- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day ... service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has...requirements are met + Additional duties as requested by supervisor + Maintains knowledge of CMS, State and NCQA… more
- Commonwealth Care Alliance (Boston, MA)
- …Operations and in direct partnership with Care Delivery Business Ops and Clinical Management teams, the Supervisor partners in ensuring the delivery of primary ... Interdisciplinary Care Team members and/or other Clinical staff and management . In addition, the Supervisor is the...(nice to have): - Medical Assistant or Licensed Practical Nurse - Coding Certification Required Experience (must have): -… more
- Monte Nido (Dedham, MA)
- …they need and deserve. Learn more at www.waldenbehavioralcare.com. The Nursing Supervisor provides clinical leadership, management oversight, and guidance during ... and in the residential program. + Assists in the management of medical and/or psychiatric emergencies. + Investigates critical...Graduate of an accredited nursing program. + 2 years RN experience, and 2 years of Supervisor … more
- Alameda Health System (Oakland, CA)
- …of the required experience.) Required License/Certifications:CCRN - Critical Care Registered Nurse is desirable. Required Licenses/Certifications:ACLS - Advanced ... Services As Needed / Per Diem - Varies + Management + $76.03-$106.89 + Req #:42315-31381 + FTE:0.01 +...Emergency department). Required Licenses/Certifications:Valid license to practice as a Registered Nurse in the State of California… more
- Alameda Health System (Oakland, CA)
- …in Nursing preferred. Required License/Certifications: CCRN - Critical Care Registered Nurse is desirable. Required Licenses/CertificationsTPM: ACLS, TNCC, ... MCH/OB Clinic (K6) + Full Time - Day + Management + $64.00- $96.00 + Req #:42878-31844 + FTE:1...department). Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California.… more
- Commonwealth Care Alliance (Boston, MA)
- …ongoing deployment of predictive models which help instED identify ER and in-patient utilization patterns as well as service needs of high-risk patient populations - ... care delivery models - Complete data science projects independently with minimum supervisor and guidance - Propose and conduct optimal solution to projects… 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 ... 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
- Centene Corporation (Sacramento, CA)
- …Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact ... ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks...with all policies and standards **Candidates must have a Registered Nurse ( RN ) license for… more
- Integra Partners (Troy, MI)
- The Utilization Management (UM) Nurse Supervisor is responsible for providing direct leadership and oversight to the UM nursing team. This role ensures ... internal partners (eg, Provider Relations, Quality) to resolve escalations and address utilization management issues. + Represent UM nursing team in internal… more
- Molina Healthcare (Sacramento, CA)
- …and Monitoring team responsible for prior authorizations, inpatient/outpatient medical necessity/ utilization review, and/or other utilization management ... clinical and non-clinical team activities to facilitate integrated, proactive utilization management , ensuring compliance with regulatory and accrediting… more
- UPMC (Pittsburgh, PA)
- …within one year of hire or 1 year health plan management experience required + Registered Nurse ( RN ) + Act 34 *Current licensure either in the state ... UPMC Health Plan is seeking a full-time Professional Care Manager, Supervisor to join our Utilization Management (UM) Clinical Operations team. This position… more
- AmeriHealth Caritas (Washington, DC)
- …the direction of a supervisor , the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... overtime, and weekends based on business needs. **Responsibilities:** + Conduct utilization management reviews by assessing medical necessity, appropriateness of… more
- Ventura County (Ventura, CA)
- Senior Registered Nurse - Hospital Management Utilization ...Supervisor Pay - $4.00 per hour + Charge Nurse Premium Pay - $1.50 per hour + Float ... Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061650) Apply Senior Registered Nurse - Hospital Management Utilization Salary… more
- Bon Secours Mercy Health (Richmond, VA)
- …Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. ** Registered Nurse Supervisor ( RN ) - ASU PACU - ... Mary's Hospital** Primary Function/General Purpose of Position The Surgery Supervisor is responsible for oversite of the staff and...- American Heart Association (required) Currently Licensed as a Registered Nurse in the State of Practice… more
- Bon Secours Mercy Health (Greenville, SC)
- …an environment where associates want to work and help communities thrive. ** Registered Nurse ( RN ) OR Supervisor Surgery** - **St. Francis Downtown - ... Greenville, SC** **Job Summary:** The Surgery Supervisor is responsible for oversite of the...American Heart Association (required) + Currently Licensed as a Registered Nurse in the State of Practice… more
- Banner Health (Queen Creek, AZ)
- …(code events and internal disasters), patient transports, dispatch, and data analysis. As a ** Registered Nurse House Supervisor ** , you will be responsible ... work and receive care. In your role as a ** RN House Supervisor ** , you will work...This position provides administrative supervision of campus workflow, resource utilization and management , and operations for all… more
- Bon Secours Mercy Health (Suffolk, VA)
- …Advanced Cardiac Life Support acceptable in lieu of BLS) Medical-Surgical Nursing Certification RN -BC ( Registered Nurse - Board Certified) (preferred) CCRN ... ( RN ) - Med-Surg -Harbour View Medical Center_** **Job Summary:** The Med-Surg Registered Nurse ( RN ) position is responsible for delivering exceptional… more
- Bon Secours Mercy Health (Greenville, SC)
- …and operational excellence. FT Nights **Summary of Primary Functions** The Critical Care Registered Nurse ( RN ) provides, coordinates, plans, and evaluates ... Nurse (preferred) PCCN Progressive Care Certified Nurse (preferred) RN -BC Registered Nurse - Board Certified (preferred) TCRN Trauma Certified… more
- Good Samaritan (Inver Grove Heights, MN)
- …schedule with a weekend on-call rotation shared with the other supervisory staff. MN Registered Nurse , RN required. Prior MDS experience preferred. $10,000 ... week MDS Coordinator will be a part of our management team. Primary responsibilities will be MDS duties for...Assistance, Annual Increases, PTO + more! **Job Summary** The RN Case Manager, Long Term Care (LTC) assesses, implements,… more
- Avera (Pierre, SD)
- …cause undue hardship to the employer. **Required Education, License/Certification, or Work Experience:** + Registered Nurse ( RN ) - Board of Nursing An active ... License/Certification, or Work Experience:** + 1-3 years clinical experience as RN + supervisory or management experience **Expectations and Standards**… more
