- Banner Health (AZ)
- …benefits, better opportunities and a better community. As a ** Registered Nurse RN Utilization Management Care Reviewer,** you will be working in ... proper coordination upon discharge from facilities. **The Registered Nurse RN Utilization Management Care Reviewer position is a fully remote… more
- Mount Sinai Health System (New York, NY)
- …the delivery of comprehensive front-line Case Management services, including utilization management , care facilitation and discharge planning. The ... field, Master's degree preferred + 5 years of Case Management and 6 years as a clinical nurse... management is preferred Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West… more
- AmeriHealth Caritas (Philadelphia, PA)
- …in Nursing preferred. + Minimum of 3 years of experience providing direct patient care ;as a Registered Nurse working with medically fragile pediatric ... and 5:00p EST.** ; + Current, active, and unrestricted Registered Nurse licensure in Pennsylvania. + Associate...+ Minimum of 3 years of Utilization Management experience, preferably within a managed care … more
- Covenant Health Inc. (Knoxville, TN)
- Overview Registered Nurse , Revenue Integrity & Utilization Management Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant ... by Forbes as a Best Employer. Position Summary: The RN Utilization Management I will...word and excel. Licensure Requirements: Current licensure as a Registered Nurse ( RN ) as issued… more
- AdventHealth (Orlando, FL)
- …**The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by analyzing patient ... and valid license to practice in Florida as a Registered Nurse (ADN or BSN) required. +...- greater than five years + Minimum four years Utilization Management within acute care … more
- McLaren Health Care (Pontiac, MI)
- **Position Summary:** Responsible for Utilization and Care Management services to the Emergency Center. Advises providers to determine initial medical ... needs in EMR for continued communication with ICM UM RN and Care Management staff...as assigned. #LI-KH1 _Required_ + State licensure as a Registered Nurse ( RN ) + Bachelor's… more
- Central Maine Medical Center (Lewiston, ME)
- …experiences for our community and for each other every day. Position Summary: The Utilization Management Nurse is responsible for a comprehensive clinical ... minimum qualifications for the position including:*Current State of Maine RN licensure.*Three (3) or more years of previous experience...licensure.*Three (3) or more years of previous experience in Utilization Management and/or Care … more
- McLaren Health Care (Indianapolis, IN)
- We are looking for a Utilization Management RN , to join us in leading our organization forward. McLaren Integrated HMO Group (MIG) is a fully owned ... + Two(2)yearsclinicalnursingexperience. + One (1) year previous experience in Managed Care Utilization Management , Medical Management , Case Management… more
- CVS Health (Raleigh, NC)
- …will include holidays and evening hours **Preferred Qualifications** + Prior Authorization or Utilization Management experience + Managed care experience + ... **Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current...Friday, 9:00am to 5:30pm EST with occasional holiday rotation. Utilization Management is a 24/7 operation and… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is...player. Must be able to work independently. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- Catholic Health Services (Melville, NY)
- …development to remain current with industry standards and business objectives related to Utilization and Care Management as appropriate. Sound knowledge and ... for additional clinical documentation. Acts as liaison between the Utilization and Appeals Management Department and the...as applicable to position needs. Experienced appeals writer and Care Management experience required in an acute… more
- Guthrie (Binghamton, NY)
- Provides health care services regarding admissions, case management , discharge planning and utilization review. Responsibilites: Reviews admissions and ... coordinates compliance to federally mandated and third party payer utilization management rules and regulations The pay...a part of a tradition of excellence in health care . In all areas and at all levels of… more
- Ascension Health (Nashville, TN)
- …cross-functional meetings to drive collaboration and efficiency, lead strategic initiatives in utilization management to optimize patient care and partner ... **Details** + **Department:** Utilization Management + **Schedule:** Monday -...all clients. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Tennessee Board… more
- Children's Mercy Kansas City (Kansas City, MO)
- …of daily operations of the case management department which includes utilization management , care progression and discharge planing promoting ... Administration + and 5-7 years experience + experience in Management , Care Management , Utilization...Performance Improvement Leadership + One of the following: Licensed RN - MO, Registered Nurse … more
- Alameda Health System (Oakland, CA)
- …and reports to appropriate committees and in conjunction with the Director of Care Management identifies utilization issues affecting the quality of ... + Manages and assumes responsibility for day-to-day operations of utilization management , care coordination and...or lead role. **Required Licenses/Certifications:** Active licensure as a Registered Nurse in the State of California… more
- Elevance Health (Woodbridge, VA)
- RN Utilization Review Nurse (Washington DC Medicaid) JR149756 **Location** : This role requires associates to be in-office 4 days per week, Monday - ... is located at 609 H. Street NE. The **Medical Management Nurse ** is responsible for review of...the District of Columbia is required. **Preferred Qualifications:** + Utilization Management /Review in managed care … more
- RWJBarnabas Health (Livingston, NJ)
- Case Manager Registered Nurse ( RN ), Case Management (per diem)Req #:0000191479 Category:Nursing Status:Per Diem Shift:Day Facility:Cooperman Barnabas ... skills and professional experience. Job Summary: The Case Manager Registered Nurse will coordinate discharge planning to...Minimum of one year experience in Case Management / Utilization Management or Home Care … more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …required to meet the healthcare needs of the patients using the functions of Utilization Resource Management , Transition of Care , Discharge Planning, and ... safe discharge coverage for all hospital units. + Participates in utilization management initiatives/opportunities for improvement through departmental committee… more
- RWJBarnabas Health (Rahway, NJ)
- Per Diem Case Manager Registered Nurse ( RN ), Case...Minimum of one year experience in Case Management / Utilization Management or Home Care ... all Orientation Programs Certifications and Licenses Required: + Current Registered Nurse License in the state of...Management Plan and State and Federal guidelines, the RN Case Manager Discharge Planner will be responsible for… more
- Hackensack Meridian Health (Hackensack, NJ)
- …requirements. The role integrates and coordinates utilization management , care coordination, and discharge planning functions. RN Case Managers may work ... discharge planning, utilization management , case management , performance improvement, and managed care reimbursement....Certifications Required:** + NJ State Professional Registered Nurse License. + AHA Basic Health Care … more