- 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
- Children's Hospital Los Angeles (Los Angeles, CA)
- …years nursing experience with advanced level pediatric clinical experience and utilization management and/or discharge planning experience. Thorough knowledge of ... **It's Work That Matters.** **Overview** **Purpose Statement/Position Summary:** The Nurse Care Manager performs complex discharge planning for patients...managed care, utilization management , discharges planning, and continuous quality… more
- ERP International (Camp Pendleton, CA)
- **Overview** ERP International, LLC is seeking a **Licensed Vocational / Practical Nurse ** for a full-time position supporting the **Branch Health Clinics** at ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- Moses/Weitzman Health System (Meriden, CT)
- …licensure as appropriate. Fully established practice standards for productivity and appropriate utilization of care. Position is designed to support evening and or ... meeting client's health care needs. Participates with Community Health Center management in developing and achieving optimal clinical performance and organizational… more
- Commonwealth Care Alliance (Boston, MA)
- …(must have): - Meaningful clinical experience including: - 3+ years' experience as a Registered Nurse in a high-touch clinical environment or home care, OR - 2+ ... the people we serve and help keep them at home , by providing best-in-class disability competent primary care. -...Manager will collaborate closely with other members of the management team. This role is full-time on site in… more
- Humana (Little Rock, AR)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...appropriate courses of action. As a Utilization Management RN working on the OneHome/ Home Solutions… more
- Humana (St. Paul, MN)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...at a time that is best for your schedule. **Work-At- Home / Internet Information:** To ensure Home … more
- AdventHealth (Tampa, FL)
- …such as heart failure, cancer and other diseases. **The role you'll contribute:** The Utilization Management nurse uses clinical expertise to review patient ... gynecology, internal medicine and transitional year. AdventHealth Tampa is home to the renowned AdventHealth Pepin Heart Institute, a...nursing in an acute care setting - preferred + Utilization Management or Care Management … more
- CVS Health (Columbus, OH)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + UMNC meets set productivity and ... extended periods, talking on the telephone and typing on the computer. + Work from home position:During work hours, Colleagues who are working from home must be… more
- CenterWell (Austin, TX)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous...Current nursing experience in Hospital, SNF, LTAC, DME or Home Health. + Bilingual We offer tangible and intangible… more
- Access Dubuque (Dubuque, IA)
- …Butler/ SISCO Utilization Management Assistant Cottingham & Butler/ SISCO Utilization Management Nurse Cottingham & Butler/ SISCO Condition ... Utilization Management CNA **Cottingham & Butler/...will also triage the call to determine if a Utilization Review Nurse is needed to complete… more
- Humana (Lincoln, NE)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Truman Medical Centers (Kansas City, MO)
- …into myWORKDAY (http://www.myworkday.com/trumed/d/ home .htmld) to search for positions and apply.** Utilization Management RN Team Leader - Care Continuity - ... 4:30PM **Hours Per Week** 40 **Job Description** **Team Lead, Utilization & Case Management ** Join a mission-driven...Master's degree + 3+ years of experience in healthcare nurse case management + Proven track record… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... net required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II...but not limited to: Skilled nursing facility, outpatient needs ( home health, physical therapy, infusion), and case management… more
- AmeriHealth Caritas (Washington, DC)
- **$5,000.00 SIGN ON BONUS** **Role Overview** Our Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient services, ensuring ... in the least restrictive and most effective manner. The Utilization Management Reviewer must maintain a strong...3 years of diverse clinical experience as a Registered Nurse in an Intensive Care Unit (ICU), Emergency Department… more
- Sanford Health (Sioux Falls, SD)
- …Conduct level of care medical necessity reviews within patient's medical records. Performs utilization management (UM) activities in accordance with UM plan to ... utilization and potentially, prior authorization. Assists the department in monitoring the utilization of resources, risk management and quality of care for… more
- Children's Mercy Kansas City (Kansas City, MO)
- …of, and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including patient ... To provide leadership to integrated inpatient teams; assists Director in the management of department; including personnel and fiscal management and development… more
- Sanford Health (Fargo, ND)
- …** **Job Summary** Provides expertise and leadership to ensure effective resource management for patient care delivery across the care continuum for assigned patient ... patient wellness through evidenced based practice, improved care outcomes, efficient utilization of health services, and appropriate level of care for patients… more
- Providence (Olympia, WA)
- …a strong clinical background blended with well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. ... + Bachelor's Degree Or Associate's Degree in Nursing + 3 years of Utilization Review, Care Management , Quality Management , and/or Discharge planning… more
Related Job Searches:
Home,
Management,
Nurse,
Nurse Home,
Utilization,
Utilization Management,
Utilization Management Nurse