- CVS Health (Springfield, IL)
- …to make health care more personal, convenient and affordable. Position Summary This Utilization Management (UM) Nurse Consultant role is fully remote ... Managed care experience - UM Certification - MedCompass - 1+ year(s) of inpatient utilization experience Education Associates Degree required BSN preferred Pay… more
- Veterans Affairs, Veterans Health Administration (Roseburg, OR)
- …outcomes and External Peer Review Program (EPRP) metrics. Acts as the Utilization Management nurse for the inpatient acute psychiatric unit. Serves as an ... focus on older adults and mental health. Acts as the Utilization Management (UM) nurse for the inpatient acute psychiatric unit. Tracks quality data for… more
- Adecco US, Inc. (Dallas, TX)
- **Join Our Team as a Utilization Management Nurse !** **Experience Required:** + Five years inpatient clinical nursing experience in an acute care ... hospital setting + Minimum of two years Utilization Management acute care setting experience + Minimum of one year drafting and submitting reconsiderations and… more
- Adecco US, Inc. (Dallas, TX)
- …a team player is a must! The Utilization Management Nurse will provide precertification of inpatient hospitalizations and all outpatient procedures and ... courses of outpatient. The nurse will use clinical judgement, utilization management , application of product benefits, understanding of regulatory… more
- Ventura County (Ventura, CA)
- …Registered 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 /...the patient does not meet the medical necessity for Inpatient hospitalization; interacts with the family, patient and other… more
- ERP International (Tinker AFB, OK)
- …and Tasks: Duties may include but are not limited to** : Provides Utilization Management activities and functions by using MTF-specific Quality Improvement ... **Overview** ERP International, LLC is seeking a **Registered Nurse - Utilization Managment** for a...and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case… more
- EM Key Solutions, Inc. (Eglin AFB, FL)
- …EM Key Solutions is seeking Registered Nurse (RN) for a full-time Utilization Review / Management position supporting the Medical Maintenance Team at Eglin ... Eglin AFB, FL, USA | Full Time Registered Nurse - Utilization Manager Onsite Position...to the following: + Develops and implements a comprehensive Utilization Management plan/program in accordance with the… more
- EM Key Solutions, Inc. (Eglin AFB, FL)
- …EM Key Solutions is seeking a Registered Nurse (RN) for a full-time Utilization Review / Management position supporting the Medical Maintenance Team at Eglin ... AFB, FL, USA | Hourly | Full Time Registered Nurse - Utilization Manager Location: Eglin Hospital...to, the following: + Develops and implements a comprehensive Utilization Management plan/program in accordance with the… more
- Trinity Health (Albany, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Title:** Nurse Senior_ Utilization Management Lead **Shift** : M-F 8hr days/Hybrid (2 ... responsible for upholding and developing standardized processes around, Utilization Management , both concurrent and retrospective for both Inpatient and… more
- Indian Health Service (Red Lake, MN)
- Summary This position is a Supervisory Nurse ( Inpatient ) located at the PHS Hospital Facility in Red Lake, MN. The Clinic and Emergency Room provide ambulatory ... and qualities improved plans, methods, procedures, documentation, and follow-up with maximum utilization of staff and resources. Maintains current inpatient care… more
- WellSpan Health (Mount Gretna, PA)
- Care Nurse Coordinator RN - Child Adolescent Inpatient - Days / Evenings Location: WellSpan Philhaven, Mount Gretna, PA Schedule: PRN/Per Diem Sign-On Bonus ... Performs a variety of duties to facilitate quality clinical care within the Inpatient Child/Adolescent and Adult Psychiatric Units. Supports bedside staff in day to… 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...of referral determination. Actively monitors for admissions in any inpatient setting. Performs telephonic and/or on site admission and… 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 ... as Assigned:** 1. Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure that appropriate… 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Bassett Healthcare (Cooperstown, NY)
- …Employer 2022! What you'll do The Assistant Nurse Manager, Acute Care - Inpatient Surgical Unit provides management assistance on an assigned shift and is ... Manager. Completes Performance Appraisals for selected unit staff, as observed by the Nurse Manager. Engages in timely communication with management team and… more
- The Mount Sinai Health System (New York, NY)
- **Job Title: Nurse Practitioner- Inpatient Oncology - FT - Nights** A nurse practitioner (NP) as described in Title VIII, Article 139 section 6910 of the New ... clinical nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and prescribe for… 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 ... + Managed care experience + UM Certification + MedCompass + 1+ year(s) of inpatient utilization experience Education + Minimum of an Associate's Degree in… more
- Lancaster General Health (Lancaster, PA)
- …maintaining quality patient care. + Coordinates care across the continuum ( inpatient /outpatient/community) to assure appropriate utilization of clinical and ... Medicine Lancaster General Health is recruiting for a full-time inpatient Case Manager to join a team of dedicated...+ Bachelor's degree in Nursing (BSN). + Knowledge of utilization review or managed care. + Care management… more
- Martin's Point Health Care (Portland, ME)
- … required; BSN preferred. + 3+ (total) years clinical nursing experience + Utilization management experience in a managed care or hospital environment required ... "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member...medical outcomes for those enrollees with a need for inpatient / outpatient authorizations. This position receives and reviews prior… more
- Beth Israel Lahey Health (Burlington, MA)
- …Functions and Responsibilities:** Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure that ... payer certification, and denied cases. Monitors effectiveness/outcomes of the utilization management program, identifying and applying appropriate metrics,… more