- Cognizant (Concord, NH)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Humana (Concord, NH)
- **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 ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state)… more
- Humana (Concord, NH)
- **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 ... 7pm EST approximately 3-4 Thursday and Friday's annually. The Utilization Management Nurse 2 uses clinical...Qualifications** + Minimum of an Associate's degree + Licensed Registered Nurse (RN) with no disciplinary action… more
- CVS Health (Concord, NH)
- …both verbal and written **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must have active ... all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedules...will include weekends, holidays, and evening hours. * Utilizes clinical experience and skills in a collaborative process to… more
- CVS Health (Concord, NH)
- …good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult inpatient… more
- Fresenius Medical Center (Lowell, MA)
- …requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory ... FMCNA Compliance Program, and FMS patient care and administrative policies as the clinical leader, has the authority to make daily decisions to ensure continuity of… more
- Veterans Affairs, Veterans Health Administration (Manchester, NH)
- …of the EDRP application. Former EDRP participants ineligible to apply. Responsibilities This Registered Nurse - Community Living Center (CLC) is located in the ... equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion… more
- Humana (Concord, NH)
- **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 ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse (RN)** in the (appropriate state)… more
- Tufts Medicine (Lowell, MA)
- …an **ED Clinical Resource Nurse .** The ED Clinical Resource Nurse is a Registered Nurse with responsibility and accountability for the ... customer satisfaction, while striving for optimal efficiency, productivity and utilization of all resources. The ED Clinical ...and utilization of all resources. The ED Clinical Resource Nurse utilizes the nursing process,… more
- CVS Health (Concord, NH)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… more
- HCA Healthcare (Portsmouth, NH)
- …support our colleagues in their positions. Join our Team as a Patient Safety Coordinator Registered Nurse and access programs to assist with every stage of your ... job skills. Apply today for our Patient Safety Coordinator Registered Nurse opening and continue to learn!...lead, coordinate and carry out an assigned portfolio of clinical quality and patient safety functions to support the… more
- HCA Healthcare (Portsmouth, NH)
- …and more affordable to gain certifications and job skills. Apply today for our Registered Nurse Inpatient Wound Care opening and continue to learn! **Job Summary ... and Qualifications** As a Registered Nurse , you will be responsible for...will do in this role:** + Inpatient wound care nurse to provide clinical oversight and coordinator… more
- Sharecare (Concord, NH)
- …to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they… more
- Datavant (Concord, NH)
- …clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for...by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well… more
- State of Massachusetts (Tewksbury, MA)
- …with the Chief Executive Officer (CEO), Chief Medical Officer (CMO), Chief Clinical Officer (CCO), Chief Nursing Officer (CNO), Director of Nursing (DON), Facilities ... Director, and Quality and Clinical Services to maintain and surpass the high level...operational leadership and evaluates departmental performance, resource allocation, and utilization to establish and prioritize departmental goals and activities.… more
- HCA Healthcare (Portsmouth, NH)
- …3+ years experience in clinical nursing Required InterQual experience Preferred Registered Nurse license for New Hampshire or compact licensure required ... and expertise! **Job Summary and Qualifications** **Job Summary and Qualifications** The Registered Nurse (RN) CM is responsible for promoting patient-centered… more
- HCA Healthcare (Portsmouth, NH)
- …3+ years experience in clinical nursing Required InterQual experience Preferred Registered Nurse license for New Hampshire or compact licensure required ... and continue to learn! **Job Summary and Qualifications** The Registered Nurse (RN) CM is responsible for...supporting a balance of optimal care and appropriate resource utilization . Provides case management services for both inpatient and… more
- Highmark Health (Concord, NH)
- …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more