- Fallon Health (Worcester, MA)
- …more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn. The UM Nurse uses a multidisciplinary approach to organize, coordinate, monitor, ... on selected complex medical and psychosocial needs of FH members and their families. The UM Nurse is responsible for assuring the receipt of high quality, cost… more
- CVS Health (Carson City, NV)
- …required 3 weeks training required 100% participation during 8:30am-5pm EST Monday-Friday As a UM Nurse Consultant you will work in a clinical telephone queue ... Qualifications + 5+ years of clinical experience required + RN with current unrestricted state licensure in state of...Care experience + Remote work experience Education Associate degree RN required, BSN preferred Pay Range The typical pay… more
- YesCare Corp (Brentwood, TN)
- …internet, medical records and other proprietary company/client systems. + Certificates and Licenses: Registered Nurse ( RN ) active license + Language Ability: ... development, implementation, evaluation and reporting. + Work with other UM inpatient and outpatient nurse reviewers to...Work with other UM inpatient and outpatient nurse reviewers to assure proper treatment in the appropriate… more
- Ventura County (Ventura, CA)
- …care services to County employees and their covered dependents. The Senior Registered Nurse -Ambulatory Care series is distinguished from other nursing ... Medical Management Nurse Senior- UM , CM/DM, &/or QA (Updated)...of supervision commensurate with their experience. PAYROLL TITLE: Senior Registered Nurse - Ambulatory Care AGENCY/DEPARTMENT: Health… more
- CVS Health (Springfield, IL)
- …Required Qualifications - 3+ years of experience as an RN (MED-SURG, ER, ICU) - 1+ years of inpatient hospital ... experience - Must have active current and unrestricted RN licensure in state of residence - Must have...Knowledge of Medicare/Medicaid - Managed care (MCO) experience - UM , and Concurrent review experience - UM /CM/MCG… more
- CVS Health (Salem, OR)
- …years demonstrated ability to make thorough, independent decisions using clinical judgement. A Registered Nurse that must hold an unrestricted license in their ... will occasionally be required.Required Qualifications 1 year of varied UM (utilization management) experience within an inpatient/outpatient setting, concurrent… more
- CVS Health (Montgomery, AL)
- …management function. Required Qualifications3+ years of acute care clinical experience as RN RN with current unrestricted state licensure in state of ... high volume clinical call center environment Remote work experience Education Associate degree RN required, BSN preferred Pay Range The typical pay range for this… more
- CVS Health (Columbus, OH)
- …Review Management and/or Medical Management experience. -Must have active and unrestricted RN license in the state you reside. -5 years demonstrated to make ... thorough independent decisions using clinical judgement -5 Years proficient use of equipment experience including phone, computer, etc and clinical documentation systems -Required to attend all classes the first 3 weeks of initial training required with 100%… more
- Humana (Columbus, OH)
- …update training for UM nurses. + Develops programs to improve UM nurse competencies (critical thinking skills, interpreting criteria, communication with ... part of our caring community and help us put health first** The RN , Nursing Educator 2 plans, directs, coordinates, evaluates, develops, delivers training and… more
- AdventHealth (Tampa, FL)
- …a Primary Stroke Center. **The role you'll contribute:** The role of the Utilization Management ( UM ) Registered Nurse ( RN ) is to use clinical expertise ... hospital admission, treatment, and appropriate level of care. The UM RN leverages the algorithmic logic of.... Current and valid license to practice as a Registered Nurse (ADN or BSN) required. .… more
- Molina Healthcare (Bronx, NY)
- …based on the severity of illness and the site of service. **We are seeking a Registered Nurse with UM and Inpatient Review experience. The Care Review ... acute care/medical experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. Must… 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 ... admission order and validates status and level of care matches order. Collaborates with UM Nurse to assure that all payor and status requirements are aligned… more
- CVS Health (Columbus, OH)
- …management function. Required Qualifications + 3+ years of experience as a Registered Nurse + Must hold active and unrestricted RN licensure in state of ... pm EST. Holiday rotation 1-2 per year. Position Summary CCR - Duals UM Nurse Consultant Utilizes clinical experience and skills in a collaborative process to… more
- CVS Health (Springfield, IL)
- …am- 6:00 pm in EST zone with rotating weekends and holidays. CCR - Duals UM Nurse Consultant Utilizes clinical experience and skills in a collaborative process ... personal, convenient and affordable. Position Summary This Utilization Management ( UM ) Nurse Consultant role is fully remote...Required Qualifications - 3+ years of experience as an RN - 1+ years of inpatient hospital experience -… more
- CVS Health (Plantation, FL)
- …highly preferred + Compact RN License or license in multiple states + UM Nurse Consultant experience + Experience with overseas access to care + Working ... EST No nights, no weekends, and no holidays. The UM Nurse Consultant job duties include (not...diverse cultural dynamics of clinical staff and patients. Education Registered Nurse : Diploma, Associates degree in Nursing… more
- CVS Health (Harrisburg, PA)
- …and state regulated turn-around times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all encompassing): - ... health care more personal, convenient and affordable. Position Summary: This Utilization Management ( UM ) Nurse Consultant role is 100% remote and the candidate… more
- CVS Health (Columbus, OH)
- …and motivated team environment and is detail oriented and highly organized. The UM Nurse Consultant reviews services to assure medical necessity, applies ... employee can live in any state. As a Utilization Nurse Consultant you will utilize clinical skills to coordinate,...member.Required Qualifications- Must have an active, current and unrestricted RN licensure in state of residence - Minimum of… more
- Elevance Health (Chicago, IL)
- …for payment as part of consideration for employment. **Director of Medical Mgmt, Post Acute Care UM ** + Job Family: MED > Licensed Nurse + Type: Full time + Date ... the ideal Director is also a certified wound care nurse . _Position can work 1 day a week from...which would provide an equivalent background. Current active unrestricted RN license to practice as a health professional within… more
- Humana (Oklahoma City, OK)
- …an impact** **Required Qualifications:** + Must Reside in Oklahoma + An active Licensed Registered Nurse ( RN ), a licensed Master's Level Social Worker (LCSW, ... to helping people achieve their best health. The Utilization Management ( UM ) Nurse 2 uses clinical nursing skills to support the coordination, documentation,… more
- UPMC (Erie, PA)
- …+ Basic Life Support (BLS) OR Cardiopulmonary Resuscitation (CPR) + Driver's License + Registered Nurse ( RN ) OR Temporary Practice Permit (TPP) + Act ... UPMC Home Health is hiring a Hospice Registered Nurse to join its team...of care in collaboration with the physician, patient and UM Professional in accordance with the physician orders and… more