- Crouse Hospital (Syracuse, NY)
- Utilization Management Registered Nurse has well-developed knowledge and is proficient with standard Utilization Review processes. The Utilization ... their appropriate admission status. This individual will support the Utilization Management process by maintaining effective and.../ LICENSURE + Required: + Currently licensed as a Registered Professional Nurse in New York State.… more
- Humana (Louisville, KY)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the state of… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** Utilization Management Nurse - Weekend Front End Review utilizes clinical nursing ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in Florida with no… more
- Veterans Affairs, Veterans Health Administration (Chicago, IL)
- Summary The Jesse Brown VA Medical Center has a full-time Registered Nurse - Utilization Management position available for current, permanent employees ... while maintaining quality of care. Responsibilities The Registered Nurse (RN) - Utilization Management (UM) is responsible for reviewing all inpatient… more
- Cedars-Sinai (Los Angeles, CA)
- …condition of continued employment. **Req ID** : 5044 **Working Title** : Registered Nurse - Utilization Management 8 Hour Days Per Diem **Department** : ... fro an accredited nursing program required. Bachelors Degree in Nurse preferred. California RN License required. **Experience:** + Minimum... Utilization Management **Business Entity** : Cedars-Sinai Medical Center **Job Category**… more
- Dartmouth Health (Lebanon, NH)
- Overview The Manager of Utilization Management is responsible for day to day operations of the utilization review program at multiple Dartmouth Health system ... leadership, communication and computer skills desired. Required Licensure/Certifications - Licensed Registered Nurse with NH eligibility - BLS certification… more
- Stanford Health Care (Palo Alto, CA)
- …adoption assistance! **This is an onsite Stanford Health Care job.** **A Brief Overview** The Utilization Management Registered Nurse (UM RN) will be ... the institution, navigating the complexities of patient care and resource utilization management , and education. Primary responsibilities include: 1.… more
- McLaren Health Care (Detroit, MI)
- **Department: Utilization Management ** **Daily Work Times: 7:00am-3:30pm** **Shift: Days** **Scheduled Bi-Weekly Hours: 40** **Position Summary:** Responsible ... Assigned:** 1. Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure...projects as needed. _Required:_ + State licensure as a registered nurse (RN) + Bachelor's degree in… more
- WellSpan Health (York, PA)
- …+ 5 years In leadership experience. Required + 3 years Utilization Management Experience. Preferred Licenses: + Licensed Registered Nurse Preferred ... Full Time General Summary Supervises and oversees the operations of the utilization management department. Works with hospital, regional, medical group,… more
- Sharp HealthCare (San Diego, CA)
- …Qualifications** + Bachelor's degree + Prior experience in Quality Improvement/ Utilization Management + California Registered Nurse (RN) - CA Board ... **FTE** 1 **Shift Start Time** **Shift End Time** California Registered Nurse (RN) - CA Board of...processing and works as a liaison to Sharp Risk Management for the identification of potential risk issues. +… more
- Veterans Affairs, Veterans Health Administration (St. Louis, MO)
- …Louis Health Care System (VASTLHCS), St. Louis, Missouri. The Registered Nurse Case Manager ( Utilization Management ) demonstrates leadership, experience, ... and creative approaches in providing complex patient management in delivering and improving holistic care through collaborative...Nurse Total Rewards The primary purpose of this Registered Nurse Case Manager (RNCM) is to… more
- ERP International (Corpus Christi, TX)
- **Overview** ERP International is seeking a ** Registered Nurse (RN)** ** Utilization Manager** for a full-time position in support of the **Naval Health ... staff, newcomers, as appropriate. * Participate in all phases of the Utilization Management Program (UMP) and ensure that the UMP meets established … more
- McLaren Health Care (Bay City, MI)
- …and Responsibilities:** 1. Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure that appropriate ... cases. 5. Assists with monitoring the effectiveness/outcomes of the utilization management program, identifying and applying appropriate...educational institution + State of Michigan licensure as a Registered Nurse (RN) + Two years of… more
- Ascension Health (Manhattan, KS)
- **Details** + **Department:** Utilization Management + **Schedule:** Full Time, 40 hours weekly, Monday - Friday 7:30am - 4pm + **Hospital:** Ascension Via ... and coordinate compliance to federally mandated and third party payer utilization management rules and regulations. **Requirements** Licensure / Certification… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse (RN) - Active, current and… more
- CVS Health (Columbus, OH)
- …and work schedules may include weekends, holidays, and evening hours_ As a Utilization Management Nurse Consultant, you will utilize clinical skills ... **Required Qualifications** - 3+ years of experience as a Registered Nurse - Must have active current...of clinical experience in acute or post-acute setting - Utilization management is a 24/7 operation. Work… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Clinical Quality Nurse Reviewer RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, ... and to support the safety net required to achieve that purpose. Job Summary The Utilization Management Clinical Quality Nurse Reviewer RN II, under the… more
- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in KY, IN, MI,… more
- CVS Health (Raleigh, NC)
- …solutions to make health care more personal, convenient and affordable. **Position Summary** ** Utilization Management is a 24/7 operation and work schedules may ... **Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current...experience with Microsoft Office applications (Outlook, Teams, Excel) + Utilization Management is a 24/7 operation and… more