- Molina Healthcare (Boston, MA)
- …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... JOB DESCRIPTION Job Summary The Care Review Clinician, IP Provides support...with a MA RN licensure. Candidates with UM Medical Review background and experience using… more
- UCLA Health (Los Angeles, CA)
- …clinical documentation related to prior authorization requests for medical services. The UM Review Nurse applies clinical judgment, regulatory standards, ... Description At UCLA Health, the Utilization Management ( UM ) Review Nurse plays...vital role in ensuring the delivery of high-quality, evidence-based care . This position is responsible for reviewing and evaluating… more
- MVP Health Care (Tarrytown, NY)
- …thinking and continuous improvement. To achieve this, we're looking for a **Professional, Sub-Acute RN UM Reviewer - Medicare** to join #TeamMVP. If you have a ... you'll bring:** + Current and unrestricted NY & VT RN licensure + Associate or bachelor's degree in nursing...providers, facilities, and interdisciplinary teams to ensure optimal patient care and resource utilization. + Document review … more
- Commonwealth Care Alliance (Boston, MA)
- …Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management ( UM ) Reviewer is responsible for day-to-day ... timely clinical and service authorization review for medical necessity and decision-making. The ...applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance… more
- AdventHealth (Daytona Beach, FL)
- …PKWY, Daytona Beach, 32117 **The role you'll contribute:** The role of the Utilization Management ( UM ) Registered Nurse ( RN ) is to use clinical expertise ... legitimacy of hospital admission, treatment, and appropriate level of care . The UM RN leverages...+ Current and valid license to practice as a Registered Nurse (ADN or BSN) required. +… more
- University of Michigan (Ann Arbor, MI)
- …**Job Detail** **Job Opening ID** 268863 **Working Title** REGISTERED NURSE (Mott Childrens Hospital-10W, Pediatric Cardio Thoracic Intensive Care Unit) **Job ... REGISTERED NURSE (Mott Childrens Hospital-10W, Pediatric Cardio...to deliver the safest and highest quality of health care . Applicants are expected to review the… more
- University of Michigan (Ann Arbor, MI)
- REGISTERED NURSE : Ambulatory Care ...to meet billing requirements. + Cross cover for other RN diabetes educators. + Participate as a member of ... employment opportunity employer. **Job Detail** **Job Opening ID** 269100 **Working Title** REGISTERED NURSE : Ambulatory Care Services (Domino Farms Diabetes… more
- Magellan Health Services (Boise, ID)
- …- Care MgmtCare Mgmt, PC - Professional Counselor - Care MgmtCare Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care ... development and on-going management of designated staff. + Performs care management review activities consistent with Magellan...required: BCBA, LCSW, LMFT, LMSW, LPCC, LPC, PC or RN . If RN , BSN preferred but ASN… more
- Ivyhill Technologies LLC (Bethesda, MD)
- …referral management services for beneficiaries in the Defense Health Network. Registered Nurse will have overall responsibility for timely review of Right of ... First Refusal (ROFR) requests, review of Specialty Care Referrals, sustaining up-to-date Specialty Clinic Referral Review...RM Team. Requirements Qualified candidate must be a Licensed Registered Nurse ( RN ), with an… more
- University of Michigan (Ann Arbor, MI)
- REGISTERED NURSE (Cardiovascular Center- CVC 5,...to deliver the safest and highest quality of health care . Applicants are expected to review the ... opportunity employer. **Job Detail** **Job Opening ID** 269110 **Working Title** REGISTERED NURSE (Cardiovascular Center- CVC 5, Adult Intermediate… more
- University of Michigan (Ann Arbor, MI)
- REGISTERED NURSE : University Hospital ( PACU ) Apply Now **Mission Statement** Michigan Medicine improves the health of patients, populations and communities ... review charts for H&P, consent, etc.). Provide direct care for Pre-op patients. **Nursing Specific Info** Salary &...employer. **Job Detail** **Job Opening ID** 269128 **Working Title** REGISTERED NURSE : University Hospital ( PACU )… more
- Health Care Service Corporation (Chicago, IL)
- …This position can include weekend rotation and holiday rotation. **JOB REQUIREMENTS:** + Registered Nurse ( RN ) with current, valid, unrestricted license to ... professional development. This position is responsible for performing concurrent review activities in accordance with approved departmental guidelines; discharge… more
- ERP International (Barksdale AFB, LA)
- **Overview** ERP International is seeking a **Utilization Management Registered Nurse ( RN )** for a full-time position supporting the 2d Medical Group, ... review will be required.Reviews previous and present medical care practices as needed for patterns, trends, orincidents of...Utilization Management is required. Full time employment as a registered nurse within the last 36 months… more
- University of Miami (Miami, FL)
- … this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Advanced Practice Registered Nurse Human Genetics Full Time ... The Advanced Practice Registered Nurse (H) (APRN) d elivers medical care ...needed + Evaluates and diagnoses new patients referred to UM /JMH Genetics + Provides long-term follow-up to diagnosed patients… more
- US Tech Solutions (Wichita, KS)
- …and implementation of QM Work Plan Activities **Experience:** + 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior ... CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . +... Review ? + Do you have an Active Registered Nurse License? **About US Tech Solutions:**… more
- University of Miami (Miami, FL)
- …. CORE JOB SUMMARY The Registered Nurse 2 delivers patient-family centered care in ... of quality, safety, and service while ensuring population-specific patient care . The Registered Nurse 2...necessary. Serves as mentor and role model Compliance with UM , Hospital and department policies and procedures Other duties… more
- CVS Health (OK)
- …: + Unrestricted OK state independent Behavioral Health clinicianlicense or a Registered Nurse ( RN ) with psychiatric specialty,certification, or Behavioral ... resulting in independent Behavioral Health licensure (LCSW, LPCC, LMFT, LPAT, LP) or a Registered Nurse ( RN ) with unrestricted state license with psychiatric… more
- University of Miami (Miami, FL)
- …please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Registered Nurse works as a part of a ... team to provide quality care to designated patients. The RN works...are not limited to: Performance Nursing Duties as per Nurse Job Description 100% Perform patient interview and obtains… more
- Lawrence General Hospital (Methuen, MA)
- Job Description: The RN Care Coordinator is responsible for overseeing the appropriateness of care provided to members of health plans contracted by the ... appropriate financial and clinical outcomes of these patients. The RN Care Coordinator will be assigned to...acute care setting with discharge planning, continuing care , care management, and utilization review… more
- University of Miami (Miami, FL)
- …not require direct physician involvement as per physician orders and within the scope of RN licensure 7. Renders dire ct patient care by assisting providers with ... 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) . Sign on Bonus:… more