- Aveanna Healthcare (Birmingham, AL)
- $7500 Sign-On Bonus Position Overview: The Hospice Registered Nurse is responsible for pain management, symptom control in the delivery of care to hospice ... of care and patient needs. Participates in quality improvement, utilization review , and infection control activities as...Time, and Paid Holidays Qualifications: Current license as a Registered Nurse in the State of Alabama… more
- Stony Brook University (Stony Brook, NY)
- Registered Nurse 1 (T&RC) - Blood Donor Full -Time Day Shift **Position Summary** At Stony Brook Medicine, our Registered Nurses are critical members of ... while adhering to a medical regimen. **Duties of a Registered Nurse in the Blood Donor Department...Donor and Therapeutic Apheresis as assigned.. + Perform blood utilization quality assurance, donor related work as assigned. +… more
- ERP International (San Diego, CA)
- **Overview** ERP International is seeking a full -time ** Registered Nurse ( RN ) Health Educator** supporting **Naval Medical Center San Diego, CA ... management/prevention. Lead position requires at leats 4 years experience Licensure:** Current, full , active, and unrestricted RN license from any state.… more
- Katmai (Fort Carson, CO)
- …the Commission on Collegiate Nursing Education (CCNE). + Shall possess a current, active, full and unrestricted Registered Nurses ( RN ) licensed in Colorado ... RESPONSIBILITIES** None. **Job Requirements:** **MINIMUM QUALIFICATIONS** + Associates Degree of Nursing. Registered nurse shall be a graduate from a college or… more
- Stony Brook University (Stony Brook, NY)
- …Department may include the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes UR ... cases for authorization for in patient stay. + Staff review short stay, long stay and complex cases to...required. **Qualifications** **Required** : A Bachelor's degree or a nurse working on their degree with an RN… more
- Stanford Health Care (Palo Alto, CA)
- …affect the processes and outcomes of patient health care **Licenses and Certifications** + Nursing\ RN - Registered Nurse - State Licensure And/Or Compact ... responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient… more
- Alameda Health System (Oakland, CA)
- …necessarily performed by each individual in the classification. + Coordinates all utilization review functions, including response to payor requests for ... experience in Case Management in an acute setting or utilization review at a medical group or...or health plan. Required Licenses/Certifications: Active licensure as a Registered Nurse in the State of California,… more
- Commonwealth Care Alliance (Springfield, MA)
- …success. + Conduct regular provider meetings (virtual and in-person) to review performance, discuss program updates, and address operational challenges. + Represent ... + Lead the monitoring and analysis of provider performance using utilization , quality, and member experience metrics. + Collaborate with Business Intelligence,… more
- ERP International (Luke AFB, AZ)
- …and 5:00pm, including a one hour lunch **Core Duties:** - Participate in Utilization Management/Case Management meetings to review and identify opportunities to ... seeking a **Licensed Clinical Social Worker/Case Manager** for a Full -Time position in support of the **56th Medical Group,...- Provide patient referrals. - Interface with the MTF RN Case Manager(s) in the development and implementation of… more
- Providence (Mission Hills, CA)
- **Description** ** RN Utilization Review at Providence Holy Cross Medical Center in Mission Hills, CA. This position is Full - time and will work 8-hour, ... empower them. **Required Qualifications:** + Associate's Degree Nursing. + Upon hire: California Registered Nurse License. + 2 years Experience working in a… more
- Providence (Napa, CA)
- …in an inpatient or outpatient case management setting + Upon hire: California Registered Nurse License + 2 years Case management, discharge planning, or ... and their families throughout the continuum of care. The RN Case Manager assists patients in the utilization...time **Job Shift:** Day **Career Track:** Nursing **Department:** 7810 UTILIZATION REVIEW **Address:** CA Napa 1000 Trancas… more
- Henry Ford Health System (Warren, MI)
- …screening criteria and critical thinking to maximize reimbursement. EDUCATION/EXPERIENCE REQUIRED: + Registered Nurse required. + Minimum 3-5 years of clinical ... Management experience in lieu of bachelor's degree. CERTIFICATIONS/LICENSURES REQUIRED: + Registered Nurse with a valid, unrestricted State of Michigan License.… more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical ... using indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical necessity… more
- Beth Israel Lahey Health (Burlington, MA)
- …the medical necessity of the hospital care. Using the concepts of utilization review , clinical documentation improvement and revenue integrity, these specialized ... making a difference in people's lives.** This position is full time, 40 hours per week, with weekend and...improve outcomes. 8. Assists with preparation and presentation of utilization review monitoring/trending reports for review… more
- Beth Israel Lahey Health (Plymouth, MA)
- …you're not just taking a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management ... Our Team of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager, you will:** + Directs staff performance… more
- Avera (Sioux Falls, SD)
- …cause undue hardship to the employer. **Required Education, License/Certification, or Work Experience:** + Registered Nurse ( RN ) - Board of Nursing An active ... the Clinical Appeals Specialist to ensure tracking and trending of all Utilization Review related denials/appeals are appropriately documented. + Assists with… more
- Ventura County (Ventura, CA)
- Senior Registered Nurse - Hospital Management Utilization Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061650) Apply Senior ... Registered Nurse - Hospital Management Utilization Salary $118,668.43...EDUCATION, TRAINING, and EXPERIENCE Requires two (2) years of full -time professional registered nurse experience,… more
- Crouse Hospital (Syracuse, NY)
- …outreach programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse ( RN ) to track and manage data and client ... Schedule: Full Time: 8:00am-4:30pm, requires 6 weekends a year. Utilization Management Registered Nurse ( RN ) Position Responsibilities: + Works… more
- Penn Medicine (Lancaster, PA)
- …NCLEX within 60 days of starting in their RN role. + A graduate registered nurse may only practice professional nursing under supervision and if the graduate ... Location: Women and Babies Hospital - Lancaster, PA Schedule: Full -Time, Night Shift, three 12-hour shifts. 7p-7a with rotation...their NCLEX within 60 days of starting in their RN role.A graduate registered nurse … more
- AdventHealth (Orlando, FL)
- …environment. **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by analyzing ... of admission; and when warranted by length of stay, utilization review plan, and/or best practice guidelines,...and valid license to practice in Florida as a Registered Nurse (ADN or BSN) required. +… more
