- Novo Nordisk Inc. (Omaha, NE)
- …relationships include key opinion leaders (KOL's), academic institutions, physicians, nurse practitioners, diabetes educators, pharmacists, blood bank staff , ... providers and IHNs; c) develops appropriate use of NNI products and greater utilization of its services d) supports and assists representatives and managers in… more
- Commonwealth Care Alliance (Boston, MA)
- …clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA ... CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is… more
- Luke Staffing (Glendale, CO)
- **REGISTERED NURSE ** **SITE OF SERVICE:** Department of Veterans Affairs, Eastern Colorado Healthcare System (ECHCS), 4100 E. Mississippi Ave, Glendale, CO 80246 ... consider Part Time and Full Time Applicants** **POSITION OVERVIEW:** The Registered Nurse (RN) will provide on-site professional nursing services to beneficiaries of… more
- Battelle Memorial Institute (Fort Benning, GA)
- …within legal and professional parameters + Knowledge and skill in using pre-established utilization review criteria to recognize and report actual or potential ... (HRA) business line is seeking a highly motivated, full-time ** Nurse Case Manager** to join our team in support...will support positive programs for equal treatment of all staff and full utilization of all qualified… 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 ... of other individuals performing similar services. ? Participate in peer review and performance improvement activities. ? Practice aseptic techniques as necessary.… more
- Katmai (Fort Carson, CO)
- …with facility staff members to facilitate patient care. + Accurately review and confirm completeness of patient chart and report any abnormalities to appropriate ... those required of any military or government civil service nurse of similar experience and in similar duty assignments....safe, clean work environment is maintained for patients and staff . Exercises the standard precautions set forth by the… more
- Stanford Health Care (Palo Alto, CA)
- …development of their APPs. The Lead APP also functions under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered Nurse ... management team. . Conduct regularly scheduled meetings with the staff APPs. . Ensure clinical competency and adherence to...and adherence to policy through practice analysis and case review of APPs with physicians. . Investigate and respond… more
- Stanford Health Care (Palo Alto, CA)
- …responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient ... other interdisciplinary team members; arranges follow up care as appropriate. + Utilization Review -- Reviews prospectively, concurrently and retrospectively all… more
- Stanford Health Care (Palo Alto, CA)
- …responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient ... provide requested clinical and psychosocial information to assurereimbursement. + Utilization Review -- Reviews prospectively, concurrently and retrospectively… more
- Stanford Health Care (Palo Alto, CA)
- …growth and development of their APPs. Also functions under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered ... management team. + Conduct regularly scheduled meetings with the staff APPs. + Ensure clinical competency and adherence to...and adherence to policy through practice analysis and case review of APPs with physicians. + Investigate and respond… more
- BroadPath Healthcare Solutions (Tucson, AZ)
- …results-driven **UM RN Appeals Coordinator.** This role collaborates with clinical review staff , medical directors/physician reviewers, network physicians, and ... and weekends, to address pharmacy-related denials + Educates physician reviewers and clinical review staff on managed care and Medicaid policies and procedures… 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 ... Follows cases for authorization for in patient stay. + Staff review short stay, long stay and...patients who were readmitted within thirty days. Documents over utilization of resources and services. + All Medicare cases… more
- Battelle Memorial Institute (Columbus, OH)
- …and organizational objectives. We will support positive programs for equal treatment of all staff and full utilization of all qualified employees at all levels ... while also maintaining records, managing supplies, and providing information to staff and families. This role requires independent judgment, initiative, and the… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …Nurse issued by the State of Minnesota. **Title:** * Staff Nurse - Utilization Review (ED)* **Location:** *MN-Minneapolis-Downtown Campus* ... *_SUMMARY:_* We are currently seeking a* Staff Nurse *to join our Utilization...may require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse … more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW ... information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to...new or revised procedures. + Works with Professional Standards Review Organization representative to orient new staff … more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW ... medical direction, administrative and technical supervision over the nursing staff engaged in utilization review ...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of ... acute care indicators and criteria as approved by medical staff , payer guidelines, CMS, and other state agencies. In...this position is able to cover a multitude of utilization review functions through point of entry,… more
- Emory Healthcare/Emory University (Decatur, GA)
- …development _,_ and leadership programs + And more **Description** We're seeking a **Clinical Utilization Review Nurse Preceptor (Registered Nurse / ... be responsible for training, mentoring, and coaching for the Utilization Review Department and must be an...department. This will consist of regular audits of each staff member which will assist with identification in knowledge… more
- YesCare Corp (Brentwood, TN)
- …standards of best practice. + Facilitate quality health care intervention recommendations. + Review and assess over/under utilization issues. + Track, trend and ... community standards, regionally based as indicated. + Communicate and guide staff and physicians regarding utilization management program development,… more
- University of Utah Health (Salt Lake City, UT)
- …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** + ... excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion,...Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of… more
