- Trinity Health (Fresno, CA)
- **Employment Type:** Full time **Shift:** **Description:** **Are you an experience RN Manager , Utilization Review of Acute Care seeking your next ... adventure?** **Duration:** 13-week Assignment The Interim Utilization Management , RN Manager is responsible...Utilization Management will ensure the timely delivery of utilization review , discharge planning and support case… more
- CommonSpirit Health Mountain Region (West Jordan, UT)
- …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 with ... them maintain and build on positive outcomes. In the role of RN Case Manager , you will also: + Utilize clinical expertise, discretion, and independent judgment in… more
- Providence (Medford, OR)
- …based on population focus. Duties also include complex discharge planning and utilization review . The Nurse Case Manager must be competent to analyze ... **Description** The RN Case Manager is an expert professional registered nurse...year home health, mental health, substance use, hospice, and/or utilization review + Progressive nursing leadership experience,… more
- Beth Israel Lahey Health (Burlington, MA)
- …Shift:** Day (United States of America) Joint role of Case Manager and Utilization Review Nurse Hospital at Home Full Time Days 8:00am-4:30pm potential ... and varying other shifts **Job Description:** The Inpatient Registered Nurse (RN) Case Manager for Hospital at...Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality… more
- Lowe's (Mooresville, NC)
- …Degree in Nursing and 3 years of Experience as a Case Manager or Utilization Review Nurse in worker's compensation + Associate's Degree + Experience in ... **Job Summary** The Lowe's Care Nurse position is a telephonic medical case management...Clinical experience + 3 Years of Experience required with Nurse Case Management Software, along with Microsoft Office Unrestricted… more
- EM Key Solutions, Inc. (Eglin AFB, FL)
- Eglin AFB, FL, USA | Full Time Registered Nurse - Utilization Manager Onsite Position EM Key Solutions is seeking Registered Nurse (RN) for a full-time ... + Monitors active duty, reserve/guard admissions to civilian hospitals and notifies Utilization Manager and Patient Administration Element as required. + Serves… more
- EM Key Solutions, Inc. (Eglin AFB, FL)
- Eglin AFB, FL, USA | Hourly | Full Time Registered Nurse - Utilization Manager Location: Eglin Hospital at Eglin AFB, Fort Walton Beach, FL. Position Type- ... a Registered Nurse (RN) for a full-time Utilization Review / Management position supporting the...duty and reserve/guard admissions to civilian hospitals and notifies Utilization Manager and Patient Administration Element as… more
- University of Utah Health (Salt Lake City, UT)
- …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** + ... of InterQual Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of CMS Regulations. **Working… more
- Milford Regional Medical Center (Milford, MA)
- …services to our community with dignity, compassion, and respect. Statement of Purpose: The Utilization Review Nurse is responsible for utilization ... Minimum of 1 year Nurse Case Management experience Minimum of 1 year Utilization Review Nurse Experience including solid working knowledge with InterQual… more
- Glens Falls Hospital (Glens Falls, NY)
- …be foundhere. **Job:** **Nursing - Case Management* **Title:** *Registered Nurse - Utilization Review Nurse - Care Management (Sign-On Bonus for ... timely and accurate information to payers. The role integrates and coordinates utilization management and denial prevention by focusing on identifying and removing… more
- ERP International (Tinker AFB, OK)
- …of the plan and continually evaluates the impact of implementation. Incorporates applicable utilization review tasks to ensure patients receive the right care, ... Case Management Society of America (CMSA); American Accreditation Healthcare Commission/ Utilization Review Accreditation Commission (URAC); Comprehensive Accreditation… more
- Children's Mercy Kansas City (Kansas City, MO)
- …improve the lives of children beyond the walls of our hospital. Overview The Manager of Utilization Review will provide leadership to integrated inpatient ... MCG screening guidelines, and oversight of clinical denials/appeals. The Manager of Utilization Review participates...One of the following: Licensed RN - MO, Registered Nurse Multistate License Missouri required upon hire. RNs who… 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 Type: ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will...setting. Performs telephonic and/or on site admission and concurrent review , and collaborates with on site staff, physicians, providers,… more
- Commonwealth Care Alliance (Boston, MA)
- …clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA ... **Why This Role is Important to Us:** The Nurse Utilization Management (UM) Reviewer is...is responsible for day-to-day timely clinical and service authorization review for medical necessity and decision-making. The Utilization… more
- Cedars-Sinai (Los Angeles, CA)
- **Job Description** **Job Summary: Key Job Responsibilities** The Utilization Review Case Manager validates the patient's placement to be at the most ... follows the UR process as defined in the Utilization Review Plan in accordance with the...Coordination **Req ID** : 1261 **Working Title** : Registered Nurse - Utilization Management - 8 Hour… more
- Prime Healthcare (Weslaco, TX)
- …#patientrentry #patienttreatmentplan Connect With Us! (https://careers-primehealthcare.icims.com/jobs/156984/registered- nurse -case- manager utilization ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...intensity of service and severity of illness. RN Case Manager a plus Qualifications Education and Work Experience Required… more
- Catholic Health (Lockport, NY)
- …and Holiday Rotation Hours: 8:00a-4:00p, 9:00a-5:00p, 10:00a-6:00p, 11:00a-7:00p Summary: The RN Care Manager , Utilization Review / Transitions of Care, as an ... the Care Management and interdisciplinary care team, provides comprehensive Utilization Review and transitions of care services...review experience in the role of a Care Manager or Disease Manager , Population Health ,… more
- Providence (Missoula, MT)
- **Description** **Care Manager RN in Utilization Review Unit at Providence St. Patrick Hospital Missoula, MT** The Nurse Case Manager (NCM) is ... Schedule:** Part time **Job Shift:** Variable **Career Track:** Nursing **Department:** 3500 UTILIZATION REVIEW **Address:** MT Missoula 500 W Broadway **Work… more
- Trinity Health (Fresno, CA)
- …responsible for management, leadership, and coordination of the departments of the Utilization Manager Team to ensure payor reimbursement for services rendered ... the healing mission of Saint Agnes Medical Center. The Manager Utilization Management will ensure the timely...Utilization Management will ensure the timely delivery of utilization review , discharge planning and support case… more
- Billings Clinic (Billings, MT)
- …starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Utilization Review RN CARE MANAGEMENT ... loan reimbursement Under the direction of department leadership, the Utilization Review / Management RN. This position is...*Priority 5: Escalation *Refers cases that require second level review to Physician Advisor, Manager , and Director… more