- Commonwealth Care Alliance (Boston, MA)
- … Mgmt - Directs, coordinates and evaluates efficiency and productivity of utilization management functions for physical health services and long term ... a high quality team.collaboration with the broader clinical organization. - Ensures that utilization management processes are integrated with care management … more
- Commonwealth Care Alliance (Boston, MA)
- …Management is responsible for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for ... & Utilization Mgmt Position Summary: Commonwealth Care Alliance's (CCA) Utilization Management (Authorization) Unit is primarily responsible for the… more
- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in… more
- BroadPath Healthcare Solutions (Tucson, AZ)
- **Overview** BroadPath is seeking a highly motivated and results-oriented ** Utilization Management (UM) Nurse ** . Our ideal **UM Nurse ** will ensure ... policy, regulatory, and Health Plan guidelines. + Apply case management skills to members who have been identified as...Perform other duties as assigned. **Qualifications** + Current, active RN license in the state of California (CA) +… more
- ERP International (Macdill AFB, FL)
- **Overview** ERP International is seeking a ** Registered ** ** Nurse ( RN )** for a Full-Time position in ** Utilization Management ** at MacDill AFB, FL. ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- ERP International (Vandenberg AFB, CA)
- **Overview** ERP International is seeking a full-time ** Registered Nurse ( RN ) Utilization Management ** for a temporary contract position in support ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- CHRISTUS Health (San Antonio, TX)
- …for assigned areas; at CHRISTUS St. Patrick Hospital. The nurse manager affects departmental outcomes through interpretation, implementation, and evaluation ... excellence in patient care, patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically… more
- Skaggs Community Hospital Association (Branson, MO)
- …and utilization of Aseptic Technique. ◦ Licensure/Certification/Registration ▪ Required:Missouri State Registered Nurse AND Certified as a Registered ... and utilization of Aseptic Technique. ◦ Licensure/Certification/Registration ▪ Required:Missouri State Registered Nurse AND Certified as a Registered … more
- Daiichi Sankyo, Inc. (Chesapeake, VA)
- …driver's license with a driving record that meets company requirements Licenses and Certifications RN - Registered Nurse - State Licensure and/or Compact ... State Licensure The ideal candidate will be a Registered Nurse with previous relevant clinical as well as pharmaceutical industry experience calling on different… more
- Stony Brook University (Stony Brook, NY)
- …the following but are not limited to:** + Responsible for addressing Utilization management , denials and appeal, discharge and transition planning activities, ... Management leadership and staff functions regarding care management and utilization management activities....Qualifications:** * Possession of license to practice as a registered nurse in New York State. *… more
- Alameda Health System (San Leandro, CA)
- … Management provides Care Coordination, Compliance, Transition Coordination, and Utilization Management . **DUTIES & ESSENTIAL JOB FUNCTIONS** NOTE:The ... background. Within the last 3 years, experience in Case Management in an acute setting or utilization ...or health plan. Required Licenses/Certifications: Active licensure as a Registered Nurse in the State of California,… more
- ERP International (Nellis AFB, NV)
- **Overview** ERP International is seeking a full-time ** Registered Nurse ( RN ) Disease Manager** in support of theMike O'Callaghan Military Medical Center ... managed care principles, military and civilian population healthcare, case management , utilization management , and demand...are required: Minimum of five years of experience as registered nurse with at least 12 months… more
- ERP International (Tinker AFB, OK)
- **Overview** ERP International, LLC is seeking a ** Registered Nurse - Case Manager** for a full-time position supporting **SHG Clinic** in support of **Tinker ... and databases for community resources. - Integrate CM and utilization management (UM) and integrating nursing case...or pending adverse actions) to practice nursing as a registered nurse in any US state/jurisdiction. Security**… more
- ERP International (Yuma, AZ)
- …(CRRN),(COHN), (ACCC), (CRC), ( RN -NCM),(CMC) **OR** Possess a Master's Degree in Nurse Case Management from a program accredited by the American Nurses ... **Overview** ERP International, LLC is seeking a ** Registered Nurse - Case Manager** for...and databases for community resources. - Integrate CM and utilization management (UM) and integrating nursing case… more
- Katmai (Fort Carson, CO)
- …all levels of health care management to include outside agencies. Performs utilization management activities to optimize cost, quality, and access to care. ... **Job Requirements:** **MINIMUM QUALIFICATIONS** + Associates Degree of Nursing. Registered nurse shall be a graduate from...+ Shall possess a current, active, full and unrestricted Registered Nurses ( RN ) licensed in Colorado or… more
- ERP International (San Diego, CA)
- **Overview** ERP International is seeking a full-time ** Registered Nurse ( RN ) Health Educator** supporting **Naval Medical Center San Diego, CA ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- Luke Staffing (Yigo, GU)
- …of clinical nursing experience is required. One year of previous experience in Utilization Management is required. Full time employment in a nursing field ... of this position, it must be directly related to referral/ utilization management . + **Licensure:** Current, full, active,...and unrestricted license to practice as a Practical OR Registered Nurse in any one of the… more
- Commonwealth Care Alliance (Boston, MA)
- …Work collaboratively with internal departments-including Clinical Operations, Contracting, Network Management , Utilization Management , and Business ... & Language (nice to have):** + Familiarity with care management and utilization management systems...applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance is an… more
- Commonwealth Care Alliance (Boston, MA)
- …member experience. - Address provider inquiries related to care coordination, utilization management , and program participation, collaborating with internal ... does not have direct reports. Essential Duties & Responsibilities: Provider Relationship Management - Serve as the primary relationship manager and point of contact… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …years nursing experience with advanced level pediatric clinical experience and utilization management and/or discharge planning experience. Thorough knowledge of ... managed care, utilization management , discharges planning, and continuous quality...Nursing, Health Care Administration, or related field preferred. Current Registered Nurse licensure in the State of… more
