- Prime Healthcare (Ontario, CA)
- …school of nursing and a current state Registered Nurse license. + Minimum 3 years RN Utilization Manager working for a Health Plan. + At least 3 ... Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)( 3 ) not-for-profit public charity. Prime Healthcare is actively seeking new members… more
- Ventura County (Ventura, CA)
- Per Diem Registered Nurse II/III - Utilization Management VCMC Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5009956) Apply Per Diem ... Registered Nurse II/III - Utilization ...Registered Nurse II/III - Utilization Management VCMC Salary...current and future Intermittent vacancies. There is currently three ( 3 ) Per Diem vacancies in Utilization Management.… more
- Veterans Affairs, Veterans Health Administration (Houston, TX)
- Summary The Registered Nurse Utilization Management Registered Nurse delivers fundamental knowledge-based care to assigned clients while developing ... policies and guidelines. Responsibilities Major Duties (To include but not limited to): The Registered Nurse Utilization Management Registered Nurse … more
- Veterans Affairs, Veterans Health Administration (Phoenix, AZ)
- …members of the interdisciplinary team. Responsibilities Duties include but not limited to: Utilization Review (UR) Registered Nurse (RN) is responsible for ... level degree in Nursing may have opportunity to become registered as a nurse with a state...BSN with 2 years of professional nursing equivalent to Nurse I, Level 3 ; OR an MSN… more
- AdventHealth (Tampa, FL)
- …and other diseases. **The role you'll contribute:** The role of the Emergency Department Utilization Management (UM) Registered Nurse (RN) is to use clinical ... for additional review as determined by department standards. The Utilization Management Nurse is accountable for a...+ Associate's of Nursing Required + Registered Nurse (RN) license Required + 3 years… more
- CVS Health (Richmond, VA)
- …we do it all with heart, each and every day. **Position Summary** The Utilization Management (UM) Nurse Consultant is a remote, full-time role responsible for ... services using evidence-based clinical criteria. This position involves conducting utilization reviews, collaborating with healthcare providers, and supporting care… more
- BJC HealthCare (St. Louis, MO)
- …(commercial, behavioral health, inpatient, ect) **Requirements:** + 2 years of staff nurse experience performing care for hospitalized patients. + 2 years of ... utilization review (UR) experience reviewing hospital admissions for medical...Illinois and southeast Missouri regions. With net revenues of $6. 3 billion and more than 30,000 employees, BJC serves… more
- Beth Israel Lahey Health (Plymouth, MA)
- …years recent, broad clinical experience in the hospital setting + Experience with utilization management within the last 3 years required + An understanding ... making a difference in people's lives.** 32 hpw; 8-hr shifts (7a- 3 :30p flex); rotating weekends and holidays **Job Description:** **Duties/Responsibilities:** +… more
- State of Connecticut, Department of Administrative Services (New Haven, CT)
- Utilization Review Nurse (40 Hour) Office/On-Site...Three ( 3 ) years of experience as a Registered Nurse . MINIMUM QUALIFICATIONS - SPECIAL EXPERIENCE ... View Benefits (https://www.jobapscloud.com/CT/jobs/?b=Benefits) + + + + Introduction Are you a Registered Nurse looking for an opportunity to make a difference… more
- CVS Health (Baton Rouge, LA)
- …demonstrated ability to make thorough, independent decisions using clinical judgement. + A Registered Nurse that must hold an unrestricted license in their state ... will occasionally be required.** **100% attendance is required during the first 3 weeks of training / 8:30am-5pm EST, Monday-Friday.** American Health Holding, Inc… more
- US Tech Solutions (Chicago, IL)
- …Plan Activities **Experience:** + 3 + years of experience as an RN + Registered Nurse in state of residence + Must have prior authorization utilization ... have experience with Utilization Review? + Do you have an Active Registered Nurse License? **About US Tech Solutions:** US Tech Solutions is a global staff… more
- CVS Health (Baton Rouge, LA)
- …verbal and written. **Required Qualifications** + 3 + years of experience as a Registered Nurse in a clinical setting. + Must have active current and ... CST with weekend/holiday coverage required (as needed). As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document… more
- AmeriHealth Caritas (LA)
- …Degree in Nursing (ASN) required; Bachelor's Degree in Nursing (BSN) preferred. + An active Registered Nurse (RN) license in good standing is required. + 3 + ... Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ensuring… more
- AmeriHealth Caritas (Washington, DC)
- …environment. + Current driver's license required **Licensure:** + An active and unencumbered Registered Nurse license in the District of Columbia is required. ... Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ensuring… more
- CVS Health (Annapolis, MD)
- …and administration of the utilization /benefit management function. Required Qualifications + Registered Nurse in state of residence. + 3 + years ... opportunities to promote quality effectiveness of Healthcare Services and benefit utilization . + Consults and lends expertise to other internal and external… more
- US Tech Solutions (May, OK)
- …years of experience as an RN . 1+ years of inpatient hospital experience . Registered Nurse in state of residence . Must have prior authorization utilization ... and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review. . MUST HAVE 1 YEAR OF... management review. . MUST HAVE 1 YEAR OF UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG. . MUST… more
- Signature Healthcare (Louisville, KY)
- …documentation to facility accurate billing. What you Need to make a Difference + Registered Nurse (RN) in good standing with required current state license. + ... communication with leadership, patients, families, internal care givers, and external Utilization Management Nurses. + Coordinate internal and external health care… more
- CVS Health (Boise, ID)
- …to meet quality and metric expectations. **Required Qualifications** + Registered Nurse (RN) - active license. + 3 + Years of clinical experience. ... Director referral as needed. Assists management with training new nurse reviewers/business partners or vendors to include initial and...+ 1+ Year of Utilization Review Management and/or Medical Management experience. + Must… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Registered Nurse (RN) PRN position is a licensed staff nurse , an experienced clinician, functions at the Competent to Proficient ... prioritize daily tasks. Provides input into the unit resource utilization including unit capital and operational budget needs. +...School of Nursing **WORK EXPERIENCE** + Two years of registered nurse experience in a healthcare environment… more
- CVS Health (Charleston, WV)
- …sitting, listening, speaking, and computer use. **Required Qualifications** + Active, unrestricted ** Registered Nurse (RN) license** in state of residence + ... Minimum of ** 3 years of clinical experience** + Availability to work **Monday-Friday, 8 AM-5 PM** , with occasional **weekend/holiday on-call** (differential pay for… more