- Veterans Affairs, Veterans Health Administration (Gainesville, FL)
- Summary The Utilization Management (UM) Registered Nurse ( RN ) is responsible for UM reviews for patients who receive hospital care. Responsibilities An ... UM Registered Nurse is responsible for UM reviews...InterQual coupled with reference to InterQual citations and other point of care resources. Reviews medical records and accurately… more
- Bon Secours Mercy Health (Richmond, VA)
- …stewardship to create an environment where associates want to work and help communities thrive. ** Registered Nurse ( RN ) - Clinical Nurse Educator - ... model into care delivery **EMPLOYMENT QUALIFICATIONS:** Must be currently licensed as a Registered Nurse in the State of Virginia or awaiting reciprocity.… more
- Bassett Healthcare (Cooperstown, NY)
- …needs. The RN contributes to the support of patients through interdisciplinary teamwork. Registered Nurse I: The RN I status is only appropriate for ... after hire. Salary Range: $39.01 - $58.51 per hour Registered Nurse II: The RN ...chart review as per probationary appraisal schedule ( RN I only) Performs and documents Point … 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 ... the State of Practice and organization policies and procedures; serves as point of contact for patients' care coordination throughout hospital departments. Acts as… more
- Bassett Healthcare (Cooperstown, NY)
- …random preceptor and supervisory chart review as per probationary appraisal schedule. ( RN I only) Performs and documents Point of Care (POC) testing and ... of safe patient care utilizing the nursing process. The RN assesses, plans, delivers, coordinates, integrates, and evaluates nursing...or less than one year of experience as an Registered Nurse , required License/ Certification: NYS licensure… more
- AdventHealth (Clearwater, FL)
- …care needs in this senior population. AdventHealth Senior Care is looking for a Registered Nurse to be responsible for achieving and leading a high-quality care ... to increase quality, increase patient satisfaction and reduce unnecessary utilization of health care resources. AdventHealth Senior Care is...for the member throughout the health care system. The Registered Nurse serves as an advocate for… more
- HCA Healthcare (Houston, TX)
- …Hospital we support our colleagues in their positions. Join our Team as a(an) Registered Nurse Quality Coordinator and access programs to assist with every stage ... and more affordable to gain certifications and job skills. Apply today for our Registered Nurse Quality Coordinator opening and continue to learn! **Job Summary… more
- McLaren Health Care (Lansing, MI)
- …other related duties as required and directed. _Required_ + State licensure as a Registered Nurse ( RN ) + Bachelor's degree in nursing from accredited ... Identifies unsigned level of care (LOC) orders; communicates with utilization management nurse and obtains orders from...with providers and identifies which family member is the point of contact. 6. Assesses risk of readmission for… more
- Martin's Point Health Care (Portland, ME)
- …certified as a "Great Place to Work" since 2015. Position Summary Job Description The Utilization Review Nurse works as is responsible for ensuring the ... for retrospective authorization requests as well as claims disputes.The Utilization Review Nurse will use...Nurse Education/Experience: + Unrestricted state license as a Registered Nurse BSN required + 3+ years… 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
- CVS Health (Doral, FL)
- …all with heart, each and every day. **Position Summary** The Care Manager RN is responsible for driving and supporting care management and care coordination ... care (assessing, planning, implementing, coordinating, monitoring, and evaluating). The CM RN utilizes advanced clinical judgment and critical thinking skills to… more
- Veterans Affairs, Veterans Health Administration (Aurora, CO)
- …basis until positions are filled. This Vacancy Announcement may be removed at any point during the open period. The SCI RN Administers medications and procedures ... Summary The Spinal Cord Injury (SCI) RN is responsible and accountable for all elements...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- CVS Health (Chicago, IL)
- …we do it all with heart, each and every day. **Position Summary** The RN Case Manager is responsible for coordinating all case management activities with members to ... through integration. + Through the use of clinical tools and information/data review , conducts comprehensive assessments of member's needs and recommends an approach… more
- The County of Los Angeles (Los Angeles, CA)
- …Considerable ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience ... OPTION II: Two (2) years of experience as a registered nurse , of which one year must...the County of Los Angeles, a Utilization Review Nurse is an RN … more
- Sanford Health (Sioux Falls, SD)
- …for Nursing Commission for Nursing Education Accreditation (NLN CNEA). Currently holds an unencumbered registered nurse ( RN ) license with the State Board of ... level of care medical necessity reviews within patient's medical records. Performs utilization management (UM) activities in accordance with UM plan to assure… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse ( RN ) who comprehensively conducts point of ... in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
- Prime Healthcare (Montclair, CA)
- …experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum 5 ... patients that are admitted to the facility from the point of their admission and across the continuum of...to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,… more
- Baystate Health (Springfield, MA)
- …DIVERSE LOCATIONS. **Education:** Bachelors Degree in Nursing (Required) **Certifications:** Certified Registered Nurse - OtherOther, Registered Nurse ... strongly preferred + Requires a working knowledge of community resources and Utilization /Quality Review standards. + Understanding of the hospitals patient… more
- Guthrie (Binghamton, NY)
- …or, a Bachelor of Arts (BA) degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant experience willing to pursue a BSN or ... of hire. Individual consideration may be given to a registered nurse , with significant clinical experience, who...in an acute care setting with strong care management, utilization review , and payer knowledge. A Case… more
- Catholic Health Initiatives (Bismarck, ND)
- **Responsibilities** Empowering Recovery: Registered Nurse ( RN ) - Partial Hospitalization Program (PHP) **Are you a compassionate and skilled Registered ... with family members, community resources, and other healthcare professionals. *Conducts utilization review : Act as a liaison with insurance companies… more