- CenterWell (Austin, TX)
- …of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent ... your skills to make an impact** **Required Qualifications** + Licensed Registered Compact Nurse license (RN) with no disciplinary action and ability to obtain non… more
- Molina Healthcare (GA)
- … Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family ... JOB DESCRIPTION **Job Summary** The Supervisor, Healthcare Services UM leads and supervises a multidisciplinary team of...5 years of health care experience, and at least 2 years of managed care experience in one or… more
- Molina Healthcare (Boston, MA)
- …Job Summary The Care Review Clinician, IP Provides support for clinical member services review assessment processes. Responsible for verifying that services ... are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members...a candidate with a MA RN licensure. Candidates with UM Medical Review background and experience using MCG or… more
- Magellan Health Services (Boise, ID)
- Under general supervision, and in collaboration with other members of the clinical team, authorizes and reviews utilization of mental health and substance abuse ... develops discharge plans and oversee their implementation. + Performs quality clinical reviews while educating and making appropriate interventions to advance the… more
- Queen's Health System (Honolulu, HI)
- …02/25 I. JOB SUMMARY/RESPONSIBILITIES: * Directs and manages administrative and clinical operations of Emergency Department and Inpatient Case Management services. * ... LICENSURE: * Current Hawaii State license as a Registered Nurse . * Bachelor's degree in Nursing. * Master's degree...three (3) years experience in Case Management. * Two ( 2 ) years supervisory/leadership experience. * Prior experience in a… more
- University of Michigan (Ann Arbor, MI)
- CLINICAL NURSE SPECIALIST (CNS)- University Hospital- 5A Ortho/Trauma Surgical Unit & 5C Adult Med/Surg, Transplant, and GI Apply Now **Job Summary** The ... Clinical Nurse Specialist will be responsible for...includes: + Excellent medical, dental and vision coverage + 2 :1 Match on retirement savings and immediate vesting +… more
- Fallon Health (Worcester, MA)
- …of clinical criteria and medical necessity determinations. The Appeal Nurse is responsible for ensuring compliance with all applicable state and federal ... the nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge,… more
- University of Miami (Miami, FL)
- …(https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . CORE JOB SUMMARY The Registered Nurse 2 delivers patient-family centered care ... of quality, safety, and service while ensuring population-specific patient care. The Registered Nurse 2 oversees nurses and allied health staff in their daily… more
- University of Miami (Miami, FL)
- …please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Registered Nurse works as a part of a team to ... position include, but are not limited to: Performance Nursing Duties as per Nurse Job Description 100% Perform patient interview and obtains vital signs. Assists… more
- Commonwealth Care Alliance (Boston, MA)
- …Reporting to the Manager Utilization Management, the Nurse Utilization Management ( UM ) Reviewer is responsible for day-to-day timely clinical and service ... with Standard Operating Procedures + Ensures accurate documentation of clinical decisions and works with UM Manager...Utilization Management experience in a managed care setting + 2 or more years working in a clinical… more
- Humana (Lansing, MI)
- …our caring community and help us put health first** The Utilization Management Nurse Lead uses clinical knowledge, communication skills, and independent critical ... years of clinical experience in utilization management. + Minimum two ( 2 ) years of direct or indirect leadership experience. + Knowledge of Medicare regulatory… more
- University of Michigan (Ann Arbor, MI)
- …as a Pediatric Nurse Practitioner-Acute Care. Also will consider Pediatric Nurse Practitioner-Primary Care (with 2 years of Pediatric GI and/or Pediatric ... Nephrology RN/NP experience) or Family Nurse Practitioner (with 2 years of Pediatric...AHA Approved BLS and PALS + Two years of clinical experience in pediatrics PA + Current licensure to… more
- ERP International (Yuma, AZ)
- **Overview** ERP International, LLC is seeking a **Registered Nurse - Case Manager** for a full-time position at the Camp Pendleton **Branch Health Clinic** in ... such as those used for patient identification and patient assessment, clinical practice guidelines, algorithms, CM software, and databases for community resources.… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …improvement initiatives *Education*: * Attains and maintains current knowledge in UR/ UM practices, payer requirements, clinical guidelines, and regulations ... *_SUMMARY:_* We are currently seeking a*Staff Nurse *to join our Utilization Management department in a*/*FLOAT*/*/assignment...Bachelor's degree in nursing * Certification in area of clinical specialty * Minimum 2 years of… more
- University of Miami (Miami, FL)
- …metabolic disorders using independent discretion and judgment + Covers for other departmental nurse practitioners and/or clinical fellow(s) when they are out on ... at JMH/ UM Genetics clinics (including satellite clinics) + Manages clinical care for NBS/metabolic patients admitted to the hospital + Provide cross-coverage… more
- University of Michigan (Ann Arbor, MI)
- Advanced Practice Professional ( Nurse Practitioner) Critical Care Medicine Service Apply Now **How to Apply** This is an Advanced Practice Professional (APP) job ... forward to?** Flexible Health, Dental, and Vision Plans Retirement Savings Plans with 2 :1 Matching Group Term Life Insurance Long Term Disability Plan Generous Time… more
- University of Miami (Miami, FL)
- …health status of the patient in an ongoing timely and systematic manner. 2 . Obtains baseline information utilized for the development of individualized patient plan ... plan of care with patients, family and interdisciplinary team. 2 . Ensures the plan of care is accessible to...teaching nee ds as applicable. 4. Promotes development of clinical practice based on research and evidence. 5. Assists… more
- University of Michigan (Ann Arbor, MI)
- …+ Licensed registered nurse in the State of Michigan. + Two ( 2 ) or more years of adult and/or medical/surgical nursing experience within the last 5 ... REGISTERED NURSE (HomeMed Infusion) Apply Now **Mission Statement** Michigan...year of home care experience including home infusion within 2 years. + Two years of recent clinical… more
- University of Michigan (Ann Arbor, MI)
- …following completion of orientation. The selected candidate will practice as a Neonatal Nurse Practitioner for 2 years in the CS Mott Children's Hospital, ... REGISTERED NURSE - Neonatal Nurse Practitioner Internship...Differential- $4.00 / hour + Day Shift Weekend Differential- $ 2 .90 / hour + Evening Shift Weekend Differential- $5.90… more
- University of Michigan (Ann Arbor, MI)
- REGISTERED NURSE ( Ambulatory Care, Rheumatology Clinic; Briarwood Health Associates ) Apply Now **Mission Statement** Michigan Medicine improves the health of ... population. + Perform telephone triage, including assessment, screening, and clinical advice; direct patient care including injections, patient education,… more