- A-Line Staffing Solutions (Harrisburg, PA)
- A-Line Staffing is now hiring a Nurse Auditor Hybrid / Remote in Harrisburg PA . If you are interested in this Nurse Auditor Hybrid / Remote position, ... please contact Marcia Hamilton at ### or ###@alinestaffing.com Nurse Auditor Hybrid / Remote Compensation The...health setting drug and alcohol setting managed care quality management / utilization review or other related clinical experience… more
- A-Line Staffing Solutions (Cleveland, OH)
- Remote RN Case Manager openings with a major...BSN, Medical Management , Utilization Review, Utilization Management , Registered Nurse , MCO, ... Starting ASAP!! Apply now with Jake Z. at A-Line! Remote Position, but the candidate needs to be from...BSN, Medical Management , Utilization Review, Utilization Management , Registered Nurse , MCO,… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …members as needed to ensure services will be covered.Coordinate and communicate with Utilization Review Nurse on a daily, consistent basis to ensure patients ... Job Category:Nursing - Registered Nurse Work Shift/Schedule:8 Hr Morning - AfternoonNortheast Georgia...patient needs; Works collaborate with the Physicians, patient/family, nursing, utilization review and other members of the healthcare team… more
- Monogram Health Professional Services (Yuma, AZ)
- …powered by a suite of technology-enabled clinical services, including case and disease management , utilization management and review, and medication therapy ... Position Title: Nurse PractitionerMonogram Health is looking for skilled ...practiceThis position will not be office-based but will be remote in state in which employed and will need… more
- Yakima Valley Farm Workers Clinic (Cowiche, WA)
- …This position is not eligible for bilingual differential pay. Knowledge of utilization management , quality improvement, discharge planning, and cost ... required education. Experience: Five years experience in care coordination, case/care management , utilization /resource management , quality management ,… more
- A-Line Staffing Solutions (Harrisburg, PA)
- …care, acute care, behavioral health, drug and alcohol, managed care, quality management / utilization review, or home care experience required . Proficient writing ... 8 weeks - will require hybrid schedule - 1-2 day in office and 3-4 days remote 8 hours per day required Hybrid Research RN Compensation The pay for this position is… more
- ProgenyHealth (Elk Grove Village, IL)
- ProgenyHealth is a leading provider of care management solutions for premature and medically complex newborns. Our program promotes appropriate utilization , ... attaining quality outcomes for the members. The clinical care nurse serves as a nurse reviewer for...events throughout the year + Role specific - full remote work week ProgenyHealth positively recruits people from diverse… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** 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 ensuring CCA meets CMS compliance standards in… more
- CVS Health (Raleigh, NC)
- …care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any state. ... the dedicated team supporting the membership of plan sponsor. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate,… more
- CVS Health (Columbus, OH)
- …convenient and affordable. Position Summary: This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any ... state. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate all aspects of the … more
- CVS Health (Harrisburg, PA)
- …convenient and affordable. Position Summary: This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any ... state. There is no travel expected with this position. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document… more
- CVS Health (Harrisburg, PA)
- …convenient and affordable. Position Summary: This Utilization Management (UM) Nurse Consultant role is 100% remote and the candidate can live in ... Pennsylvania. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate all aspects of the … more
- CVS Health (Columbus, OH)
- …care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any ... internal and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications + 3+ years of… 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
- Intermountain Health (Murray, UT)
- …to members and providers in accordance with notification standards. Implements utilization management processes and coordinate medical services with other ... intervention. Perform all required documentation and entry into utilization management operating system for authorization and...Department: Healthy Connections Medicare - Select Health + **Other: Remote work,** **needs to be able to come into… more
- R1 RCM (Detroit, MI)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Utilization Review Nurse ** , you will help our hospital ... you must have experience in a clinical inpatient environment and hospital-based utilization or case management experience. Proficiency in basic computer skills… more
- CVS Health (Albany, NY)
- …deliver solutions to make health care more personal, convenient and affordable. 100% remote positionHours: Monday through Friday, 8am -5pm in time zone of residence ... services and/or programs + Identifies opportunities to promote benefit utilization + Typical office working environment with productivity and...+ 3+ years of acute experience as a Registered Nurse + Must have active current and unrestricted RN… more
- CVS Health (Sandy, UT)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable ... internal and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications - 3+ years of… more
- Dartmouth Health (Lebanon, NH)
- Overview 40 hours per week - Fully Remote Position The Utilization Review RN facilitates transitions of care and bed availability through review of patient ... training program is available, howeverknowledge of UR and Care Management is preferred. Works with physicians and multidisciplinary team...These are just a few highlights of being a nurse at Dartmouth Hitchcock Medical Center and Clinics in… more
- Commonwealth Care Alliance (Boston, MA)
- …management and leadership with the development, refinement and enhancement of utilization management workflows, policies and procedures. + Participate in ... reports to the UM Manager. The Team Leader provides management ,oversight and mentorship to team members and ensures that...review, workflow review and other relevant business related to utilization review process. + Works in collaboration with the… more
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