- Universal Health Services (Colorado Springs, CO)
- …an accredited college or university with a current Colorado RN license. Experience in utilization review , managed care , or determining appropriateness ... position is responsible for providing initial, ongoing, and systematic utilization review on all patients assigned by...with work hours to accommodate work volumes. Knowledge of utilization management and managed care … more
- CVS Health (Columbus, OH)
- …IT platforms/systemPreferred Qualifications - Knowledge of Medicare/Medicaid - Utilization Review experience preferred - Managed care experience - ... purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our...in state of residence - Must have previous inpatient utilization review experience - Must be able… more
- Catholic Health (Lockport, NY)
- …+ Two years medical surgical nursing and/or job related experience + Preferred prior insurance / managed care / utilization review experience in the role of ... and Holiday Rotation Hours: 8:00a-4:00p, 9:00a-5:00p, 10:00a-6:00p, 11:00a-7:00p Summary: The RN Care Manager, Utilization Review / Transitions of Care… more
- CVS Health (Raleigh, NC)
- …(PowerPoint, Word, Excel, Outlook) Preferred Qualifications - 1+ years' experience Utilization Review experience - 1+ years' experience Managed Care - ... ability to innovate and deliver solutions to make health care more personal, convenient and affordable. This Utilization... care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote… more
- CVS Health (Columbus, OH)
- …1 holiday per year). Preferred Qualifications: - 1+ years' experience Utilization Review experience - 1+ years' experience Managed Care - Strong ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- CVS Health (Harrisburg, PA)
- …- Holiday rotation required Preferred Qualifications: - 1+ years' experience Utilization Review experience - 1+ years' experience Managed Care - Strong ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- CVS Health (Harrisburg, PA)
- …(PowerPoint, Word, Excel, Outlook) Preferred Qualifications: - 1+ years' experience Utilization Review experience - 1+ years' experience Managed Care - ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- Lancaster General Health (Lancaster, PA)
- …Board of Nursing. + Bachelor's degree in Nursing (BSN). + Knowledge of utilization review or managed care . + Care management experience in a ... care across the continuum (inpatient/outpatient/community) to assure appropriate utilization of clinical and community resources. + Oversees and guides the… more
- CVS Health (Frankfort, KY)
- …outside of the standard schedule based on business needs Preferred Qualifications: + Managed care / utilization review experience preferred + Experience ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- Trinity Health (Farmington Hills, MI)
- …years of nursing experience, to include two (2) years of utilization review /case management, managed care or comparable patient payment processing ... rejection, denial and appeal activities with Ministry Organization (MO) based Utilization Review /Case Management departments; + Reviews and understands … more
- Kelsey-Seybold Clinic (Pearland, TX)
- …2 years in area of specialization, 2 years of Case Management/ Utilization Review experience **Other** Required: Managed Care knowledge Preferred: N/A ... and various internal departments **Job Title: Case Manager Concurrent Review ** **Location: Pearland Administrative Office** **Department:** **KCA Utilization … more
- St. Luke's University Health Network (Lehighton, PA)
- …health/crisis intervention experience required. Previous experience with case management/ utilization review and managed care models preferred. Please ... mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care… more
- St. Luke's University Health Network (Phillipsburg, NJ)
- …health/crisis intervention experience required. Previous experience with case management/ utilization review and managed care models preferred. WORK ... mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care… more
- CVS Health (Salt Lake City, UT)
- …setting such as ambulatory care or outpatient program- Managed care and utilization review experience preferred.- Crisis intervention skills ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- Trinity Health (Farmington Hills, MI)
- …office staff, Patient Access, Medical Records/Health Information Management, Utilization Review /Case Management, Managed Care , Ancillary and Nursing ... Medicaid, Social Security Disability, Champus, Supplemental Security Income Disability, etc.), managed care contracts and coordination of benefits is required.… more
- Martin's Point Health Care (Portland, ME)
- …years clinical nursing experience + Utilization management experience in a managed care or hospital environment required + Certification in managed ... has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of a team responsible for ensuring… more
- Providence (Napa, CA)
- … management experience in the acute, sub-acute, home health setting or managed care environment. **Preferred qualifications:** + Bachelor's Degree in Nursing. ... . The RN Case Manager assists patients in the utilization of appropriate health care services. Position...time **Job Shift:** Day **Career Track:** Nursing **Department:** 7810 UTILIZATION REVIEW **Address:** CA Napa 1000 Trancas… more
- CDPHP (Albany, NY)
- …of two (2) years quality/ utilization review experience in an HMO, managed care organization, or similar experience as a hospital inpatient coder or ... and clinical management/cost containment issues preferred. + Demonstrated ability to review health care delivery against established criteria. + Demonstrated… more
- Billings Clinic (Billings, MT)
- …to starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Utilization Review RN CARE ... Rule, or payer authorization for status and level of care *Priority 2: Performs Utilization Review...At hire * Current working knowledge of payer and managed care reimbursement preferred. * Working knowledge… more
- Ventura County (Ventura, CA)
- Per Diem Registered Nurse III - Hospital Case Management/ Utilization Review Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4396275) Apply ... Per Diem Registered Nurse III - Hospital Case Management/ Utilization Review Salary $119,061.54 - $151,803.47 Annually...Centers for Medicare & Medicaid Services (CMS), Department of Managed Health Care (DMHC), National Committee for… more