- Appcast (Canton, MA)
- …required. Job Summary The Clinical Reviewer is a licensed professional -a Registered Nurse preferred- that is expected to function independently in her / ... all aspects of clinical decision making and support needed to perform utilization management , medical necessity determinations and benefit determinations using… more
- AmeriHealth Caritas Health Plan (Wilmington, DE)
- Role Overview Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and ... overtime, and weekends based on business needs Responsibilities Conduct utilization management reviews by assessing medical necessity,...Degree in Nursing (BSN) preferred An active compact state Registered Nurse ( RN ) license in… more
- UnitedHealth Group (Grand Junction, CO)
- …to work Monday - Friday, 930am-6pm Mountain Standard Time Preferred Qualification: Utilization Management experience *All employees working remotely will be ... approved medical necessity criteria, escalating cases to secondary medical director review when necessary, and collaborating with leadership and medical directors on… more
- Vivian (Cambridge, MA)
- Talent4Health is seeking a travel nurse RN Case Management for a travel nursing job in Cambridge, Massachusetts.Job Description & RequirementsSpecialty: Case ... hours per weekShift: 8 hours, daysEmployment Type: TravelPrimary Responsibilities:1. Performs utilization review and discharge planning to inpatient admissions… more
- TrackFive (New York, NY)
- …to $2,900 per weekAbout The PositionJob Opportunity: Registered Nurse (Case Management - Utilization Review ) Bronx, NY 10457 Duration: 13 Weeks Shift ... Experience Prior critical care experience Knowledge of CarePort, MCG, and/or InterQual Utilization Review e.xperience a plus About Lancesoft IncEstablished in… more
- TrackFive (Bronx, NY)
- …Shift: 8-hour days 27422608EXPPLATJob Requirements 9-5 schedule: Monday-Friday Two years case/resource management and utilization management is required 3-5 ... management experience is preferred. EPIC experience PRI (Patient Review Instrument) and SCREEN experience/certification ideal Education Required: New York State… more
- TrackFive (Augusta, GA)
- …its next amazing RN ( Registered Nurse ) to work in Case Management ( Utilization Review ). Read on if this sounds like your perfect fit! Nurses ... with Medical Solutions to find a qualified Case Manager RN in Atlanta, Georgia, 30305!Pay Information$2,588 per weekAbout The...and adding your skill and talent to our Travel Nurse workforce. Hit the road with Medical Solutions and… more
- University Health (San Antonio, TX)
- …Three years recent, full-time hospital experience preferred. Work experience in case management , utilization review or hospital quality assurance experience ... of Nurse Examiners of the State of Texas to practice as a registered nurse is required. National certification in related field is preferred. Case Manager… more
- Vivian (Fort Myers, FL)
- Lee Health is seeking a Registered Nurse ( RN ) Case Management for a nursing job in Fort Myers, Florida.Job Description & RequirementsSpecialty: Case ... criteria to promote high-quality, cost-effective care.Take the lead on discharge planning, utilization review , and coordination of services that support patient… more
- JobAdX (Green Bay, WI)
- …and auditing activities.Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding.Manages clinic financials ... including efficient utilization of supplies or equipment and regular profits and loss review .Responsible for all required network reporting and on-site state or… more
- TrackFive (Los Angeles, CA)
- …discharge planning - Required Experience with all patient populations - Required Case Management or Utilization Review Certification - Highly Preferred ... Case Manager RN in Hanford, California, 93230!About The PositionSpecialty: RN Case Management Job Details: Responsible for coordinating medical care,… more
- TrackFive (Houston, TX)
- …experience in a long-term acute care setting. discharge planning, clinical case management & utilization review Must have Texas RN or multi-state RN ... is working with Compunnel Healthcare to find a qualified Case Manager RN in Houston, Texas, 77030!Pay Information$2,400 to $2,520 per weekAbout The PositionFacility… more
- Vivian (Cambridge, MA)
- …2 years of case management or utilization review experience3+ years of medical/surgical RN experienceEpic experience preferred Additional ... Rang Healthcare is seeking a travel nurse RN Case Management for a travel nursing job in Cambridge, Massachusetts.Job Description & RequirementsSpecialty:… more
- MindMatch (Aiken, TX)
- …managerial problems/issues, demonstrates professional accountability for competency and growth. The Registered Nurse Clinical Supervisor assists the DON in some ... Nurses on clinic days, and on the floor. The Registered Nurse Clinical Supervisor is expected to...of gerontology, the care of women religious and nursing management through literature review and attendance at… more
- TrackFive (Boston, MA)
- …current Massachusetts RN license, 3 years of prior hospital Case Management plus Utilization Review experience required.About Patterns LLCPatterns is ... with Patterns LLC to find a qualified Case Manager RN in Milford, Massachusetts, 01757!Pay Information$60 to $75 per...Case Manager is accountable for coordinating and facilitating the management of care for an assigned group of patients.… more
- NCH Healthcare System (Estero, FL)
- …Degree in Nursing required; BSN preferred.. Minimum of 1 years Discharge planning, case management , managed care, or Registered Nurse experience in a medical ... activities relevant to identified opportunities. . Actively collaborates with utilization review team to facilitate and meet...setting. . Licensed as a Registered Nurse ( RN ) in the… more
- TrackFive (Worcester, MA)
- …Massachusetts RN license, 3 years of prior hospital Case Management plus Utilization Review experience required.27644978EXPPLATAbout Patterns LLCPatterns ... is working with Patterns LLC to find a qualified Case Manager RN in Milford, Massachusetts, 01757!Pay Information$70 to $80 per hourAbout The PositionRequirements:… more
- Vivian (Kentfield, CA)
- Openwork Health is seeking a travel nurse RN Case Management Supervisor for a travel nursing job in Greenbrae, California.Job Description & ... to be determined.About Openwork HealthWe're not your average travel nurse agency. At Openwork Health, we're all about helping...2+ years of experience in your specialty, an active RN license, BLS certification from the American Heart Association… more
- TrackFive (New York, NY)
- …in Johnson City, New York, 13790!Pay Information$2,669 per weekAbout The PositionJob Title: Registered Nurse Profession: Nurse Specialty: Staff Duration: 13 ... lidocaine, milrinone, heparin, insulin). Experience with anticoagulants. Description: The Registered Nurse protects, promotes, and optimizes health and… more
- Kaiser Permanente (Pleasanton, CA)
- …assigned areas. Essential Responsibilities: Assists in the coordination of the quality management / utilization management department activities. Acts as a ... consultant for appropriate departments on quality management , utilization management ...three (3) years of home care experience or quality utilization review experience. Education Bachelors degree in… more
