• Kern Health Systems (Bakersfield, CA)
    …to property, and to individual safety. EDUCATION, EXPERIENCE & TRAINING REQUIRED: Registered Nurse with an active, current, unrestricted license Minimum of ... and Administrative Director of Health Services, the Utilization Management Nurse , RN , is responsible for clinical review...two years (2) full -time clinical experience in acute care, community health setting,… more
    ZipRecruiter (09/03/18)
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  • Kern Health Systems (Bakersfield, CA)
    …KHS Medical Director and Administrative Director of Health Services the Utilization Management Nurse RN is responsible for clinical review for members receiving ... Job Description We are seeking a Utilization Management RN to join our team You will be...property and to individual safety EDUCATION EXPERIENCE TRAINING REQUIRED Registered Nurse with an active current unrestricted… more
    Geebo.com (09/23/18)
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  • UnitedHealth Group (Rancho Cucamonga, CA)
    …are required to pass a drug test before beginning employment. Job Keywords: RN , LVN, UM, Registered nurse , utilization management, Referral, Authorization, ... health care system. NAMM California develops and manages provider networks, offering a full range of services to assist physicians and other providers in supporting… more
    Neuvoo (09/21/18)
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  • Kern Health Systems (Bakersfield, CA)
    …Possession of a valid California RN nursing license and five (5) years of full -time experience as a registered nurse in an acute care hospital, or ... the Administrative Director of Health Services, the UM Outpatient Clinical Supervisor RN is responsible for supervising the functions and activities for all… more
    ZipRecruiter (09/21/18)
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  • KARNA (Greenbelt, MD)
    …preferably in a clinical discipline Minimum five (5) years of relevant experience Registered nurse ( RN ) Experience with claims review, hospital experience ... 2018-1951 US-MD-Greenbelt Category Public Health Type Full -Time/Regular Overview This position is for a medical...and responding to provider appeals. Responsibilities Medical claims review nurse ( registered nurse ) on the… more
    KARNA (09/13/18)
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  • Sentara Healthcare (Virginia Beach, VA)
    …- 3 years Preferred: None, unless noted in the "Other" section below LicenseRequired: Registered Nurse Preferred: None, unless noted in the "Other" section below ... section below OtherCPC within 1 year of eligibility. If RN candidate is not BSN prepared must be willing...will not be considered. Optima Health is hiring a Registered Nurse for the Clinical Claims Reviewer… more
    Washington Post (09/03/18)
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  • NCI Inc. (Grove City, OH)
    …payment, and state-specific policy requirements for health care coverage and payment; and Must be a Registered Nurse ( RN ) in one or more of the 50 states of ... Nursing A minimum ofsix (6) years experience practicing nursing as a licensed Registered Nurse ; A minimum ofsix (6) years experience in a supervisory/managerial… more
    ZipRecruiter (09/19/18)
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  • Karna (Greenbelt, MD)
    …BA BS preferably in a clinical discipline Minimum five years of relevant experience Registered nurse RN Experience with claims review hospital experience ... US MD Greenbelt Category Public Health Type Full Time Regular Overview This position is for...and responding to provider appeals Responsibilities Medical claims review nurse registered nurse on the… more
    Geebo.com (09/13/18)
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  • UnitedHealth Group (San Antonio, TX)
    …may be substituted in lieu of a bachelor s degree). Active and unrestricted Registered Nurse license in Texas 5 or more years of management-level utilization ... of Utilization Management is responsible to the Medical Management Committee for the full range of endeavors required to ensure that all functions of the UM… more
    Jobs2Careers (09/20/18)
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  • RN Case Manager ( Registered

    Blue Cross Blue Shield of Massachusetts (Quincy, MA)
    …your true colors to blue. BCBSMA is seeking a caring, compassionate and driven RN Care Manager!The Case Manager focuses on arranging and coordinating services that a ... + Social work experience, a plus + Active MA RN License, required; Multi-state licenses, preferred + Bilingual, a...eligibility on BCBSMA's benefit and bonus performance plans + Full support, training and engagement from a dedicated, dynamic… more
    Blue Cross Blue Shield of Massachusetts (09/09/18)
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  • ( RN ) Nurse Case Manager…

    Cigna (Pittsburgh, PA)
    …to the work described herein\. **Qualifications:** **Minimum requirements:** + Active unrestricted Registered Nurse \( RN \) license in state or territory ... Monday\- Friday 11:00 am\- 7:30 pm\.** **Position Scope:** The RN Case Manager will use techniques such as motivational...business need as required by Cigna\. + Two years full \-time equivalent of direct clinical care to the consumer… more
    Cigna (08/29/18)
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  • Lead Disability Claims Nurse ( RN )

