- Veterans Health Administration (Houston, TX)
- Summary The Registered Nurse Quality & Patient Safety Nurse Manager - Utilization Management functions as a clinical expert and is responsible and ... qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. Preferred Experience: 1-3 years Utilization Management , Nurse Case Manager/Caseworker,… more
- AmeriHealth Caritas Health Plan (Philadelphia, PA)
- …judgment, and meaningful collaboration. Lead with Clinical Insight. Whether you're an experienced utilization review nurse , a sharp case manager, or a ... services. Discover more about us at www.amerihealthcaritas.com. Join a mission-driven Utilization Management team where your clinical expertise helps shape… more
- Medical Solutions (Omaha, NE)
- Ready to Plant Roots? This Permanent Case Management ( Utilization Review )/RN (Registered Nurse ) Position in White Plains, NY Has Your Name on It! A ... top-tier facility is looking for a dedicated Case Management ( Utilization Review )/RN (Registered Nurse ) to join their team. If you've been craving the… more
- Central Maine Healthcare (Lewiston, ME)
- …for each other every day. Position Summary: The Utilization Management Nurse is responsible for a comprehensive clinical review to assess for medical ... RN licensure. *Three (3) or more years of previous experience in Utilization Management and/or Care Management . *BSN preferred *Certified Case manager… more
- Medical Solutions (Omaha, NE)
- …Ana, CA is seeking its next amazing RN (Registered Nurse ) to work in Case Management ( Utilization Review ). Read on if this sounds like your perfect fit! ... Nurses and allied healthcare professionals are in high demand nationwide, and our team of industry-leading, traveler-favorite recruiters can get you where you want to go - personally and professionally. Wherever you may roam, travel healthcare helps you hone… more
- Valley Health System (Paramus, NJ)
- …Minimum 5 years experience in clinical nursing, minimum of 3 years in case management / utilization . SPECIAL SKILLS: Registered Nurse , Licensed in State of ... POSITION SUMMARY: Performs concurrent utilization review activities on all patients...Commercial payors guidelines. Monitors and intervenes on LOS, resource utilization and denial management / prevention within the… more
- VNA of the Treasure Coast (Vero Beach, FL)
- …quality of care, utilization , documentation and outcome and process management through associate interaction, education and timely review of electronic ... discounts The VNA is seeking a part time Quality Reviewer . This position supports the efforts of VNATC Home...and completeness on a ongoing basis Collaborate with QAPI nurse and home health educator regarding review … more
- Berkshire Hathaway Homestate Companies (Omaha, NE)
- …in our Omaha, Nebraska office for Utilization Review Nurses. The Utilization Review Nurse ensures all aspects of an injured worker's treatment ... This is a full-time, permanent position within our Medical Management team and that will allow experienced nurses to...attorneys. Act as a medical resource in regards to utilization review to Claims Support Nurse… more
- EvergreenHealth (Kirkland, WA)
- …arrange for equipment, and arrange for additional services in the community. Utilization Management /Case Management Nurses provide clinical information to ... provides intervention to facilitate patient care in an optimal timeline. Oversees utilization review process including education, support, and training of team… more
- Riverside County, CA (Moreno Valley, CA)
- …Riverside - Riverside University Health System-Medical Center is seeking an Assistant Director of Case Management and Utilization Review to join our UR Case ... in nursing is preferred. Experience: Three years of charge nurse or supervisory experience working as a registered ...an accredited acute care hospital. Professional experience in case management and utilization review in… more
- Lifepoint Health (Louisburg, NC)
- Description Registered Nurse (RN) Utilization Review Job Type: Full Time | Day Your experience matters At Maria Parham Hospital, we are driven by a profound ... an employee but as a person. As a registered nurse (RN) joining our team, you're embracing a vital...the responsibilities involved in monitoring adherence to the hospital's utilization review plan, which ensures the appropriate… more
- Kaiser Permanente (Santa Cruz, CA)
- Description: Eligible for Sign on bonus! Job Summary: Conducts utilization review for in-house patients and/or those members at contracted facilities. Assists in ... the discharge planning process. Essential Responsibilities: Conducts utilization review for in-house patients and/or members who have been admitted to contracted… more
- Kaiser Permanente (Ontario, CA)
- …utilize/apply the general and specialized principles, practices, techniques and methods of Utilization review / management , discharge planning or case ... the interdisciplinary approach to providing continuity of care, including Utilization management , Transfer coordination, Discharge planning, and obtaining… more
- Franciscan Missionaries of Our Lady Health System (Baton Rouge, LA)
- Job Description Under broad direction from the Centralized Utilization Management Manager, is responsible for the hospital-wide Utilization Management ... retrospective case review and reporting quality issues identified during the utilization review process to department leaders. b. Notifies physicians of need… more
- Progeny HR Solutions LLC (El Paso, TX)
- …calls with patients and/or families as needed You will complete accurate and timely utilization review of patient charts to insure appropriate utilization of ... About the job REGISTERED NURSE MANAGER - CASE MANAGEMENT (RN MGR - NCM) JOB RESPONSIBILITIES- Registered Nurse Manager - Case Management RN MGR - NCM… more
- Geisinger (Wilkes Barre, PA)
- Job Title: RN - Graduate Registered Nurse (Geisinger Wyoming Valley, Wilkes-Barre) Location: Wilkes-Barre, Pennsylvania Job Category: Inpatient RN - Registered ... Nurse , Nursing and Nursing Support Schedule: Rotation Work Type:...Support Schedule: Rotation Work Type: Full time Department: Talent Management Nursing & Nursing Support Team Date Posted: 04/29/2025… more
- Veterans Health Administration (Phoenix, AZ)
- …promotion, health education and coaching on wellness, disease prevention, and chronic care management . The nurse will assist in directing the provision of ... responsibility for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care. Administers… more
- Kaiser Permanente (Olympia, WA)
- …team members. Preferred Qualifications: Minimum two (2) years of RN experience in utilization review , ambulatory case management , care coordination or ... management . Education Bachelors degree License, Certification, Registration Registered Nurse License (Washington) required at hire OR Compact License: Registered… more
- University of Southern California (Los Angeles, CA)
- The Assistant Nurse Manager, in collaboration with and under the direction of the Department Nurse Manager, is accountable for ongoing leadership and operations ... of the assigned area(s) and for nursing care safety and quality. The Assistant Nurse Manager uses sound human resource and budget principles to guide the daily… more
- Hackensack Meridian Health (Eatontown, NJ)
- …and Abilities Required : Associate's Degree in Nursing. Familiarity with Utilization Management Criteria, PQRS, HEDIS, Meaningful Use, Patient-Centered Medical ... serve as a leader of positive change. The Registered Nurse , RN Community Based Care Management provides...and cost of patient care. Facilitate ongoing patient communications, review gaps in care and relevant outcome measures. HOMECARE… more
Related Job Searches:
Management,
Nurse,
Nurse Management,
Nurse Reviewer,
Reviewer,
Utilization,
Utilization Management,
Utilization Management Nurse,
Utilization Nurse