- HonorHealth (Scottsdale, AZ)
- …of communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors ... 1 year experience in UR/UM or Case Management Required Licenses and Certifications Registered Nurse ( RN ) State And/Or Compact State Licensure Required more
- BAYADA Home Health Care (Orlando, FL)
- …with an industry leader. Apply now for immediate consideration. OASIS Review , Utilization Review , Quality Assurance, Remote , Home Health Coding, Coder, ... immediate opening for a **Full Time,** OASIS and Coding Review Manager with OASIS and Coding certification to work...Manager with OASIS and Coding certification to work remotely. RN , PT, OT, and SLP's with certifications will be… more
- Ochsner Health (New Orleans, LA)
- …case management or utilization review . **Certifications** Required - Current registered nurse license in state of practice. Basic Life Support (BLS) from ... and implement discharge plans based on patient's individualized needs. Registered Nurse ( RN ) Case Manager...of the conditions of participation as it relates to utilization review and discharge planning. + Maintains… more
- Community Health Network (Indianapolis, IN)
- Registered Nurse ( RN ) Case Manager - North Job Ref 2502503 Category Nursing Job Family Case Manager Department Case Management Schedule Full-time Facility ... full-time RN Case Manager position available. The Registered Nurse Case Manager is responsible for...effectiveness through the integrating and functions of case management, utilization review and management and discharge planning.… more
- Banner Health (Greeley, CO)
- …the completion of a bachelor's degree in case management or health care. Requires current Registered Nurse ( RN ) license in state worked. For assignments in ... RN Case Manager, your work will be primarily remote with in clinic rounding every other month in...of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through… more
- Sharecare (Columbus, OH)
- …cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification of those ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting the goals and… more
- Bon Secours Mercy Health (Greenville, SC)
- …utilizing the nurse triage algorithms. Assists with the evaluation and review of all incoming ambulatory oncology referrals and may be asked to assist ... are recognized for clinical and operational excellence. **This position will work remote , following an initial on-site training period (approx. 90 days). The work… more
- AdventHealth (Altamonte Springs, FL)
- … **The role you will contribute:** The role of the Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by analyzing patient ... of admission; and when warranted by length of stay, utilization review plan, and/or best practice guidelines,.... Current and valid license to practice as a Registered Nurse (ADN or BSN) required. .… more
- CVS Health (Frankfort, KY)
- …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... in a hospital setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- CVS Health (Jackson, MS)
- …- Perform medical necessity reviews **Required Qualifications** - 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... setting - A Registered Nurse that holds an active, unrestricted...lower levels of care - 1+ years' experience in Utilization Review - CCM and/or other URAC… more
- Saint Francis Health System (Tulsa, OK)
- …from ER, ICU, and CTU units. + All private rooms Job Summary: The Registered Nurse I assesses, plans, implements and evaluates nursing care, utilizing the ... therefrom. Licensure, Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License. Work Experience: 0 - 6 months related… more
- Humana (Columbus, OH)
- …consistent across markets. **Use your skills to make an impact** **Required Qualifications:** + Registered Nurse with a Bachelor's degree in Nursing, BSN, and an ... our caring community and help us put health first** The Senior Compliance Nurse reviews utilization management activities and documentation to ensure adherence… more
- Veterans Affairs, Veterans Health Administration (Aurora, CO)
- Summary This is an OPEN-CONTINOUS ANNOUNCEMENT. The Outpatient Mental Health Registered Nurse is responsible and accountable for all elements of the nursing ... basis and will remain on file through 9-30-2025. Initial review will be conducted within two weeks from the...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Veterans Affairs, Veterans Health Administration (Albany, NY)
- …application. Former EDRP participants ineligible to apply. Responsibilities The Inpatient Staff Registered Nurse ( RN ) is responsible for providing competent, ... orientation, competencies and providing quality improvement and enhance outcomes utilization . This nurse integrates knowledge, skills, abilities,...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Insight Global (Philadelphia, PA)
- …Active RN License or Active LPN License 2-3 years of clinical experience ( Utilization management or utilization review ) Strong computer skills Ability to ... looking for HEDIS RNs or LPNs for a partially remote contract position in PA and NJ. PARTIALLY ...Previous HEDIS review experience or experience with Utilization Review , Quality, Medical Record auditing Bachelors… more
- Veterans Affairs, Veterans Health Administration (West Haven, CT)
- …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 ... Summary The RN -Surgical Case (Perioperative Clinic) Coordinator position is...the pre-operative period. - Perform an initial and ongoing review of patients to identify needs, issues, resources, and… 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 - ... located at 609 H. Street NE. The **Medical Management Nurse ** is responsible for review of the...experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or… more
- Molina Healthcare (WI)
- …will be supporting our Appeals and Grievances department. We are seeking a Registered Nurse with previous claims and appeals experience. The candidate must ... be discussed during our interview process. This is a remote position. Illinois & Wisconsin RN compact...3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review… more
- Centene Corporation (San Antonio, TX)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... BHEC if you hold a LPC, LCSW, or LMFT. Registered Nurse can hold Texas State Licensure...preferred. + Knowledge of mental health and substance abuse utilization review process is preferred. + Experience… more
- Centene Corporation (Tallahassee, FL)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... Complies with all policies and standards **This is a remote position. Candidates must be licensed and located in...abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with… more