- RestoraCare Staffing (Houston, TX)
- RestoraCare Staffing is seeking a Registered Nurse ( RN ) Case Management for a nursing job in Houston, Texas.Job Description & RequirementsSpecialty: Case ... of Social Work program. Licenses/Certifications: Current and valid license to practice as a Registered Nurse in the state of Texas or Current and valid license… more
- Integrated Resources, Inc (New York, NY)
- …the MetroPlusHealth members. . Coordinate with Utilization Management (UM) department on concurrent and retrospective review . . Follow up with assigned nurses ... Job Title: RN - Care Manager Location: New York, NY, 10004...Using the assessments and interview done by the Assessment Nurse , the Care Manager identifies the risk factors, strengths,… more
- Dignity Health (Rancho Cordova, CA)
- …- Clear and current CA RN license. **Preferred Qualifications:** - Concurrent review prior authorizations for medical determination. - Bachelors degree ... is responsible for monitoring Dignity Health Medical Foundation inpatient admissions and concurrent review for appropriate level of care and medical necessity… more
- InnovaCare (San Juan, PR)
- …customer focus to the business. MMM Holdings, Inc.Job Description Inpatient Unit POSITION: Concurrent Review Nurse (CRN) POSITION DESCRIPTION Manages the ... within forty-eight (48) hours of having performed the first concurrent review of notified admission cases.4. On...* Bachelor's Degree in Science of Nursing. * Current RN permanent license in Puerto Rico and Collegiate. *… more
- Centene Corporation (Salem, OR)
- …**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
- Kelsey-Seybold Clinic (Houston, TX)
- **Responsibilities** The Concurrent Review Case Manager is responsible for telephonic monitoring and the documentation of medical treatment and comparing it to ... criteria to determine if treatment meets established guidelines. In addition, the Concurrent Review Case Manager monitors patients progress toward recovery for… more
- University of Miami (Miami, FL)
- … review for services requiring prior authorization as well as timely concurrent review for continuation of care services + Follows the authorization ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The University of… more
- BayCare Health System (Cotton Plant, AR)
- …Critical Care or Emergency Nursing RN . **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred ACM (Case Management) + Preferred ... parties to ensure appropriate level of care through comprehensive concurrent review for medical necessity of outpatient...2 years in Case Management + Preferred 3 years Registered Nurse in Critical Care or Emergency… more
- Trinity Health (Maywood, IL)
- …and communication skills are necessary. + CPR (Cardiopulmonary Resuscitation) + Current Registered Nurse License State of Illinois + Specialty certification in ... **Employment Type:** Full time **Shift:** Day Shift **Description:** Utilization Review - RN Reviewer- Regional Coverage for Loyola, Gottlieb and MacNeal… more
- Molina Healthcare (Long Beach, CA)
- …NURSE ** **For this position we are seeking a ( RN ) Registered Nurse with previous experience in Acute Care, Concurrent Review / Utilization ... **JOB TITLE: CARE REVIEW CLINICIAN INPATIENT REVIEW : ...care/medical experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
- Robert Half Office Team (Los Angeles, CA)
- Description We are seeking a UM Review Nurse to ensure the quality and cost-efficiency of medical care by applying clinical knowledge and implementing policies ... referrals that meet specific criteria as a Utilization Management Nurse Specialist RN * Ensure timely and...inpatient setting admissions actively * Conduct telephic and/or on-site review for admission and concurrent review… more
- Robert Half Office Team (Monterey Park, CA)
- …any inpatient setting * May performs telephonic and/or on-site admission and concurrent review , and collaborates with onsite staff, physicians, providers, ... Description The Utilization Management Nurse Specialist LVN promotes the quality and cost...Director and Medical Director on case reviews for pre-service, concurrent , post-service, retrospective claims medical review , and… more
- Prime Healthcare (Lynwood, CA)
- …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum 5… more
- Martin's Point Health Care (Portland, ME)
- …has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of the Utilization Review Team and ... clinical review prior to payment. The Utilization Review Nurse will use appropriate governmental policies...also review prior authorization requests (prior authorization, concurrent review , and retrospective review )… more
- HCA Healthcare (Las Vegas, NV)
- …We want your knowledge and expertise! **Job Summary and Qualifications** The Registered Nurse Case Manager will be responsible for promoting patient-centered ... School of Nursing program + Current licensure as a Registered Nurse in the state of Nevada...compiled by hospital medical records for the purpose of admission/ concurrent review for Medicare and self-pay patients… more
- Centene Corporation (Salem, OR)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... medical appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine… more
- Glens Falls Hospital (Glens Falls, NY)
- …care, utilization management, or payer experience preferred. *Licenses, Certifications, Registrations:* * Registered Nurse ( RN ) in New York State *Skills ... least 30 hours per week, can be foundhere. **Job:** **Nursing - Case Management* **Title:** * Registered Nurse - Utilization Review Nurse - Care… more
- Ellis Medicine (Schenectady, NY)
- …on first working day post admission with communication to insurance as needed. Does concurrent review on criteria and nursing judgment. Make all contact with ... the anticipation, identification, and resolution of issues through pre-admission, admission, concurrent and post discharge medical record review 3. Services… more
- Prime Healthcare (Bloomington, IN)
- …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... an accredited school of nursing and a current state Registered Nurse license. + Grandfathered prior to...Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred. + Five years acute care… more
- Billings Clinic (Billings, MT)
- …Under the direction of department leadership, the Utilization Review / Management RN . This position is to conduct initial, concurrent , retrospective chart ... to starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Utilization Review RN CARE MANAGEMENT (Billings Clinic Main… more
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