- Aequor (New York, NY)
- …an occupational nursing professional Minimum experience of 1-3 years in case management , utilization review and/or quality assurance Experience in episodic care, ... services to employees within regulated scope of practice and disability case management .Experience/Education: MS/NP in nursing degree and current NP license in New… more
- Dana-Farber Cancer Institute (Boston, MA)
- …of which must be in Nursing.Licensed as a Registered Nurse in the Commonwealth of Massachusetts.Hematology-Oncology experience required. Management experience ... the highest quality patient experience while maximizing provider time and space utilization . The Nurse Director uses extensive theoretical, evidence-based, and… more
- Insight Global (New York, NY)
- Job Description Insight Global is looking for a Pre-Access Utilization Management Registered Nurse to sit remotely with one of their large health ... and send to me with QB - 4-5 years of Remote Utilization Management experience at Payors, inpatient or outpatient - Proficiency using a MacBook… more
- Universal Health Services (Fremont, CA)
- …Come join our team and love what you do! We are currently hiring a per diem Utilization Management Registered Nurse (RN) for Fremont Hospital! The per ... diem Utilization Management RN is responsible for the facilitation of clinically...for continued stay reviews including completion of certifications. The Utilization Management RN will interface with managed… more
- Trinity Health (Hartford, CT)
- …provide that care efficiently to control costs. **What you will do:** + As a ** Utilization Management Registered Nurse RN** you will conduct prospective, ... Connecticut Joint Replacement Institute, and the Smilow Cancer Hospital. **Keywords: Case Management ; Case Manager; Registered Nurse ; RN; BSN; Connecticut**… more
- ERP International (Vandenberg AFB, CA)
- **Overview** ERP International is seeking a full-time ** Registered Nurse (RN) Utilization Management ** in support of the30th Medical Group at Vandenberg ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- AdventHealth (Tampa, FL)
- …Primary Stroke Center. **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse (RN) is to use clinical expertise by ... . Current and valid license to practice as a Registered Nurse (ADN or BSN) required. ....care clinical nursing experience required. . Minimum two years Utilization Management experience, or equivalent professional experience.… 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 ... Assigned:** 1. Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure...projects as needed. _Required:_ + State licensure as a registered nurse (RN) + Bachelor's degree in… more
- University of Washington (Seattle, WA)
- Req #: 228720 Department: HARBORVIEW - UTILIZATION MANAGEMENT Posting Date: 05/03/2024 Closing Info: Open Until Filled Salary: $7375 - $13,396 per month Shift: ... benefits for this position, click here (https://hr.uw.edu/benefits/wp-content/uploads/sites/3/2018/02/benefits-summary-classified-staff-greater-than-half-time-20220908\_a11y.pdf) . RN2, Utilization Management Specialist. This is a hybrid… more
- Glens Falls Hospital (Glens Falls, NY)
- …30 hours per week, can be foundhere. **Job:** **Nursing - Case Management * **Title:** * Registered Nurse - Utilization Review Nurse - Care ... timely and accurate information to payers. The role integrates and coordinates utilization management and denial prevention by focusing on identifying and… more
- Trinity Health (Albany, NY)
- …NY** is looking for an experienced RN to work as a Registered Professional Utilization Management Nurse (UMRN) full time evenings. M-F 8hr shifts The ... **The selected candidate will** : + Be responsible for the utilization management , both concurrent and retroactive for inpatient and outpatient services in… more
- Centene Corporation (Raleigh, NC)
- …degree and 4+ years of related experience. Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse ... to ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks UM resources to ensure adherence… more
- Geisinger (Danville, PA)
- …of 5 years-Health Insurance/Managed Care (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania; Basic ... with decision making and documentation processes. + Works with staff and management team to support recommendations for high risk members to improve transitions… more
- Geisinger (Danville, PA)
- …and efficiency results for assigned population. + Works to appropriately apply benefits and utilization management serving as a resource to the patient or member ... + Required experience: 3 years of RN work experience + Preferred Experience: Utilization Review/ Utilization Management Work from Home Internet requirements:… more
- WellSpan Health (York, PA)
- Utilization Management Nurse (RN) -...administration or management . Preferred Licenses: + Licensed Registered Nurse Upon Hire Required or + ... quality health care. Provides leadership in the integration of utilization management principles throughout the System. Responsible...Registered Nurse Multi State License Upon Hire Required Apply Now… more
- State of Connecticut, Department of Administrative Services (Middletown, CT)
- …View Benefits (http://portal.ct.gov/DAS/smART/General-Employee-Benefits) + + + + Introduction Are you a Registered Nurse looking for an opportunity to make a ... Valley Hospital (CVH (https://portal.ct.gov/DMHAS/CVH/Agency-Files/CVH Home-Page) ) + UNIT: ASSD Utilization Management Unit (Administrative Support Services Division)… more
- Humana (Jackson, MS)
- **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...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) compact licensure with no… 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...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse (RN) - Active, current and… more
- Kepro (Indianapolis, IN)
- …partner for health solutions in the public sector. Acentra is currently looking for a Utilization Management Appeals Nurse - LPN/RN to join our growing team. ... Job Summary: Our Utilization Management Appeals Nurse -...applicable to the position assignment. Required Qualifications/Experience: + Active Registered Nurse (RN) or Licensed Practical … more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …BHPS provides Utilization Management services to its clients. The Utilization Management Nurse - Prior Authorization performs medical necessity ... Oncology, and/or elective surgical cases preferred. Essential Qualifications * Current licensed Registered Nurse (RN) with state licensure. Must retain active… more
