- Glens Falls Hospital (Glens Falls, NY)
- …30 hours per week, can be foundhere. **Job:** **Nursing - Case Management * **Title:** * Registered Nurse - Utilization Review Nurse - Care ... timely and accurate information to payers. The role integrates and coordinates utilization management and denial prevention by focusing on identifying and… more
- ERP International (Tinker AFB, OK)
- **Overview** ERP International, LLC is seeking a ** Registered Nurse - Utilization Managment** for a full-time position supporting **Medical Managment** in ... may include but are not limited to** : Provides Utilization Management activities and functions by using...or pending adverse actions) to practice nursing as a registered nurse in any US state/jurisdiction. Security**… more
- McLaren Health Care (Detroit, MI)
- **Department: Utilization Management ** **Daily Work Times: 7:00am-3:30pm** **Shift: Days** **Scheduled Bi-Weekly Hours: 40** **Position Summary:** Responsible ... Assigned:** 1. Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure...projects as needed. _Required:_ + State licensure as a registered nurse (RN) + Bachelor's degree in… more
- Prime Healthcare (Weslaco, TX)
- …#patientrentry #patienttreatmentplan Connect With Us! (https://careers-primehealthcare.icims.com/jobs/156984/ registered - nurse -case-manager utilization - ... Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC\_KnowYourRights\_screen\_reader\_10\_20.pdf Responsibilities Responsible for the quality and resource management of all patients that are admitted to the… more
- Trinity Health (Albany, NY)
- …NY** is looking for an experienced RN to work as a Registered Professional Utilization Management Nurse (UMRN) full time evenings. M-F 8hr shifts The ... **The selected candidate will** : + Be responsible for the utilization management , both concurrent and retroactive for inpatient and outpatient services in… more
- Dignity Health (Northridge, CA)
- …required. + Current CA Registered Nurse (RN) license + Prior Utilization Management experience in a clinical or insurance setting required. + Previous ... 400 care centers. Visit dignityhealth.org/northridgehospital for more information. The RN Utilization Management Coordinator (UMC) is responsible for assessing… more
- Actalent (San Diego, CA)
- …admission status and patient classification. Skills: case management , acute care, registered nurse , utilization management , Care management ... service, Rn license Shift: 9PM - 7AM Top Skills Details: case management ,acute care, registered nurse , utilization management Additional Skills &… more
- Actalent (San Diego, CA)
- …admission status and patient classification. Skills: case management , acute care, registered nurse , utilization management , Care management ... care coordination for patients under the direction of a Registered Nurse and in compliance with evidence-based...for case management scope of services including: Utilization Management supporting medical necessity and denial… more
- Trinity Health (Hartford, CT)
- …provide that care efficiently to control costs. **What you will do:** + As a ** Utilization Management Registered Nurse RN** you will conduct prospective, ... Connecticut Joint Replacement Institute, and the Smilow Cancer Hospital. **Keywords: Case Management ; Case Manager; Registered Nurse ; RN; BSN; Connecticut**… more
- AdventHealth (Daytona Beach, FL)
- …Daytona Beach, FL 32117 **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse (RN) is to use clinical expertise by ... standards. **The value you'll bring to the team:** The Utilization Management Nurse is accountable...qualifications** : o Associate and 3 years experience o Registered Nurse o Current and valid license… more
- CommonSpirit Health Mountain Region (West Jordan, UT)
- …to help you flourish and leaders who care about your success. As a Registered Nurse , RN Case Manager you'll advocate for patients while collaborating closely ... discretion, and independent judgment in assessing/reassessing, facilitating care coordination, utilization management , and patient advocacy. + Assure medical… 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 ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse (RN) - Active, current and… more
- Kepro (Indianapolis, IN)
- …partner for health solutions in the public sector. Acentra is currently looking for a Utilization Management Appeals Nurse - LPN/RN to join our growing team. ... Job Summary: Our Utilization Management Appeals Nurse -...applicable to the position assignment. Required Qualifications/Experience: + Active Registered Nurse (RN) or Licensed Practical … more
- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) with compact license with… more
- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in KY, IN, MI,… more
- Humana (Columbus, OH)
- …and help us put health first** Humana Healthy Horizons in Ohio is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to support ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (Dublin, OH)
- …caring community and help us put health first** Humana Healthy Horizons is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (Carson City, NV)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the states of… more
- CVS Health (Columbus, OH)
- …and deliver solutions to make health care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote ... external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications + 3+...Required Qualifications + 3+ years of experience as a Registered Nurse + Must hold active and… more
- CVS Health (Plantation, FL)
- …clinical setting with diverse cultural dynamics of clinical staff and patients. Education Registered Nurse : Diploma, Associates degree in Nursing or greater. Pay ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. -Utilizes clinical experience and skills in a… more