- Adecco US, Inc. (Dallas, TX)
- **Join Our Team as a Utilization Management Nurse !** **Experience Required:** + Five years inpatient clinical nursing experience in an acute care ... hospital setting + Minimum of two years Utilization Management acute care setting experience + Minimum of one year drafting and submitting reconsiderations and… more
- Adecco US, Inc. (Dallas, TX)
- …a team player is a must! The Utilization Management Nurse will provide precertification of inpatient hospitalizations and all outpatient procedures and ... courses of outpatient. The nurse will use clinical judgement, utilization management , application of product benefits, understanding of regulatory… more
- ERP International (Tinker AFB, OK)
- …and Tasks: Duties may include but are not limited to** : Provides Utilization Management activities and functions by using MTF-specific Quality Improvement ... **Overview** ERP International, LLC is seeking a **Registered Nurse - Utilization Managment** for a...and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case… more
- Veterans Affairs, Veterans Health Administration (Columbia, MO)
- … nurse staffing coordinator for Patient Flow (Admission Advisor/Bed Manager), Inpatient RN Case Managers ( Utilization Management ), Infection Prevention, ... Patient Care Services. On an ad hoc basis, the Nurse Manager serves as the acting Quality Management...conducting reviews and inputting data Performing Utilization Management reviews utilizing InterQual(R) Functioning as an inpatient… more
- Albany Medical Center (Albany, NY)
- …proactively with the Quality Improvement Teams, patient care standards, Social Work, and utilization management to coordinate the appropriate use of resources to ... service. Acute care nursing experience preferred. 4. Recent experience in case management , utilization management and/or discharge planning/home care in… more
- Indian Health Service (Red Lake, MN)
- Summary This position is a Supervisory Nurse ( Inpatient ) located at the PHS Hospital Facility in Red Lake, MN. The Clinic and Emergency Room provide ambulatory ... and qualities improved plans, methods, procedures, documentation, and follow-up with maximum utilization of staff and resources. Maintains current inpatient care… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist 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 Nurse Specialist RN...of referral determination. Actively monitors for admissions in any inpatient setting. Performs telephonic and/or on site admission and… more
- WellSpan Health (Mount Gretna, PA)
- Care Nurse Coordinator RN - Child Adolescent Inpatient - Days / Evenings Location: WellSpan Philhaven, Mount Gretna, PA Schedule: PRN/Per Diem Sign-On Bonus ... Performs a variety of duties to facilitate quality clinical care within the Inpatient Child/Adolescent and Adult Psychiatric Units. Supports bedside staff in day to… more
- McLaren Health Care (Detroit, MI)
- **Department: Utilization Management ** **Daily Work Times: 7:00am-3:30pm** **Shift: Days** **Scheduled Bi-Weekly Hours: 40** **Position Summary:** Responsible ... as Assigned:** 1. Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure that appropriate… more
- Humana (Columbus, OH)
- **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 (Carson City, NV)
- **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
- CVS Health (Columbus, OH)
- …current and unrestricted RN licensure in state of residence - Must have previous inpatient utilization review experience - Must be able to work Monday through ... internal and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications - 3+ years of… more
- CVS Health (Columbus, OH)
- …and deliver solutions to make health care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote ... + Managed care experience + UM Certification + MedCompass + 1+ year(s) of inpatient utilization experience Education + Minimum of an Associate's Degree in… more
- The Mount Sinai Health System (New York, NY)
- **Job Title: Nurse Practitioner- Inpatient Oncology - FT - Nights** A nurse practitioner (NP) as described in Title VIII, Article 139 section 6910 of the New ... clinical nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and prescribe for… more
- Martin's Point Health Care (Portland, ME)
- … required; BSN preferred. + 3+ (total) years clinical nursing experience + Utilization management experience in a managed care or hospital environment required ... "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member...medical outcomes for those enrollees with a need for inpatient / outpatient authorizations. This position receives and reviews prior… more
- Lancaster General Health (Lancaster, PA)
- …maintaining quality patient care. + Coordinates care across the continuum ( inpatient /outpatient/community) to assure appropriate utilization of clinical and ... Medicine Lancaster General Health is recruiting for a full-time inpatient Case Manager to join a team of dedicated...+ Bachelor's degree in Nursing (BSN). + Knowledge of utilization review or managed care. + Care management… more
- Albany Medical Center (Albany, NY)
- …Review Nurse Salary Range: $31.28 - $51.61 per hour Responsible for Utilization Management , Quality Screening and Delay Management for assigned patients. ... Qualifications and Ideal Characteristics + Registered nurse with a New York State current license. +...in an assigned service. + Recent experience in case management , utilization management and/or discharge… more
- Sharp HealthCare (La Mesa, CA)
- …Day **FTE** 1 **Shift Start Time** **Shift End Time** California Registered Nurse (RN) - CA Board of Registered Nursing; DEA Controlled Substance Registration ... of Justice; Driver's License - CA Department of Motor Vehicles; California Nurse Practitioner Furnishing Number - CA Board of Registered Nursing; AHA Basic… more
- Beth Israel Lahey Health (Burlington, MA)
- …Functions and Responsibilities:** Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure that ... payer certification, and denied cases. Monitors effectiveness/outcomes of the utilization management program, identifying and applying appropriate metrics,… more
- Milford Regional Medical Center (Milford, MA)
- … is responsible for utilization management at MRMC. The UR nurse performs reviews of current inpatient services and determines medical appropriateness of ... experience Minimum of 1 year Nurse Case Management experience Minimum of 1 year Utilization Review Nurse Experience including solid working knowledge… more