- 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...Nursing RN . **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred… more
- Munson Healthcare (Traverse City, MI)
- …families, interdisciplinary team members, payers and external case managers Why work as a Utilization Review Specialist at Munson Healthcare? + Our dynamic ... 5 years of start date. + Current licensure as Registered Nurse in the State of Michigan....+ Minimum of three years clinical experience required. Previous utilization review and/or case management in a… more
- Providence (Portland, OR)
- …the best people, we must empower them._** **Providence Health Plan is calling an Associate Utilization Review Specialist who will:** + Be responsible for all ... coding configuration + Critically assess and prepare all cases for RN /MD review of coverage (medical necessity, eligibility, network status, regulatory) + Uses… more
- Universal Health Services (Groton, CT)
- …Washington, DC, Puerto Rico and the United Kingdom. www.uhs.com Job Summary: The Utilization Review Specialist is responsible for the pre-certification, ... (UHS), has an immediate opening for a full-time UR Specialist . Stonington Institute is committed to providing quality substance...Degree in Psychology or related Human Service Field or RN . Knowledge of Utilization Review … more
- Bon Secours Mercy Health (Richmond, VA)
- …patient care) ACLS Advanced Cardiac Life Support (preferred) Medical-Surgical Nursing Certification RN -BC ( Registered Nurse - Board Certified) (preferred) ... * Weekly check-in with Nursing Professional Development Coordinator or Clinical Nurse Specialist * Ongoing educational opportunities, including quarterly… more
- AdventHealth (Hinsdale, IL)
- …resolution skills . Teamwork principles **EDUCATION AND EXPERIENCE REQUIRED:** . Associates Degree Nursing or RN Diploma degree . Registered Nurse ( RN ) . ... **LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** . State of Illinois registered nurse license **LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:**… more
- AdventHealth (Hinsdale, IL)
- …skills **.** Teamwork principles **EDUCATION AND EXPERIENCE REQUIRED:** . Associates Degree Nursing or RN Diploma degree . Registered Nurse ( RN ) . ... **LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** **.** State of Illinois registered nurse license **LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:**… more
- MyFlorida (Macclenny, FL)
- REGISTERED NURSE SPECIALIST OPS - 60955422 Date: Apr 4, 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 -...Nurse Practice Committee. Knowledge, skills and abilities, including utilization of equipment, required for the position: Ability to… more
- The Arora Group (Bethesda, MD)
- Registered Nurse Case Manager Nurse Currently recruiting a Registered Nurse ( RN ) Case Manager to work the Directorate of Healthcare Operations ... be provided one month in advance. DUTIES OF THE REGISTERED NURSE CASE MANAGER ( RN ):...Health Nurse (COHN) or Certified Occupational Health Nurse - Specialist (COHN-S). + National Board for Certification… more
- MyFlorida (Land O' Lakes, FL)
- …that all verbal orders, including telephone orders from attending physicians are received by a registered nurse . If no RN is available, receive all telephone ... SENIOR REGISTERED NURSE SUPERVISOR - 50000071 Date:...current status and providing supervision and guidance to the RN , LPN, CNA and other Allied Health Care Professionals.… more
- MyFlorida (Orlando, FL)
- …that all verbal orders, including telephone orders from attending physicians, are reviewed by a registered nurse . + If no RN is available, receive all ... resident's status, and providing supervision and guidance to the Registered ( RN ), Licensed Practical Nurse ...that the residents are receiving total nursing care. + Review shift assignments and ensure that the assignments reflect… more
- MyFlorida (Port Saint Lucie, FL)
- …that all verbal orders, including telephone orders from attending physicians, are reviewed by a registered nurse . + If no RN is available, receive all ... SENIOR REGISTERED NURSE SUPERVISOR Date: Apr 22,...current status and providing supervision and guidance to the RN , LPN, CNA, and other Allied Health Care Professionals.… more
- MyFlorida (Daytona Beach, FL)
- …that all verbal orders, including telephone orders from attending physicians are received by a registered nurse . + If no RN is available, receive all ... SENIOR REGISTERED NURSE SUPV - 50001660 Date:...current status and providing supervision and guidance to the RN , LPN, CNA and other Allied Health Care Professionals.… 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 Position ... that purpose. Job Summary The Utilization Management Nurse Specialist RN II will...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management/Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, ... Solution Center Appeals and Grievances (A&G) Nurse Specialist Registered Nurse ( RN...as assigned. Prepares resolved complaint files for CMS external review organization - Quality Improvement Organization (QIO) or Independent… more
- Louisiana Department of State Civil Service (Alexandria, LA)
- REGISTERED NURSE SUPERVISOR A Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4469636) Apply REGISTERED NURSE SUPERVISOR A Salary ... of subordinate nurses engaged in quality assurance, infection control, and utilization review activities. Receives physicians' instructions regarding patient… more
- Sanford Health (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
- Bassett Healthcare (Cooperstown, NY)
- …Best-In-State Employer 2022! What you'll do The Unit Clinical Care Coordinator Registered Nurse acts a principle liaison between emergency services, surgical ... services, nursing, finance, physicians, utilization review and medical records to ensure...for patient to receive IM letter; collaborates with UM Nurse as needed. Assists Clinical Documentation Specialist … more
- Amergis (Oakland, CA)
- …and referrals for psychosocial needs + Participates in Quality Assurance and Utilization Review activities, as directed + Empowers patients in decision-making ... The RN Case Manager is responsible for coordinating continuum...of care activities for assigned patients and ensuring optimum utilization of resources, service delivery, and compliance with medical… more
- Ascension Health (Indianapolis, IN)
- …process. + Serve as content specialist for staff in the areas of utilization criteria, appeal and review process, and case management system documentation. + ... with your Talent Advisor for additional specifics._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing… more