- HealthCare Support (Houston, TX)
- Utilization Review RN HealthCare Support is...in Remote Houston TX . Daily Responsibilities for Utilization Review RN : WIll need to ... actively seeking a Utilization Review RN to fill an opening with a Prestigious HealthCare Company… more
- SR International, Inc. (Phoenix, AZ)
- …to obtain their own laptop SOAZ - Posting ID # 5297 - Medical Review Nurse (Local Only/Mostly Remote /Onsite Trainings) Skills Required: *Medical nursing ... times for training once starting position Compliance Items: Active RN License in state of Arizona Fingerprint Clearance Card...practice, medical case management protocols, quality management and utilization review protocols as related to all… more
- Martin's Point Health Care (Portland, ME)
- …preferred + 3 years of medical management experience in a managed care setting including utilization review + RN experience in a clinical setting required + ... 2015. Position Summary The Supervisor is responsible for day-to-day operations of the utilization review team, which includes clinical and non-clinical staff, in… more
- HonorHealth (AZ)
- …of communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors ... Nurse in an acute care setting - Required Licenses and Certifications + Registered Nurse ( RN ) State And/Or Compact State Licensure - Required +… more
- Penn Medicine (Philadelphia, PA)
- …rewarding and ** REMOTE RN ** role! This role will focus primarily on utilization review which is why **we are seeking individuals who have between 3 to ... assignment (Outlook, Canopy, CERME, ECIN, shared drive, Internet) Credentials: + Registered Nurse - PA (Required) + PA RN Licensure required. Education or… more
- Henry Ford Health System (Warren, MI)
- …screening criteria and critical thinking to maximize reimbursement. EDUCATION/EXPERIENCE REQUIRED: + Registered Nurse required. + Minimum 3-5 years of clinical ... Management experience in lieu of bachelor's degree. CERTIFICATIONS/LICENSURES REQUIRED: + Registered Nurse with a valid, unrestricted State of Michigan License.… more
- CVS Health (OH)
- …healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. **Position Summary** The Team Lead plays ... 5+ years of clinical practice experience in medical healthcare. + 3+ years Medical Review or Utilization Management experience. + 2+ years of experience with… more
- Commonwealth Care Alliance (Boston, MA)
- …clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA ... CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is… more
- Cognizant (Carson City, NV)
- …to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with managed ... **Location:** Remote **About the role** As a Registered Nurse you will make an impact...as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral,… more
- Ochsner Health (New Orleans, LA)
- …case management or utilization review . **Certifications** Required - Current registered nurse license in state of practice. Basic Life Support (BLS) from ... and implement discharge plans based on patient's individualized needs. Registered Nurse ( RN ) Case Manager...of the conditions of participation as it relates to utilization review and discharge planning. + Maintains… more
- Veterans Affairs, Veterans Health Administration (Tomah, WI)
- Summary The Registered Nurse - Community Care RN is responsible and accountable for all elements of the nursing process when providing and/or supervising ... Tomah VA in Tomah, WI and is not a remote position. Responsibilities The Registered Nurse...intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation… more
- Bon Secours Mercy Health (Springfield, OH)
- …clinical and operational excellence. **Summary of Primary Function** In the capacity of a Registered Nurse ( RN ), the Ambulatory Care Manager will provide ... of care to ensure medically appropriate cost-effective care. This is primarily a remote /work at home position, but hire should live driving distance from Columbus,… more
- CVS Health (MI)
- …the case management system to organize cases dealing with disease management and utilization review ; tracks patient progress and manages specific conditions. + ... providers. Serves as advocate for patients, ensuring effective communication, resource utilization , and continuous monitoring of their progress to promote positive… more
- Saint Francis Health System (Tulsa, OK)
- …duties via secure virtual link to patient rooms \#RNSIND Job Summary: The Registered Nurse I (Virtual) assesses, plans, implements and evaluates nursing care, ... works from an on-site office location (not a remote position) Will perform admit, discharge chart review...Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License. Work Experience: Minimum 5… more
- CVS Health (LA)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- Saint Francis Health System (Tulsa, OK)
- …from ER, ICU, and CTU units. + All private rooms Job Summary: The Registered Nurse I assesses, plans, implements and evaluates nursing care, utilizing the ... therefrom. Licensure, Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License. Work Experience: 0 - 6 months related… more
- Tufts Medicine (Burlington, MA)
- …coordinates the design, development, implementation, and monitoring of the organization's utilization review functions. The position establishes the department's ... the utilization of resources, coordination of care across the continuum and utilization review and management. The position develops and leads the … more
- Robert Half Accountemps (Boston, MA)
- …seeking RNs to step into impactful non-clinical roles - including chart review , clinical auditing, utilization management, quality assurance, and case ... Description Now Hiring Registered Nurses (RNs) - Ready for a Change...Be the Right Move for You: + Use your RN skills in a fresh environment + Apply your...remote or hybrid) + Must have an active RN license and at least 2 years of clinical… more
- US Tech Solutions (Columbia, SC)
- **Location: Columbia, SC 29203 ( Remote after training)** **Duration: 3+ Months Contract (Possible temp to hire)** **Job Description:** + Must be an RN in SC and ... have an active and unrestricted SC RN license. + Training - Will last up to...six weeks but could be extended. + Skill sets/qualities: Utilization management experience and /or Appeals experience /strong clinical… more
- Humana (Lincoln, NE)
- …an impact** **Use your skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...in an acute care setting + Previous experience in utilization management/ utilization review for a… more
