- Commonwealth Care Alliance (Boston, MA)
- … Mgmt - Directs, coordinates and evaluates efficiency and productivity of utilization management functions for physical health services and long term ... a high quality team.collaboration with the broader clinical organization. - Ensures that utilization management processes are integrated with care management … more
- Commonwealth Care Alliance (Boston, MA)
- …Management is responsible for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for ... & Utilization Mgmt Position Summary: Commonwealth Care Alliance's (CCA) Utilization Management (Authorization) Unit is primarily responsible for the… more
- Commonwealth Care Alliance (Boston, MA)
- …**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 Nurse Utilization Management Reviewer has a key role in… more
- BroadPath Healthcare Solutions (Tucson, AZ)
- **Overview** BroadPath is seeking a highly motivated and results-oriented ** Utilization Management (UM) Nurse ** . Our ideal **UM Nurse ** will ensure ... policy, regulatory, and Health Plan guidelines. + Apply case management skills to members who have been identified as...Perform other duties as assigned. **Qualifications** + Current, active RN license in the state of California (CA) +… more
- ERP International (Vandenberg AFB, CA)
- **Overview** ERP International is seeking a full-time ** Registered Nurse ( RN ) Utilization Management ** for a temporary contract position in support ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- ERP International (Macdill AFB, FL)
- **Overview** ERP International is seeking a ** Registered ** ** Nurse ( RN )** for a Full-Time position in ** Utilization Management ** at MacDill AFB, FL. ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …rewarding. **It's Work That Matters.** **Overview** **Purpose Statement/Position Summary:** The Utilization Nurse is responsible for utilization review ... - 3+ years nursing experience (pediatric experience preferred) - Utilization management and/or discharge planning experience preferred...- BSN or higher degree in nursing preferred. - Registered Nurse licensure in the State of… more
- CHRISTUS Health (Arp, TX)
- DescriptionSummary: The Registered Nurse Patient Navigator Lead is a Registered Nurse or licensed Nurse Practitioner who provides health and wellness ... and other providers. Incumbent oversees integrated data warehouse including program utilization , disease management programs and contracted provider network… more
- Stony Brook University (Stony Brook, NY)
- …the following but are not limited to:** + Responsible for addressing Utilization management , denials and appeal, discharge and transition planning activities, ... Management leadership and staff functions regarding care management and utilization management activities....Qualifications:** * Possession of license to practice as a registered nurse in New York State. *… more
- ERP International (Nellis AFB, NV)
- **Overview** ERP International is seeking a full-time ** Registered Nurse ( RN ) Disease Manager** in support of theMike O'Callaghan Military Medical Center ... managed care principles, military and civilian population healthcare, case management , utilization management , and demand...are required: Minimum of five years of experience as registered nurse with at least 12 months… more
- CHRISTUS Health (San Antonio, TX)
- …for assigned areas; at CHRISTUS St. Patrick Hospital. The nurse manager affects departmental outcomes through interpretation, implementation, and evaluation ... excellence in patient care, patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically… more
- ERP International (Yuma, AZ)
- …(CRRN),(COHN), (ACCC), (CRC), ( RN -NCM),(CMC) **OR** Possess a Master's Degree in Nurse Case Management from a program accredited by the American Nurses ... **Overview** ERP International, LLC is seeking a ** Registered Nurse - Case Manager** for...and databases for community resources. - Integrate CM and utilization management (UM) and integrating nursing case… more
- Alameda Health System (San Leandro, CA)
- … Management provides Care Coordination, Compliance, Transition Coordination, and Utilization Management . **DUTIES & ESSENTIAL JOB FUNCTIONS** NOTE:The ... background. Within the last 3 years, experience in Case Management in an acute setting or utilization ...or health plan. Required Licenses/Certifications: Active licensure as a Registered Nurse in the State of California,… more
- ERP International (Tinker AFB, OK)
- **Overview** ERP International, LLC is seeking a ** Registered Nurse - Case Manager** for a full-time position supporting **SHG Clinic** in support of **Tinker ... and databases for community resources. - Integrate CM and utilization management (UM) and integrating nursing case...or pending adverse actions) to practice nursing as a registered nurse in any US state/jurisdiction. Security**… more
- Luke Staffing (Yigo, GU)
- …of clinical nursing experience is required. One year of previous experience in Utilization Management is required. Full time employment in a nursing field ... of this position, it must be directly related to referral/ utilization management . + **Licensure:** Current, full, active,...and unrestricted license to practice as a Practical OR Registered Nurse in any one of the… more
- Katmai (Fort Carson, CO)
- …all levels of health care management to include outside agencies. Performs utilization management activities to optimize cost, quality, and access to care. ... **Job Requirements:** **MINIMUM QUALIFICATIONS** + Associates Degree of Nursing. Registered nurse shall be a graduate from...+ Shall possess a current, active, full and unrestricted Registered Nurses ( RN ) licensed in Colorado or… more
- Commonwealth Care Alliance (Boston, MA)
- …Work collaboratively with internal departments-including Clinical Operations, Contracting, Network Management , Utilization Management , and Business ... & Language (nice to have):** + Familiarity with care management and utilization management systems...applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance is an… more
- Tidelands Health (Georgetown, SC)
- …and help people live better lives through better health!** **Position Summary:** The Registered Nurse Apprentice (RNA) provides age specific direct patient care ... the Nursing Process and under the supervision of the Registered Nurse . The RNA demonstrates skill in...patients, families and co-workers. The RNA utilizes the case management process to best utilize clinical resources and services… more
- Luke Staffing (Glendale, CO)
- …- Friday, 7:30 AM - 5:30 PM (excluding federal holidays) **POSITION OVERVIEW:** The Registered Nurse ( RN ) will provide on-site professional nursing services ... ** REGISTERED NURSE ** **SITE OF SERVICE:** Department...of Veterans Affairs' Eastern Colorado Healthcare System (ECHCS). The RN will serve in the Office of Community Care… more
- Highland Hospital (Rochester, NY)
- … RN Care Manager's central role integrates and coordinates access and utilization management , proactive patient management , care facilitation and ... **17006BR** **Title:** RN OB Case Manager **Department/Cost Center:** 628 -...nursing experience preferred. Progressive clinical experience; community health, care management , and/or disease management is preferred. Experience… more
