- Providence Little Company of Mary Medical Center - San Pedro (San Pedro, CA)
- …Nursing Profession RN Specialty Case Manager Job ID 33531206 Job Title Registered Nurse - Case Manager @ Providence Little Company of Mary Medical ... 09/08/2025 End Date 12/08/2025 Duration 13 Week(s) Job Description Job Title: Case Manager Profession: Registered Nurse Specialty: Case Management Duration:… more
- HealthCare Support (Houston, TX)
- Utilization Review RN HealthCare Support is actively seeking a Utilization Review RN to fill an opening with a Prestigious HealthCare Company in ... Remote Houston TX . Daily Responsibilities for Utilization Review RN : WIll need...Communicates concerns that arise in these discussions to the Manager and/or Medical Director. 4. Maintains knowledge of the… more
- Appcast (Randallstown, MD)
- …schools. This requirement will be lifted for LBH candidates employed as a Utilization Review Nurse , Clinical Care Coordinator, Patient Care Integrator ... strives to promote patient wellness, improved care outcomes, efficient utilization of health services and minimize denials of payment...or RN Case Manager . Additional Information Who We Are: LifeBridge Health is… more
- Providence Little Company of Mary Medical Center San Pedro-… (San Pedro, CA)
- …assessment, discharge planning, and utilization review skills Description: The RN Case Manager coordinates patient care plans and services across the ... of Mary Medical Center San Pedro- Case Management Job Type Travel Offering Nursing Profession RN Specialty Case Manager Job ID 33531148 Job Title RN -… more
- GIBSON AREA HOSPITAL (Gibson City, IL)
- … RN is a professional practitioner who functions as both a caregiver and care manager . In the caregiver role, the RN assumes responsibility for a group of ... use of self. In the dominant role of care manager , the RN directs and oversees the...individualizes a predefined, goal consistent and continuous manner by utilization of and adherence to pre-determined standards which define… more
- GIBSON AREA HOSPITAL (Gibson City, IL)
- … RN is a professional practitioner who functions as both a caregiver and care manager . In the caregiver role, the RN assumes responsibility for a group of ... time frame implementing the Nursing Process and therapeutic use of self. The RN assesses and monitors patient's health status and physical care needs at admission… more
- GIBSON AREA HOSPITAL (Gibson City, IL)
- … RN is a professional practitioner who functions as both a caregiver and care manager . In the caregiver role, the RN assumes responsibility for a group of ... use of self. In the dominant role of care manager , the RN directs and oversees the...individualizes a predefined, goal consistent and continuous manner by utilization of and adherence to pre-determined standards which define… more
- GIBSON AREA HOSPITAL (Gibson City, IL)
- …RN /LPN is a professional practitioner who functions as both a caregiver and care manager . In the caregiver role, the RN /LPN assumes responsibility for a group ... use of self. In the dominant role of care manager , the RN directs and oversees the...individualizes a predefined, goal consistent and continuous manner by utilization of and adherence to pre-determined standards which define… more
- GIBSON AREA HOSPITAL (Gibson City, IL)
- …or individualizes a predefined, goal consistent and continuous manner by utilization of and adherence to pre-determined standards which define the structure, ... and unit levels through use of data resources and compliance peer review monitoring. Demonstrates willingness and ability to effectively coordinate patient care/unit… more
- PharmaCord (Jeffersonville, IN)
- …clearly and articulately Have a positive attitude! Education & Experience: Licensed Registered Nurse 2-3 years nursing with experience in rare disease, ... to our Talent Acquisition team immediately at ###@pharmacord.com The Nurse Program Manager plays a pivotal role...is required Bachelor's degree required; Master's degree is preferred Nurse line triage, Call Center Utilization Management,… more
- GIBSON AREA HOSPITAL (Gibson City, IL)
- … RN is a professional practitioner who functions as both a caregiver and care manager . In the caregiver role, the RN assumes responsibility for a group of ... use of self. In the dominant role of care manager , the RN directs and oversees the...in a knowledgeable, skillful, consistent and continuous manner by utilization of/adherence to pre-determined standards which define the structure,… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional Care Team.This is a full-time role and will be required to work ... ) required or completed within three years of hire **Title:** * Utilization Review Manager * **Location:** *MN-Minneapolis-Downtown Campus* **Requisition… more
- State of Indiana (Indianapolis, IN)
- …role of Utilization Management Manager oversees the integration of utilization review , clinically appropriate care and risk management for the purpose of ... Utilization Management Manager Date Posted: Sep...and clinical criteria evaluations.They will possess a current unrestricted RN license from the State of Indiana; a minimum… more
- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day ... review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has...accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy + Works… more
- Commonwealth Care Alliance (Boston, MA)
- … Management is responsible for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for ... Knowledge, Skills & Abilities (must have): * Expertise in managing utilization review processes including prior authorization, concurrent and retrospective… more
- Humana (Augusta, ME)
- …areas. **Use your skills to make an impact** **Required Qualifications** + An active, unrestricted Registered Nurse ( RN ) license in the state of Michigan. + ... caring community and help us put health first** The Manager , Utilization Management Nursing (LTSS Utilization...Previous experience in utilization management and/or utilization review .… more
- Catholic Health Services (Melville, NY)
- …why Catholic Health was named Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and ... additional clinical documentation. + Acts as liaison between the Utilization and Appeals Management Department and the physician of...care to MCC in response to physician order, or review of updated clinical information + Acts as a… more
- Beth Israel Lahey Health (Plymouth, MA)
- …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who ... **Join Our Team of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff… more
- Northeast Alabama Regional Medical Center (Anniston, AL)
- …years of clinical experience required. Leadership experience preferred. CM or Utilization Review experience preferred. Extensive knowledge and understanding of ... stay reviews to assure hospitalizations meet payor requirements. Maintains records of review information and outcomes for billing purposes and for compliance with… more
- Prime Healthcare (Ontario, CA)
- …of nursing and a current state Registered Nurse license. + Minimum 3 years RN Utilization Manager working for a Health Plan. + At least 3 years of ... https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Connect With Us! (https://careers-primehealthcare.icims.com/jobs/222731/ utilization - review - rn… more
