- Battelle Memorial Institute (Norfolk, VA)
- …within legal and professional parameters + Knowledge and skill in using pre-established utilization review criteria to recognize and report actual or potential ... (HRA) business line is seeking a highly motivated, full-time ** Nurse Case Manager** to join our team in support...quality and risk management issues to improve practice and… more
- Luke Staffing (Glendale, CO)
- **REGISTERED NURSE ** **SITE OF SERVICE:** Department of Veterans Affairs, Eastern Colorado Healthcare System (ECHCS), 4100 E. Mississippi Ave, Glendale, CO 80246 ... consider Part Time and Full Time Applicants** **POSITION OVERVIEW:** The Registered Nurse (RN) will provide on-site professional nursing services to beneficiaries of… more
- Katmai (Fort Carson, CO)
- …with all levels of health care management to include outside agencies. Performs utilization management activities to optimize cost, quality , and access to care. ... those required of any military or government civil service nurse of similar experience and in similar duty assignments....facility staff members to facilitate patient care. + Accurately review and confirm completeness of patient chart and report… more
- ERP International (San Diego, CA)
- **Overview** ERP International is seeking a full-time **Registered Nurse (RN) Health Educator** supporting **Naval Medical Center San Diego, CA ... Facilitate the achievement of optimal outcomes in relation to clinical care, quality and cost effectiveness. - Ensure compliance with standards of care and… more
- Stanford Health Care (Palo Alto, CA)
- …models of case management, including the principles and practices of discharge planning, utilization review , and quality assurance/improvement + Knowledge of ... responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient… more
- Stanford Health Care (Palo Alto, CA)
- …of case management, including the principles and practices of discharge + planning, utilization review , and quality assurance/improvement + Knowledge of the ... responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient… more
- Stanford Health Care (Palo Alto, CA)
- …development of their APPs. The Lead APP also functions under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered Nurse ... ongoing education and training, communication and adherence to safety and quality programs, sustaining compliance with National Patient Safety goals, and licensure… more
- Stanford Health Care (Palo Alto, CA)
- …growth and development of their APPs. Also functions under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered ... clinical competency and adherence to policy through practice analysis and case review of APPs with physicians. + Investigate and respond to patient/family complaints… more
- Stony Brook University (Stony Brook, NY)
- …Department may include the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes UR ... cases for authorization for in patient stay. + Staff review short stay, long stay and complex cases to...patients who were readmitted within thirty days. Documents over utilization of resources and services. + All Medicare cases… more
- Stony Brook University (Stony Brook, NY)
- …student engagement, health and wellness practices, and quality of residential life. Click here (https://www.stonybrook.edu/commcms/studentaffairs/stu/join-us.php) ... as a healthcare provider in the state of New York (eg, physician, nurse practitioner, or registered physician assistant or equivalent). Five (5) years of full… more
- Battelle Memorial Institute (Columbus, OH)
- …ability to resolve non-recurring problems, ensuring efficient program operations and high- quality patient care. **Responsibilities** + Assist with the management and ... + Under the supervision of a licensed psychiatrist, social worker, psychiatric nurse or psychologist, responsible for providing a wide range of behavioral health… more
- George C. Grape Community Hospital (Hamburg, IA)
- Quality / Utilization Review Nurse Position Summary: The Quality / Utilization Review Nurse is responsible for evaluating the medical ... years of clinical nursing experience (acute care preferred). o Prior experience in utilization review , case management, quality improvement, and infection… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW ... information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to...Determines need for and conducts in-service training to improve quality of admission and continued stay reviews, and to… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of ... this position is able to cover a multitude of utilization review functions through point of entry,...the plan of care and services provided are patient-focused, high- quality , efficient, and cost-effective. Serves as a preceptor and… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …needs and may require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for ... evidence-based practice * Quality of Practice*: * Promotes quality through evidence-based utilization review ... issued by the State of Minnesota. **Title:** *Staff Nurse - Utilization Review (ED)*… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW ... and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General...Determines need for and conducts in-service training to improve quality of admission and continued stay reviews, and to… more
- YesCare Corp (Brentwood, TN)
- …best practice. + Facilitate quality health care intervention recommendations. + Review and assess over/under utilization issues. + Track, trend and evaluate ... review . + Track, trend and evaluate appropriateness and quality of care issues with the implementation of education...license + No less than 5 years' experience in utilization management, case management, quality management. +… more
- University of Utah Health (Salt Lake City, UT)
- …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** + ... of InterQual Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of CMS Regulations. **Working… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with ... pace and changing environment- flexibility in assignment. * Proficient in Utilization Review process including benefit interpretation, contract language, medical… more
- Albany Medical Center (Albany, NY)
- …stays, and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and ... environment.* Basic knowledge of computer systems with skills applicable to utilization review process.* Excellent written and verbal communication skills.*… more
