- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist LVN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist LVN II will facilitate, coordinate and… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will facilitate, coordinate, and… more
- University of Washington (Seattle, WA)
- …. RN2, Utilization Management ... This position will have partial/variable involvement with Harborview's Emergency Department. The Utilization Management Specialist RN2 is responsible for the… more
- BayCare Health System (Cotton Plant, AR)
- …responsibility and clinical excellence. **BayCare Health System** is currently seeking a ** Utilization Review Specialist Senior** to join our outstanding and ... compassionate team. **The Utilization Review Specialist Senior responsibilities include:** +...Nursing RN. **Certifications and Licensures:** + Required RN (Registered Nurse ) + Preferred ACM (Case Management ) +… more
- Sanford Health (Sioux Falls, SD)
- …Conduct level of care medical necessity reviews within patient's medical records. Performs utilization management (UM) activities in accordance with UM plan to ... utilization and potentially, prior authorization. Assists the department in monitoring the utilization of resources, risk management and quality of care for… more
- HonorHealth (Scottsdale, AZ)
- …communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization ... in an acute care setting. Required 1 year experience in UR/UM or Case Management Required Licenses and Certifications Registered Nurse (RN) State And/Or Compact… more
- MyFlorida (Marianna, FL)
- REGISTERED NURSE SPECIALIST - 67039438 (SUNLAND NURSING - DAY SHIFT) Date: Jun 5, 2024 Location: MARIANNA, FL, US, 32446 MARIANNA, FL, US, 32447 MARIANNA, FL, ... Requisition No: 830536 Agency: Agency for Persons with Disabilities Working Title: REGISTERED NURSE SPECIALIST - 67039438 (SUNLAND NURSING - DAY SHIFT) Pay Plan:… more
- Trinity Health (Ann Arbor, MI)
- …Type:** Full time **Shift:** Day Shift **Description:** Exceptional opportunity for a **Clinical Nurse Specialist ** to support our vision and serve with us as ... a compassionate and transforming healing presence in our community. The Clinical Nurse Specialist (CNS) functions as an advanced practice registered nurse … more
- MyFlorida (Chattahoochee, FL)
- REGISTERED NURSE SPECIALIST -F/C - 60005305 Date: May 19, 2024 Location: CHATTAHOOCHEE, FL, US, 32324 The State Personnel System is an E-Verify employer. For more ... No: 823737 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST -F/C - 60005305 Pay Plan: Career...knowledgeable of and utilize the principles of Total Quality Management . Nursing will provide guidance in the care and… more
- Hackensack Meridian Health (Hackensack, NJ)
- …to transform healthcare and serve as a leader of positive change. The **Appeal Nurse Specialist ** will be responsible for the timely review and submission of ... Management ). **Responsibilities** A day in the life of a **Appeal Nurse Specialist ** at **Hackensack Meridian** **_Health_** includes: + Reviews all… more
- Immigration and Customs Enforcement (IN)
- …an industry certification related to billing, coding, and utilization /case management [e.g., MCG Care Guideline Specialist , Certified Professional Medical ... and external stakeholders (eg, Customs and Border Patrol, Veterans Affairs) regarding utilization management (UM) processes, trainings, and principles to ensure… more
- MyFlorida (Macclenny, FL)
- REGISTERED NURSE SPECIALIST OPS - 60955422 Date: Jun 1, 2024 Location: MACCLENNY, FL, US, 32063 The State Personnel System is an E-Verify employer. For more ... . Requisition No: 772103 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST OPS - 60955422 Position Number: 60955422 Salary: $45.00… more
- MyFlorida (Chattahoochee, FL)
- REGISTERED NURSE SPECIALIST -F/C OPS - 60953529 Date: Jun 12, 2024 Location: CHATTAHOOCHEE, FL, US, 32324 The State Personnel System is an E-Verify employer. For ... No: 817418 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST -F/C OPS - 60953529 Pay Plan:...knowledgeable of and utilize the principles of Total Quality Management . The employee in this position spends a minimum… more
- Bon Secours Mercy Health (Richmond, VA)
- …Masters degree from an accredited school of Nursing. + Currently registered as a Clinical Nurse Specialist , licensed as a Nurse Practitioner or eligible to ... excellence. Job Description **Primary Function/General Purpose of Position** The Advanced Practice Nurse (APN) at St. Mary's Hospital is a professional nurse … more
- The Cigna Group (Mesa, AZ)
- **Summary** The Nurse Case Management Lead Analyst is an integral member of the Care Management department as part of Evernorth Care Group (ENCG) primary ... on the management of high- and rising-risk, disease burdened members. The Nurse Case Management Lead Analyst utilizes clinical skills to assess, plan,… more
- AdventHealth (Orlando, FL)
- …125,000 outpatients each year **The role you'll contribute:** **The Care Transitions Registered Nurse ensures that a care plan is carried out in partnership with the ... various other teams, including but not limited to Care Management nurses and social workers, nursing, home care liaisons,...high risk for readmission or for high emergency room utilization . Follows up with patients at location of post… more
- AdventHealth (Winter Park, FL)
- …AdventHealth Orthopaedic Institute **The role you'll contribute:** **The Care Transitions Registered Nurse ensures that a care plan is carried out in partnership ... various other teams, including but not limited to Care Management nurses and social workers, nursing, home care liaisons,...high risk for readmission or for high emergency room utilization . Follows up with patients at location of post… more
- Northwell Health (Manhasset, NY)
- …and transfer of patients to the facility. Job Responsibility + Promotes optimum utilization of hospital beds; conducts rounds and meets with staff regarding bed ... is complete, and ensures hand-off of communication to accepting nurse . + Ensures beds are assigned based on level...of technical experience and 0-2 years of leadership / management experience, required. + Care Escalation Experience is preferred… more
- Alameda Health System (San Leandro, CA)
- Care Management Clinical Appeals Specialist + San Leandro, CA + Finance + Patient Financial Svcs - Facil + Full Time - Day + Business Professional & IT + Req ... Resource Management issues, other issues including concerns involving under/over utilization , avoidable days and quality issues. 13. Responsible for all incoming… more
- LA Care Health Plan (Los Angeles, CA)
- …the coordination of member care with internal LA Care departments such as Care Management (CM), Utilization Management (UM), Managed Long Term Services and ... Enhanced Care Management Clinical Specialist II Job Category:... Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance Salary Range Disclaimer:… more