- 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 (Seattle, WA)
- …certification 3+ years of experience working in acute care 1+ years of care management , utilization review or discharge planning experience HMO experience ... (AHA) or CPR/AED for the Professional Rescuer (American Red Cross) Washington State Registered Nurse license. 3+ years of experience in a clinical setting… more
- Ochsner Health (Gretna, LA)
- …managed care, care management , case management or utilization review .CertificationsRequired - Current registered nurse ( RN ) license in state ... Contents are subject to change at the company's discretion. EducationRequired - Registered nurse diploma.Preferred - Associate or bachelor's degree 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
- TrackFive (Melrose, MA)
- …40 hours week, 5 days/week 8-4:30p general hours. This is RN Case management , no utilization review responsibilities. It is discharge planning etc. ASAP ... patient and family members and community resources to facilitate the utilization management review /discharge planning processLocal candidates accepted.… more
- University Health (San Antonio, TX)
- …years of recent, full-time hospital experience preferred. Work experience in case management , utilization review , or hospital quality assurance experience ... Graduation from an accredited school of nursing with current RN licensure in the State of Texas; BSN preferred....of the State of Texas to practice as a registered nurse is required. National certification in… more
- TrackFive (Cambridge, MA)
- …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 Cambridge, Massachusetts, 02138!Pay Information$2,677 per weekAbout The...and adding your skill and talent to our Travel Nurse workforce. Hit the road with Medical Solutions and… more
- TrackFive (San Diego, CA)
- …Health* Hospice* Insurance Company* Long Term Acute Care/Rehab/Skilled Nursing* Case Management / Utilization Review Admission Criteria Benefits Eligibility ... is working with Compunnel Healthcare to find a qualified Case Manager RN in Santa Rosa, California, 95405!Pay Information$2,500 to $2,600 per weekAbout The… 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 (Miami, FL)
- …the medical needs for patients Certification in Case Management , Nursing or Utilization Review is preferred Florida RN license and/or approved multistate ... to $45 per hourAbout The PositionJob Summary and Qualifications We are seeking a dynamic Case Management RN to join our team. The RN Case Manager facilitates… more
- TrackFive (Hanford, 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
- buyer (Tinton Falls, NJ)
- …, weight loss, and dehydration.Participating in Wound Rounds, Operations Meetings, Utilization Review , and Performance Improvement/Risk Management /Safety ... with potential for annual bonus. Salary based on experience**What you will need Current RN nursing license with no restrictions for the state in which they operate.… more
- TrackFive (San Diego, CA)
- …Care Case Management /Discharge Planning) Work Settings Acute Hospital Case Management / Utilization Review Admission Criteria Benefits Eligibility Care ... the Best Staffing Firms to Work for. LanceSoft specializes in providing Registered Nurses, Nurse Practitioners, LPNs/LVNs, Social Workers, Medical Assistants,… more
- TrackFive (Springfield, 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
- TrackFive (Johnson City, 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
- Valley Health System (Paramus, NJ)
- …Responsible for development and implementation of hospital's system / processes for Utilization Management , Denials /Appeals Management , Resource / LOS ... management . Accountable for directing the day-to-day operations for Concurrent Utilization Review processes for Medicare, Medicaid, Managed Care and… more
- TrackFive (Aurora, CO)
- …(CoPs), ORYX Core Measures, and accreditation bodies (TJC & HFAP) preferred. Case Management experience including utilization review and discharge planning ... TravelNurseNetwork is working with Patterns LLC to find a qualified Other RN in Grand Junction, Colorado, 81501!About The Position**Must have current RN License,… more
- American Traveler (Puyallup, WA)
- …experience required, *Healthcare financial and reimbursement knowledge required, *ER and utilization review experience preferred, *BLS not required, *Will not ... American Traveler is seeking an experienced RN for a Case Management position in an acute inpatient hospital setting requiring WA RN license, BSN, and recent… more
- TrackFive (Atlanta, GA)
- …accept more than 3 days of RTOWellstar does not allow block schedulingJob Summary: The RN Clinical Nurse is a proactive member of an interdisciplinary team of ... and Certification(s): All certifications are required upon hire unless otherwise stated.Reg Nurse (Single State) or RN - Multi-state CompactBasic Life Support… more
