago
Best Care
This role is responsible for the overall management and communication of clinically-based appeals between the Health System and various payers, requiring review of cases, utilization of guidelines, and management of appeal documentation and communication.
2 months ago
Nicklaus Children's Hospital
The RN Case Manager plans, assesses, implements, monitors, and evaluates healthcare services using Utilization Resource Management and Transition of Care functions to ensure quality care and cost-effective utilization. This role involves coordinating medical needs for pediatric patients, screening charts for admission criteria, and proactively resolving barriers to safe discharge.
3 months ago