    Exl Service (Tampa, FL)
    …MS Word, Excel, PowerPoint, Share Point, etc. Education: Associate Degree in Nursing Registered Nurse with current, valid unrestricted licensure in the state of ... Opportunities + Opportunities for Upward Mobility As a Lead Disability Claims Nurse , you will perform the medical retrieval, summarization and low complexity … more
    Exl Service (09/13/18)
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  • RN -Network Performance Improvement…

    Blue Cross Blue Shield of Michigan (Detroit, MI)
    ## Description **BLUE CARE NETWORK OF MICHIGAN** ** REGISTERED NURSE ** **NETWORK PERFORMANCE IMPROVEMENT CONSULTANT ( RN )** **PROVIDER AFFAIRS CONTRACTING ... MI** **Blue Care Network of Michigan is seeking an RN who will provide analysis and sharing of clinical...focus. Other duties, projects as assigned. ## Qualifications * Registered nurse with unrestricted current Michigan license… more
    Blue Cross Blue Shield of Michigan (07/03/18)
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  • Clinical Auditor/Analyst ( RN ) - Evolent…

    UPMC (Pittsburgh, PA)
    …Audit teams) To understand issues, identify solutions and facilitate resolution. **Qualifications** + Registered Nurse ( RN ) + Bachelor of Science in Nursing ... Word). **Licensure, Certifications, and Clearances:** + CPC Designation preferred + Registered Nurse **UPMC is an equal opportunity employer.… more
    UPMC (09/21/18)
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  • Clinical Nurse Coder

    Premera Blue Cross (Mountlake Terrace, WA)
    …and functional business relationships **What you'll bring:** The typical incumbent is a current Registered Nurse ( RN ) in Washington State, has three (3) ... clinical coding expertise AND also be either an: * Registered Nurse ( RN ) with three... Coder *Job ID:* 11614 *Location:* Mountlake Terrace, WA * Full /Part Time:* Full -Time *Regular/Temporary:* Regular Equal employment… more
    Premera Blue Cross (07/04/18)
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  • Nurse Medical Case Manager - Workers…

    Travelers (Walnut Creek, CA)
    …Use of Keyboards, Sporadic 10-Key (Continuously) Driving (Occasionally) **Minimum Qualifications:** Registered Nurse ; Licensed Practical Nurse or Licensed ... for our employees. You will find Travelers to be full of energy and a workplace in which you...Specialist (CDMS), Clinical Research Counselor (CRC), or Certified Rehab Registered Nurse (CRRN) preferred. **Primary Location:** Rancho… more
    Travelers (08/10/18)
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  • Telephonic Care Manager ( RN ) - Job Share

    UPMC (Pittsburgh, PA)
    …+ Case management certification or approved clinical certification preferred + Registered Nurse **UPMC is an equal opportunity employer. ... you will establish together with leadership and the incumbent nurse holding the other half of the job share.UPMC...the job share.UPMC job share employees are afforded with full -time benefits coverage. The Telephonic Care Manager is responsible… more
    UPMC (09/16/18)
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  • Telephonic Care Manager ( RN ) - Bilingual

    UPMC (Pittsburgh, PA)
    …+ Case management certification or approved clinical certification preferred + Registered Nurse **UPMC is an equal opportunity employer. ... **Description** The UPMC Health Plan is currently hiring full -time Bilingual Telephonic Care Managers to support the Medical Management Special Needs Plan (SNP)… more
    UPMC (09/19/18)
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  • Clinical Care Manager ( RN ) - Transition…

    UPMC (Butler, PA)
    …Act 73 FBI Clearance + Automotive Insurance + Driver's License + Registered Nurse **UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals ... may be a great fit for you! UPMC Health Plan is hiring a full -time Clinical Care Manager supporting our Medical Management group's onsite presence at Butler Memorial… more
    UPMC (09/09/18)
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  • Clinical Care Manager ( RN ) - Practice…

    UPMC (Pittsburgh, PA)
    …Life Support or Cardio Pulmonary Resuscitation + Driver's License + Registered Nurse **UPMC is an equal opportunity employer. ... for? This could be a perfect chance! UPMC Health Plan is hiring a full -time Clinical Care Manager to support our partnership with various physician practices. This… more
    UPMC (09/01/18)
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