- Beth Israel Lahey Health (Boston, MA)
- …other related duties as required and directed. **Qualifications:** _Required_ + Licensure as a Registered Nurse ( RN ), Massachusetts + Three years of recent ... high-level proficiency in navigating the Electronic Medical Record and applications related to utilization management . Compliance with the Code of Ethics and… more
- Beth Israel Lahey Health (Burlington, MA)
- …other related duties as required and directed. **Qualifications:** Required Licensure as a Registered Nurse ( RN ), Massachusetts Three years of recent ... high-level proficiency in navigating the Electronic Medical Record and applications related to utilization management . Compliance with the Code of Ethics and… more
- LA Care Health Plan (Los Angeles, CA)
- …Licensed Clinical Social Worker (LCSW); Current and unrestricted California License or Registered Nurse ( RN ); current and unrestrited California License. ... Enhanced Care Management Clinical Specialist II ( RN or... Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance Salary… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …mitigation strategies. Your Day to Day: + With minimal oversight, leads CMS utilization management related compliance activities including: + Identify and ... theory What You Bring: + Active and Unrestricted Massachusetts Registered Nurse license required + Bachelor's degree...+ 3-5 years' experience working with CMS Part C utilization management organization determination compliance … more
- Humana (Columbus, OH)
- …may include, but not be limited to, Pre-Certification, Care Management , Utilization Management , and/or Compliance . + Plans, coordinates, and implements ... caring community and help us put health first** The RN , Nursing Educator 2 plans, directs, coordinates, evaluates, develops,...-or- compact state license. + Over 1 year of Utilization Management (prior authorization) experience working in… more
- Centene Corporation (Sacramento, CA)
- …Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact ... align to goals and objectives + Develops, implements, and maintains compliance with utilization management policies and procedures + Reviews utilization… more
- Trinity Health (Hartford, CT)
- …**What you will do:** + Provide patient Centered Leadership while ensuring effective utilization management , compliance with Medicare requirements, and the ... Degree Preferred + **Licensure** : Current Licensure as a registered nurse ( RN ) in Connecticut...criteria, JCAHO and CMS requirements for discharge planning and utilization management **Position Highlights and Benefits** +… more
- Ascension Health (Pensacola, FL)
- …coordinate compliance to federally mandated and third party payer utilization management rules and regulations. **Requirements** Licensure / Certification / ... specifics._ **Responsibilities** Provide health care services regarding admissions, case management , discharge planning and utilization review. +...Registration: + Licensed Registered Nurse credentialed from the Florida Board… more
- Ventura County (Ventura, CA)
- … Nurse III - Hospital Case Management / Utilization Review Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4396275) Apply Per ... Diem Registered Nurse III - Hospital Case Management /...supervision commensurate with their experience. APPROXIMATE SALARY: Per Diem Registered Nurse III (PD RN … more
- Ascension Health (Southfield, MI)
- …coordinate compliance to federally mandated and third party payer utilization management rules and regulations. **Requirements** Licensure / Certification / ... specifics._ **Responsibilities** Provide health care services regarding admissions, case management , discharge planning and utilization review. +...Registration: + Registered Nurse credentialed from the Michigan Board… more
- Ascension Health (Wichita, KS)
- …coordinate compliance to federally mandated and third party payer utilization management rules and regulations. **Requirements** Licensure / Certification / ... specifics._ **Responsibilities** Provide health care services regarding admissions, case management , discharge planning and utilization review. +...Registration: + Licensed Registered Nurse credentialed from the Kansas Board… more
- Trinity Health (Springfield, MA)
- …our Care Coordination Department. Provide patient-centered leadership while ensuring effective utilization management , compliance with Medicare requirements, ... - Master's Degree Preferred + Current Licensure as a registered nurse ( RN ) in Massachusetts...criteria, JCAHO and CMS requirements for discharge planning and utilization management **Position Highlights and Benefits**… more
- RWJBarnabas Health (Livingston, NJ)
- Case Manager Registered Nurse ( RN ), Case...setting + Minimum of one year experience in Case Management / Utilization Management or Home Care ... Barnabas Medical Ctr, 94 Old Short Hills Road, Livingston, NJ 07039 The Case Manager Registered Nurse develops safe discharge plans in order to reduce length of… more
- Lancaster General Health (Lancaster, PA)
- …NCLEX within 60 days of starting in their RN role. + A graduate registered nurse may only practice professional nursing under supervision and if the graduate ... registered nurse holds a current temporary practice permit.... nurse is practicing. + All Clinical Nurse 1 RN 's will be required to successfully… more
- Lancaster General Health (Lancaster, PA)
- …NCLEX within 60 days of starting in their RN role. + A graduate registered nurse may only practice professional nursing under supervision and if the graduate ... that established outcomes are achieved through availability and appropriated utilization of human, material and financial resources. + Educates...area or unit where the graduate registered nurse is practicing. + For Magnet designated RN… more
- AdventHealth (Hinsdale, IL)
- …resolution skills . Teamwork principles **EDUCATION AND EXPERIENCE REQUIRED:** . Associates Degree Nursing or RN Diploma degree . Registered Nurse ( RN ) . ... documents avoidable days, and facilitates progression of care. . Collaborates with Utilization Management staff for collaboration on patient status changes and… more
- AdventHealth (Hinsdale, IL)
- …skills **.** Teamwork principles **EDUCATION AND EXPERIENCE REQUIRED:** . Associates Degree Nursing or RN Diploma degree . Registered Nurse ( RN ) . ... documents avoidable days, and facilitates progression of care. **.** Collaborates with Utilization Management staff for collaboration on patient status changes… more
- CommonSpirit Health Mountain Region (West Jordan, UT)
- …resources to help you flourish and leaders who care about your success. As a Registered Nurse , RN Case Manager you'll advocate for patients while ... discretion, and independent judgment in assessing/reassessing, facilitating care coordination, utilization management , and patient advocacy. + Assure medical… more
- Lancaster General Health (Lancaster, PA)
- …NCLEX within 60 days of starting in their RN role. + A graduate registered nurse may only practice professional nursing under supervision and if the graduate ... that established outcomes are achieved through availability and appropriated utilization of human, material and financial resources. + Educates...area or unit where the graduate registered nurse is practicing. + For Magnet designated RN… more
- Banner Health (Mesa, AZ)
- …people the tools they need to perform at their best. As a Medical/Surgical Float Registered Nurse RN you will provide patient care throughout the facility ... culture. Clinical Care Operations is the hub of patient management for the campus, including: bed assignment, unit staffing...care setting within the past 12 months as a Registered Nurse in the specialty area. Banner… more