Utilization Review Manager - Home Care jobs in Alabama

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)

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Case Manager, Utilization Review
  • Viva Health
  • Birmingham, AL FULL_TIME
  • VIVA HEALTH, ranked one of the nation's Best Places to Work by Modern Healthcare, is seeking a Case Manager, Utilization Review position to join our team in Birmingham, AL!

    VIVA HEALTH knows that nursing is not just a job; it is a calling. If you would like to fulfill your calling in healthcare, check us out! We offer regular hours with no mandatory nights and weekends. This way, you can do what you love at work and take care of the people you love at home! We also offer a great benefits package, including tuition reimbursement for employees and dependents, 401(K), paid parental leave, and paid day for community service, just to name a few!

    VIVA HEALTH is the first and only Alabama-based plan to be named an overall 5-out-of-5 Star Medicare Advantage Plan for the third year in a row! Our employees are a part of the communities they serve and proudly partner with members on their healthcare journeys. Come join our team!

    The Case Manager, Utilization Review will assist in the development, planning, coordination, and administration of the activities involved in utilization review for VIVA HEALTH members and assigned UAB High-Risk Fund-approved patients. This position will perform timely medical records checks to determine the appropriateness and medical necessity of admission, continued stay, and use of ancillary services. These duties may be performed on-site or telephonically depending on the location. This position may travel to locations within the VIVA HEALTH service area through a reliable means of transportation insured following Company policy. This position will have work-from-home opportunities.

    REQUIRED:

    • Graduate of a professional nursing program, ADN/BSN
    • Three years of clinical experience in acute, post-acute, or behavioral health setting
    • Current RN license in good standing with the State of Alabama Board of Nursing
    • Valid driver's license in good standing
    • May require significant face-to-face member contact with duties regularly performed away from the principal place of business
    • Willing to submit to vaccine testing and screening
    • Knowledge of Medicare and Medicaid regulations
    • Ability to be flexible, adaptable, and able to work effectively in a variety of settings
    • Demonstrate excellent customer service skills through written and verbal communication
    • Basic computer skills

    PREFERRED:

    • Utilization review or case management experience
    • HMO or MCO experience
    • Disease management experience
    • Certified Case Manager (CCM)

    Click Here to learn more about how VIVA HEALTH is building a culture where diverse voices, backgrounds, and perspectives are welcomed and celebrated!

  • Just Posted

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Registered Nurse (RN) - Utilization Review - Care Management- University Hospital
  • USA Health Systems
  • Mobile, AL FULL_TIME
  • Overview USA Health is Transforming Medicine along the Gulf Coast to care for the unique needs of our community. USA Health is changing how medical care, education and research impact the health of pe...
  • 22 Days Ago

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Utilization Review Coordinator
  • ADDICTION AND MENTAL HEALTH SERVICES, LLC
  • Warrior, AL FULL_TIME
  • Position Title: Utilization Review Coordinator Department: AdministrativeReports To: Executive / Program DirectorSupervises: NAEntry Level Qualifications:Must have a current LPC, LMFT, LMSW, or LCSW l...
  • Just Posted

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Part Time Utilization Review Nurse
  • JACKSON HOSPITAL AND CLINIC
  • Montgomery, AL PART_TIME
  • Under the direction of the Manager, Clinical Resource Management; the Case Manager is responsible for the activities of utilization management, case coordination and the development and implementation...
  • 9 Days Ago

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Assistant Director Case Management & Utilization Review
  • JACKSON HOSPITAL AND CLINIC
  • Montgomery, AL FULL_TIME
  • Support the Case Management Director and Utilization Review Program Monitors patient results, optimizing resource distribution and implementing continuing care plans to meet patients' post-discharge n...
  • 8 Days Ago

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Case Manager Utilization Nurse
  • JACKSON HOSPITAL AND CLINIC
  • Montgomery, AL FULL_TIME
  • Under the direction of the Manager, Clinical Resource Management; the Case Manager is responsible for the activities of utilization management, case coordination and the development and implementation...
  • Just Posted

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Director Utilization Management
  • AMI Network
  • San Diego, CA
  • I’m partnered with a major health plan in San Diego to find a Director of Utilization Management! This top-rated Medicai...
  • 3/28/2024 12:00:00 AM

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Utilities Manager
  • City of Upland, CA
  • Upland, CA
  • Salary : $124,287.53 - $158,625.88 Annually Location : Public Works - 1370 N. Benson Ave Upland, CA Job Type: Full Time ...
  • 3/28/2024 12:00:00 AM

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Utilities Manager (At-Will)
  • City of Rialto, CA
  • Rialto, CA
  • Salary : $116,448.00 - $156,060.00 Annually Location : Rialto, CA Job Type: Full-Time Job Number: 23-072 Department: RUA...
  • 3/28/2024 12:00:00 AM

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Maintenance and Utilities Manager
  • The Judge Group
  • Somerset, NJ
  • Do you love candy and snacks? Are you looking to join an ever evolving and rapidly growing team? PIM Brands might just b...
  • 3/28/2024 12:00:00 AM

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Utilization Management Assistant
  • Trinity Health
  • Des Moines, IA
  • Employment Type: Full timeShift: Description: GENERAL SUMMARY: Under general supervision, the Utilization Management Ass...
  • 3/28/2024 12:00:00 AM

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Utility Manager
  • Prairie Band Potawatomi Nation
  • Mayetta, KS
  • Tier: 2 Department: Administration Supervisor: General Manager of Operations Location: 16281 Q Road, Mayetta KS 66509 Pa...
  • 3/25/2024 12:00:00 AM

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Utility Management Consultant
  • HDR, Inc.
  • Charlotte, NC
  • Qualifications and Experience * BS in Civil or Environmental Engineering or a related technical discipline required. * M...
  • 3/25/2024 12:00:00 AM

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Utilization Management Coordinator
  • Hackensack Meridian Health
  • Point Pleasant Beach, NJ
  • Description: Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients ...
  • 3/25/2024 12:00:00 AM

Alabama (/ˌæləˈbæmə/) is a state in the southeastern region of the United States. It is bordered by Tennessee to the north, Georgia to the east, Florida and the Gulf of Mexico to the south, and Mississippi to the west. Alabama is the 30th largest by area and the 24th-most populous of the U.S. states. With a total of 1,500 miles (2,400 km) of inland waterways, Alabama has among the most of any state. Alabama is nicknamed the Yellowhammer State, after the state bird. Alabama is also known as the "Heart of Dixie" and the "Cotton State". The state tree is the longleaf pine, and the state flower is...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Review Manager - Home Care jobs
$69,856 to $89,063