- Geisinger (Scranton, PA)
- Job Title: RN - Registered Nurse ...Top 8 Most Innovative Healthcare Systems in Becker's Hospital Review , we're working to create a national model for ... Location: Scranton, Pennsylvania Job Category: RN - Registered Nurse , Nursing and Nursing Support Schedule:...avoid third party payer denials. Maintains awareness of all concurrent denials through interaction with payer liaison. Works with… more
- Bluestone Child & Adolescent Psychiatric Hospital (University Heights, OH)
- Utilization Review Registered Nurse - FT...tracking as needed. Perform all duties of the Psychiatric Nurse ( RN ) role as needed or when ... and entering all treatment orders and medications. Complete initial, concurrent , and retrospective reviews of patient care in a...for Health and Dependent Care JOB SUMMARY: The Utilization Review (UR) Registered Nurse independently… more
- Providence Little Company of Mary Medical Center - San Pedro (San Pedro, CA)
- …Offering Nursing Profession RN Specialty Case Manager Job ID 33531206 Job Title Registered Nurse - Case Manager @ Providence Little Company of Mary Medical ... Date 12/08/2025 Duration 13 Week(s) Job Description Job Title: Case Manager Profession: Registered Nurse Specialty: Case Management Duration: 13 weeks Shift: Day… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …do:** + Performs medical necessity review that includes inpatient review , concurrent review , benefits advisory/prior authorization, retrospective, out ... or four (4) years' work experience **(Required)** + Current State Licensure as a registered nurse where licensing is required by State law **(Required)** + Three… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …do:** + Performs medical necessity review that includes inpatient review , concurrent review , benefit advisory/prior authorization, retrospective, out ... or four (4) years' work experience (REQUIRED) + Current State Licensure as a registered nurse (REQUIRED) + Three (3) years of clinical experience (REQUIRED) +… more
- Alameda Health System (San Leandro, CA)
- … at a medical group or health plan. Required Licenses/Certifications: Active licensure as a Registered Nurse in the State of California, Active BLS - Basic Life ... Nurse , Care Management + San Leandro, CA +...review functions, including response to payor requests for concurrent and retrospective review information including Medicare… more
- Memorial Sloan-Kettering Cancer Center (New York, NY)
- …+ Assess discharge planning needs at the patient's admission + Perform regular concurrent review on all patients and coordinate all needed services including ... appeals and acquire authorizations for treatment **Key Qualifications:** + Current NYS Registered Nurse License/Registration and BSN preferred + At least 2-3… more
- Stanford Health Care (Palo Alto, CA)
- …affect the processes and outcomes of patient health care **Licenses and Certifications** + Nursing\ RN - Registered Nurse - State Licensure And/Or Compact ... include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient charts for timeliness… more
- MVP Health Care (Schenectady, NY)
- …New York Qualifications you'll bring: Current New York State Licensure as a Registered Nurse required. Certification in Case Management required within 24 months ... with the Medical Director to ensure appropriate outcomes. Service Authorization & Review : Conduct prospective, concurrent , and retrospective reviews to determine… more
- Commonwealth Care Alliance (Boston, MA)
- …for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for conducting centralized clinical ... reviews). - Hire, train and mentor UM staff, including nurse reviewers and support personnel. - Act as liaison...& Abilities (must have): - Expertise in managing utilization review processes including prior authorization, concurrent and… more
- Centene Corporation (New York, NY)
- …**License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required + RN - Registered Nurse - State Licensure preferred Pay Range: ... needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member… more
- Avera (Sioux Falls, SD)
- …cause undue hardship to the employer. **Required Education, License/Certification, or Work Experience:** + Registered Nurse ( RN ) - Board of Nursing An active ... Utilizes third party clinical guidelines for level of care reviews (first level review ), and refers cases to the internal or external physician advisor for… more
- HCA Healthcare (Richmond, VA)
- …set us apart from any other healthcare provider. We are seeking a(an) Case Manager Registered Nurse RN PRN to join our healthcare family. **Benefits** ... for patient care. Apply today for our Case Manager Registered Nurse RN PRN opportunity....function in this role is to Performs admission and concurrent review for all payers and maintains… more
- Tenet Healthcare (Detroit, MI)
- Registered Nurse ( RN ) - Case Manager - 2506003285 Description : Join our dedicated healthcare team where compassion meets innovation! As a Registered ... and is determined by employment status Job Description: The RN Case Manager is responsible to facilitate care along...management experience preferred. 3. License to practice as a Registered Nurse in the State of Michigan.… more
- Trinity Health (Ann Arbor, MI)
- …weeks from 8 am to 5 pm Monday through Friday. **WHAT YOU WILL DO** + The RN Registered Nurse Case manager is responsible for conducting a focused assessment ... economic/financial and discharge planning needs. + One would also review , on a concurrent basis, the appropriateness,...and clinical risk issues and documentation completeness. + The RN Registered Nurse Case Manager… more
- Geisinger (Scranton, PA)
- …theft protection, universal life and pet and legal insurance Position Details The Registered Nurse Care Manager works with physician and multidisciplinary team ... Experience Minimum of 3 years-Nursing (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE… more
- Geisinger (Danville, PA)
- …Experience Minimum of 3 years-Nursing (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE ... rewarding, lasting career with impact. Job Duties The Trauma RN Case Manger is responsible for ensuring optimal quality,...Trauma Registry. + Maintains trauma roster and updates on concurrent basis. + Summarizes concurrent daily chart… more
- Geisinger (Lewistown, PA)
- …and Control and successful Joint Commission and DOH surveys. At least 2 years of Registered Nurse work experience in a hospital setting is required. BSN is ... Experience Minimum of 2 years-Nursing (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE… more
- Geisinger (Danville, PA)
- …Experience Minimum of 3 years-Nursing (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE ... program uses highly trained staff members to perform a concurrent inpatient review of the record. This...for overall System Case Mix Index. Job Duties The RN CDI Specialist acts as a liaison between the… more
- Prime Healthcare (Inglewood, CA)
- …severity of illness. Qualifications EDUCATION, EXPERIENCE, TRAINING 1. A current California State Registered Nurse ( RN ) license is required. 2. Five years ... 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/231153/ registered - nurse %2c- rn… more
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