- Katmai (Fort Carson, CO)
- …RESPONSIBILITIES** None. **Job Requirements:** **MINIMUM QUALIFICATIONS** + Associates Degree of Nursing. Registered nurse shall be a graduate from a college or ... those required of any military or government civil service nurse of similar experience and in similar duty assignments....+ Shall possess a current, active, full and unrestricted Registered Nurses ( RN ) licensed in Colorado or… more
- Stanford Health Care (Palo Alto, CA)
- …Lead APP also functions under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered Nurse Anesthetist (CRNA), ... and adherence to policy through practice analysis and case review of APPs with physicians. . Investigate and respond...under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered … more
- Stanford Health Care (Palo Alto, CA)
- …their APPs. Also functions under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered Nurse Anesthetist (CRNA), ... and adherence to policy through practice analysis and case review of APPs with physicians. + Investigate and respond...practice provider: (Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist or Certified Registered … more
- ERP International (Camp Pendleton, CA)
- **Overview** ERP International, LLC is seeking a **Licensed Vocational / Practical Nurse ** for a full-time position supporting the **Branch Health Clinics** at ... Recognize urgent or emergent patient care situations, seek assistance of the RN and/or MD/DO, and initiate appropriate emergency interventions as directed. - Perform… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Part-Time Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital ... healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence...regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse -… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse ( RN ) who comprehensively ... this position is able to cover a multitude of utilization review functions through point of entry,...and/or case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
- Medical Center Hospital (Odessa, TX)
- + Position Summary: The Utilization Review Specialist /Outcomes Specialist conducts concurrent and retrospective review functions in support of the ... hospital Utilization Review Program and makes appropriate referrals to designated Physician...A. Education: Holds a current Texas license as a Registered Nurse OR a current Texas Licensed… more
- Hunterdon Health Care System (Flemington, NJ)
- This is an in-person role. Position Summary The Utilization Review Specialist monitors adherence to the hospital's utilization review plan to ensure ... an applicable health insurance plan. Primary Position Responsibilities 1. Performs utilization activities, using Milliman Care Guidelines under the guidance of the… more
- WestCare Foundation (Henderson, NV)
- Utilization Review Specialist Job...required Education: + Associates or Bachelors level LPN or RN and/or Bachelors or Masters level CADC/LADC with 2 ... years utilization review experience, preferred experience working with individuals with psychiatric or substance use disorder Experience and Competencies: +… more
- BriteLife Recovery (Englewood, NJ)
- What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is ... responsible for overseeing and coordinating all aspects of utilization review and insurance authorization for clients receiving substance use disorder (SUD)… more
- HonorHealth (AZ)
- …different here -- because it does. Learn more at HonorHealth.com. Responsibilities Job SummaryThe Utilization Review RN Specialist reviews and monitors ... Degree in Nursing from an accredited NLN/CCNE institution RequiredExperience3 years Registered Nurse in an acute care setting. Required1 year… more
- CaroMont Health (Gastonia, NC)
- …RAC for reversal of original determination. May serve on the Medical Record/ Utilization Review Committee, providing detailed logs of denial activity and appeal ... practice in NC (NC license or multi-state (compact) license). Certification in Utilization Review / Management, Quality and/or Case Management preferred. Minimum… more
- CareFirst (Baltimore, MD)
- …Qualifications** **PURPOSE:** Utilizing key principles of utilization management, the Utilization Review Specialist will perform prospective, concurrent ... coverage. Leveraging clinical expertise and critical thinking skills, the Utilization Review Specialist , will analyze...in addition to the required work experience. **Licenses/Certifications:** + RN - Registered Nurse -… more
- BayCare Health System (Tampa, FL)
- …a foundation of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/ RN responsibilities ... + **On Call:** No **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred...Community discounts and more Equal Opportunity Employer Veterans/Disabled **Position** Utilization Review RN **Location** Tampa:St… more
- YesCare Corp (Brentwood, TN)
- …+ Assist in completion of special projects on an as needed basis. **Key Qualifications:** + Registered Nurse ( RN ) active license + No less than 5 years' ... lives through care and expertise. **Key Responsibilities:** + The nurse will focus on what's best for the patients...practice. + Facilitate quality health care intervention recommendations. + Review and assess over/under utilization issues. +… more
- Penn State Health (Hershey, PA)
- …discrimination._ **Union:** SEIU Healthcare Pennsylvania **Position** RN Registered Nurse Utilization Management Specialist - Utilization ... setting required. + Currently licensed to practice as a Registered Nurse by state of employment or... by state of employment or holds a multistate RN license through the interstate Nurse Licensure… more
- Deloitte (Chicago, IL)
- …degree, or physician assistant required + Current Registered Nurse ( RN ) license required + Certified Clinical Documentation Specialist - CCDS (inpatient) ... registered nurse , physician, physician assistant, case manager, clinical documentation specialist , utilization review , informatics RN , Quality,… more
- AdventHealth (Orlando, FL)
- …Services in the verification process. Obtains pre-authorization and provides information to the Utilization Review Specialist , Utilization Review ... Control RN Tier 1 is a professional registered nurse functioning withing Mission Control in...and placement of all patients. Proactively initiates steps, including utilization of the hospital and physician chain of command,… more
- Roper St. Francis (Charleston, SC)
- …Charge Nurse I. Experience: Experience: At least 2 years- experience as a registered nurse in a direct care patient setting for Primary Charge Nurse ... role. Licensure/Certification: Applicant must be currently licensed as a Registered Nurse in South Carolina or hold...to run effective shift safety huddles, report safety concerns, review device utilization , report staffing concerns, and… more
- Cedars-Sinai (Los Angeles, CA)
- …Los Angeles Fair Chance Initiative for Hiring. **Req ID** : 10457 **Working Title** : Registered Nurse - Clinical Documentation Specialist - 8 Hour Days ... care field preferred Foreign trained MDs will be considered License/Certifications: Registered Nurse , LVN, Occupational Therapist, Physical Therapist, Physician… more
