- Ascension (Wichita, KS)
- …health care services regarding admissions, case management, discharge planning and utilization review . Review admissions and service requests within ... Required professional licensure at time of hire. Additional Preferences Prior experience in case management or utilization review strongly preferred. Why… more
- Novo Nordisk Inc. (San Francisco, CA)
- …include key opinion leaders (KOL's), academic institutions, physicians, nurse practitioners, diabetes educators, pharmacists, blood bank staff, organized ... providers and IHNs Develops appropriate use of NNI products and greater utilization of its services Supports and assists representatives and managers in answering… more
- Fort Duncan Regional Medical Center (Eagle Pass, TX)
- …department budget, staffing, and training needs. Function as Utilization Review /Denials Manager as required. Qualifications Registered Nurse (RN) with a ... (CCM, ACM, CCM-RN) preferred. Proven leadership experience in acute care, utilization review , case management. Strong working knowledge of hospital billing,… more
- Medical Solutions (Omaha, NE)
- …Charlotte, FL is seeking its next amazing RN (Registered Nurse ) to work in Case Management ( Utilization Review ). Read on if this sounds like your perfect ... fit! Nurses and allied healthcare professionals are in high demand nationwide, and our team of industry-leading, traveler-favorite recruiters can get you where you want to go - personally and professionally. Wherever you may roam, travel healthcare helps you… more
- NORTH EAST MEDICAL SERVICES (Burlingame, CA)
- …guides them in accurately completing their work. Provides cross coverage for MSO Nurse Case Managers and performs transition of care services, including ... $128752.00 - $165048.00 Salary Description SUMMARY OF POSITION: The Utilization Management (UM) Nurse is a licensed...for the inpatient UM process, including initial and concurrent case reviews, review of inpatient skilled nursing… more
- Cottage Health (Goleta, CA)
- Job Description Cottage Health seeks a Utilization Review Manager, Registered Nurse for their Clinical Denials and Appeals department responsible for the ... Years of Related Work Experience: Minimum: 3 years of experience working with utilization review or case management in an acute care facility or health… more
- EvergreenHealth (Kirkland, WA)
- …provides intervention to facilitate patient care in an optimal timeline. Oversees utilization review process including education, support, and training of team ... arrange for equipment, and arrange for additional services in the community. Utilization Management/ Case Management Nurses provide clinical information to our… more
- Zenex Partners (Santa Rosa, CA)
- Description Job Opportunity: Registered Nurse - Utilization Review Facility: Providence Santa Rosa Memorial Hospital - Case Management Location: Santa ... Rosa, CA Employment Type: Travel/Contract Shift: Day (5x8 Hours) 8:00 16:30 Start Date: 3/3/2025 Job Duration: 13 weeks Compensation: Rate Type: Hourly Over Time: 8 regular hours in a day OR 40 regular hours in 1 week: 1.3% Double Time: None On-Call: 15$ Call… more
- UHS (Temecula, CA)
- …The Southwest Healthcare Regional office in Temecula, CA is seeking a Full-Time RN Central Utilization Review Nurse who will be responsible for carrying out ... ensure correct payer source for hospitalization and communication. Ensures compliance of utilization review practices as required by payers, external regulatory… more
- Riverside Health System (Hampton, VA)
- …and Care Management team members based upon a thorough medical record review and knowledge of federal and evidence-based guidelines, including CMS Conditions of ... Communicates effectively and professionally regarding modality. Provides education regarding utilization management to patients, families, and other members of the… more
- WNS Global Services (Houston, TX)
- …(2) years of clinical experience and/or in an administrative role *Experience in utilization review , case management, or clinical quality improvement, ... or an alternative application process by emailing ###@healthhelp.com Job Description *Performs utilization review of cases to determine if the request meets… more
- HCA Healthcare (Kansas City, MO)
- …individual patient needs. What you will do in this role: Responsible for utilization review , discharge planning and care coordination with the patient, patient's ... apart from any other healthcare provider. We are seeking a(an) Registered Nurse RN Case Manager to join our healthcare family. Benefits Research Medical Center,… more
- East Los Angeles Doctors Hospital (Los Angeles, CA)
- …Under the general supervision of the CM Director the nurse case manager (RV/LVN) manages clinical resource utilization and documentation affecting ... documentation that affects reimbursement. In this position the RN case manager provides for a planned and systematic process...Qualifications/Experience: At least two (2) years' experience as a nurse in an acute care hospital. At least six… more
- Regal Medical Group, Inc. (San Bernardino, CA)
- …for new and existing staff. Acts as a resource for clinical staff for case review and discharge planning. Develops, monitors, and analyzes reports and identifies ... hospitalizations with inpatient staff for level of care and discharge planning, including review of face sheets and assuming a nurse leadership role with… more
- PACS (Oceanside, CA)
- …needs in area(s) of responsibility. Complete documentation as required. Performs utilization review activities to provide resident appropriate, timely and ... promote cooperation and collaboration between individuals including residents/families/caretakers, physicians, nurse and other ancillary partners. Must have excellent time… more
- Tenet Health (Delray Beach, FL)
- …knowledge and experience with case management care coordination, and/or utilization review Track record and comfort in collaborating with physicians ... and prevent avoidable readmissions. This position integrates national standards for case management scope of services including: Utilization Management… more
- MediTelecare (Winchester, VA)
- …and psychopharmacology including writing orders for medications, as appropriate Participate in case reviews, consultations and utilization review Respond to ... healthcare services to underserved communities as a Psychiatric Mental Health Nurse Practitioner (PMHNP) with MediTelecare, the nation's largest telehealth company!… more
- Advocate Aurora Health (Milwaukee, WI)
- …Hou rs Per Week: 40 Schedule Details/Additional Information: M-F 08-1630 RN Case Manager No weekend commitment Holiday and on call rotation required. ... family contacts will be at the discretion of the Case Manager and his/her assessment of need, but will...agency, accreditation, state and federal requirements. Responsible for continuous review of all aspects of every patient of her/his… more
- Arnot Health (Elmira, NY)
- …related to the management of patient care. The Case Manager will review all patients for utilization management and appropriate discharge planning. The ... self and other case managers. f. The Case Manager tracks and trends LOS, resource utilization...nursing program with a current license as a registered nurse . BSN or Case Management Certification preferred.… more
- MedPro Healthcare Staffing (Bel Air, MD)
- … Nurse , Agency Nurse , Travel Contract, Travel Nursing, Case Manager, Case Management, Utilization Review , Case Manager RN *Weekly payment ... Staffing , a Joint Commission-certified staffing agency, is seeking a quality Case Manager Registered Nurse (RN) for a travel assignment with one of our top… more
