- UNC Health (Chapel Hill, NC)
- UNC Health is seeking a Registered Nurse ( RN ) Care Manager for a nursing job in Chapel Hill, North Carolina.Job Description & RequirementsSpecialty: Care ... as appropriate. As necessary meet with the Utilization Manager ( UM ) and SW after the meeting to discuss updates...of employment date.Licensure/Certification Requirements:* Licensed to practice as a Registered Nurse in the state of North… more
- Integrated Resources, Inc (New York, NY)
- Job Title: RN - Care Manager Location: New York, NY, 10004 - Hybrid Initial Duration: 3 months with possible extension Shift Time: 9am to 5pm any 5 days in a week.- ... various providers. Using the assessments and interview done by the Assessment Nurse , the Care Manager identifies the risk factors, strengths, challenges, and service… more
- The University of Vermont Health Network (Colchester, VT)
- …well as those of various managed care insurance plans.MINIMUM REQUIREMENTSState of Vermont Registered Nurse ( RN ) license required. The University of Vermont ... POSITION SUMMARYThe Utilization Review Nurse is responsible for ensuring the medical necessity...Participation regarding Utilization Management with annual review of the UM Plan and assisting with the coordination of the… more
- CVS Health (Columbus, OH)
- …in the US Work hours: 8:30am-5:00pm EST, Monday-Friday. This position is for a UM nurse consultant who will be joining our reconsideration team. A ... demonstrated ability to make thorough, independent decisions using clinical judgement. + A Registered Nurse that must hold an unrestricted license in their state… more
- YesCare Corp (Brentwood, TN)
- …internet, medical records and other proprietary company/client systems. + Certificates and Licenses: Registered Nurse ( RN ) active license + Language Ability: ... development, implementation, evaluation and reporting. + Work with other UM inpatient and outpatient nurse reviewers to...Work with other UM inpatient and outpatient nurse reviewers to assure proper treatment in the appropriate… more
- CVS Health (Salem, OR)
- …years demonstrated ability to make thorough, independent decisions using clinical judgement. A Registered Nurse that must hold an unrestricted license in their ... will occasionally be required.Required Qualifications 1 year of varied UM (utilization management) experience within an inpatient/outpatient setting, concurrent… more
- CVS Health (Harrisburg, PA)
- …skills, both verbal and written Required Qualifications + 3+ years of experience as a Registered Nurse + 3+ years of clinical experience required + Must have ... active current and unrestricted RN licensure in state of residence + Must possess 1+ years of clinical experience in acute or post-acute setting + Must be available… more
- CVS Health (Montgomery, AL)
- …management function. Required Qualifications3+ years of acute care clinical experience as RN RN with current unrestricted state licensure in state of ... high volume clinical call center environment Remote work experience Education Associate degree RN required, BSN preferred Pay Range The typical pay range for this… more
- Molina Healthcare (Bronx, NY)
- …based on the severity of illness and the site of service. **We are seeking a Registered Nurse with UM and Inpatient Review experience. The Care Review ... acute care/medical experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. Must… more
- Bassett Healthcare (Cooperstown, NY)
- …Best-In-State Employer 2022! What you'll do The Emergency Department Registered Nurse Clinical Case Manager (Unit C3 RN ) will facilitate transitional care ... utilization of services and financial goals. The Emergency Department Registered Nurse Clinical Case Manager oversees the...status and level of care matches order. Collaborates with UM Nurse to assure that all payor… more
- CVS Health (Columbus, OH)
- …management function. Required Qualifications + 3+ years of experience as a Registered Nurse + Must hold active and unrestricted RN licensure in state of ... pm EST. Holiday rotation 1-2 per year. Position Summary CCR - Duals UM Nurse Consultant Utilizes clinical experience and skills in a collaborative process to… more
- CVS Health (Raleigh, NC)
- …1 holiday per year). There is no travel expected with this position. This UM Nurse Consultant position is part of Aetna's Commercial Care Management division ... turn-around times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not...Required Qualifications - Must have active current and unrestricted RN licensure in state of residence - 2+ years… more
- CVS Health (Plantation, FL)
- …highly preferred + Compact RN License or license in multiple states + UM Nurse Consultant experience + Experience with overseas access to care + Working ... EST No nights, no weekends, and no holidays. The UM Nurse Consultant job duties include (not...diverse cultural dynamics of clinical staff and patients. Education Registered Nurse : Diploma, Associates degree in Nursing… more
- CVS Health (Raleigh, NC)
- …state regulated turn-around times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all encompassing): -Reviews ... to make health care more personal, convenient and affordable. This Utilization Management ( UM ) Nurse Consultant role is fully remote and employee can live… more
- CVS Health (Harrisburg, PA)
- …and state regulated turn-around times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all encompassing): - ... personal, convenient and affordable. Position Summary: This Utilization Management ( UM ) Nurse Consultant role is fully remote...Required Qualifications: - Must have active, current and unrestricted RN licensure in state of residence - 3+ years… more
- CVS Health (Harrisburg, PA)
- …and state regulated turn-around times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all encompassing): - ... health care more personal, convenient and affordable. Position Summary: This Utilization Management ( UM ) Nurse Consultant role is 100% remote and the candidate… more
- CVS Health (Columbus, OH)
- …to make health care more personal, convenient and affordable. Position Summary Duals UM Nurse Consultant Pennsylvania - Institutional Special Needs Plan (PA ... utilization/benefit management function. Required Qualifications - 3+ years of experience as an RN - 1+ years of inpatient hospital, med/surge experience - Must have… more
- CVS Health (Columbus, OH)
- …and motivated team environment and is detail oriented and highly organized. The UM Nurse Consultant reviews services to assure medical necessity, applies ... employee can live in any state. As a Utilization Nurse Consultant you will utilize clinical skills to coordinate,...member.Required Qualifications- Must have an active, current and unrestricted RN licensure in state of residence - Minimum of… more
- Molina Healthcare (Bronx, NY)
- …on the severity of illness and the site of service. **We are seeking a Registered Nurse with previous UM and** **inpatient experience along with knowledge ... leadership skills. **Required License, Certification, Association** + Active, unrestricted State Registered Nursing ( RN ) in good standing. + Must have… more
- AdventHealth (Daytona Beach, FL)
- …Daytona Beach, FL 32117 **The role you'll contribute:** The role of the Utilization Management ( UM ) Registered Nurse ( RN ) is to use clinical expertise ... hospital admission, treatment, and appropriate level of care. The UM RN leverages the algorithmic logic of...qualifications** : o Associate and 3 years experience o Registered Nurse o Current and valid license… more
