- Mass General Brigham (Salem, MA)
- …preferred Can this role accept experience in lieu of a degree? No Licenses and Credentials Registered Nurse [ RN - State License] - Generic - HR Only required ... Dingley, ###@mgb.org to learn more. Job Summary Summary The Registered Nurse manages all aspects of the...treatment, teaching and discharge planning activities. -Consults the Clinical Nurse Specialist and Health Care Coordinator for… more
- NORTH EAST MEDICAL SERVICES (Burlingame, CA)
- …CA Salary Range $128752.00 - $165048.00 Salary Description SUMMARY OF POSITION: The Utilization Management (UM) Nurse is a licensed nursing professional ... other job duties as required by manager/supervisor. QUALIFICATIONS: Active California Registered Nurse license. Current documentation of Basic Life Support… more
- Lifepoint Health (Louisburg, NC)
- Description Registered Nurse ( RN ) Utilization Review...the lives of those we serve. Connect with our RN recruiting specialist . Do you need more ... as an employee but as a person. As a registered nurse ( RN ) joining our...the responsibilities involved in monitoring adherence to the hospital's utilization review plan, which ensures the appropriate use of… more
- ICON Medical Network (Charlottesville, VA)
- …hour in Charlottesville, Virginia Clinical Magnet (Part of ICON Medical) is seeking a Registered Nurse ( RN ) to join our partner's team in Charlottesville, ... or on-call) *Work-life balance and autonomy in a supportive home-based care model Keywords: registered nurse , RN , in-home care, home health, skilled nursing,… more
- UnitedHealthcare (Indianapolis, IN)
- …Must Possess One of the Following Current, unrestricted independent licensure as a Registered Nurse in Indiana Masters Degree in Social Work Bachelors Degree ... Join us to start Caring. Connecting. Growing together. As part of a care management team who will manage complex members, the Care Coordinator will be the primary… more
- UHS (Corona, CA)
- …Minimum of 5+ years strongly preferred. Certifications/Licenses: Current license as a Registered Nurse in the State of California required. Current ... . Job Summary: Southwest Healthcare is seeking a Full-Time Remote RN Clinical Documentation Integrity Specialist . Duties include but not… more
- Parkview Health (Fort Wayne, IN)
- …group. Participates in quality improvement and evaluation processes related to the management of care. Provides mentoring with staff in understanding and working in ... systems to obtain precertification and recertification for payment and utilization review. Attends treatment planning to advise regarding reimbursement issues.… more
- Guidehealth (Philadelphia, PA)
- …comfortable and confident leading a team of certified but unlicensed personnel and Registered Nurse case managers Ability to read, analyze, and interpret the ... any concerns. Identifying and disseminating of Health Plan announcements applicable to Case Management Qualifications WHAT YOU'LL NEED TO HAVE RN /BSN required 5… more
- Cedars Sinai (Los Angeles, CA)
- …of acute nursing experience required 3 years of previous experience in case management , discharge planning, utilization review, and HMO in the acute inpatient ... Case Manager will assist in the daily operations of the inpatient case management department. Primary responsibility is to provide oversight of the daily functions… more
- Lifepoint Health (Las Cruces, NM)
- …familiarity with case management issues, discharge planning and utilization management . Licensure/Certification: NM Social Work license or Provisional ... lives of those we serve. Connect with our recruiting specialist Not ready to complete an application, or have...and supervision of a current Licensed Social Worker or Registered Nurse for up to 6 months.… more
- Regency Integrated Health Services (Cuero, TX)
- …Care eligibility and benefit period through regular communications with Regional Care Management Specialist , Business Office and external Case Managers. Gathers ... in accordance with CMS Correction Policy and collaboration with Regional Care Management Specialist . Conducts regular audit of MDS process including validation… more
- Generis Tek, Inc. (Panama City, FL)
- …or BCLS Instructor must be obtained within 30 days of employment start date Registered Nurse , or Advance Nurse Practitioner Additional Information: Director ... this amazing opportunity, reach out to our Talent Acquisition Specialist Raj Patil at email address ###@generistek.com can be...###. We have Contract role for Director of Med-Surg RN f or our client Panama City, FL .… more
- East Tennessee State University (Johnson City, TN)
- …Required Qualifications Associate degree in nursing or health-related field ( Registered Nurse , Respiratory Therapist, Physical Therapy Assistant, Emergency ... and personnel to support simulation/lab activities; and maintaining accurate utilization records for all simulation/lab spaces, equipment, and personnel including… more
- University of Michigan Health-West (Wyoming, MI)
- …American Association of Radiology Technology or Surgical Technology preferred. Registered Cardiovascular Invasive Specialist (RCIS) certification preferred. BLS ... technical factors on an individual patient basis and monitors utilization of proper radiation protection for all staff in...of care and charging. Interacts as team member with management , Cardiologists and RN staff to assure… more
- Banner Health (Phoenix, AZ)
- …provider entities. Areas of responsibility could include but are not limited to: Utilization management : Leading teams and partnering with Senior leaders to ... ensure appropriate levels of health care utilization are met for our wholly owned and delegated...(CPP); Chartered Property Casualty Underwriter (CPCU); Associate in Risk Management (ARM); CPA; SPHR; Registered Health Information… more
- Cleveland Clinic (Cleveland, OH)
- …career with one of the most respected healthcare organizations in the world. As a Utilization Management Specialist , you will perform UM activities, such as ... a minimum of 85% on IRR quarterly. + Complete Utilization Management for assigned patients with a...School of Nursing + Current state licensure as a Registered Nurse ( RN ) + Basic… more
- Alameda Health System (Oakland, CA)
- System Utilization Management SUM Specialist + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Care ... 18, 2025 **Summary** **SUMMARY:** The System Utilization Management (SUM) Care Without Delay RN is...IRR) Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California… 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 ... 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,… more
- UnityPoint Health (Cedar Rapids, IA)
- …optimal clinical outcomes and patient and provider satisfaction. The RN UM Specialist provides the Utilization Management function for patients admitted ... + Shift: 8 + Job ID: 168048 Overview The Utilization Management Specialist in the...degree in a health care related field or an RN + Two years of behavioral health work experience.… more
- Sanford Health (Bemidji, MN)
- …minimum of five years of clinical practice. Knowledge and experience in case management , utilization management and/or Coding highly preferred. Currently ... written/verbal communication, critical thinking, creative problem solving, and conflict management skills. Must be proficient in organization and planning....holds an unencumbered RN license with the State Board of Nursing where… more
