- SR International, Inc. (Phoenix, AZ)
- …their own laptop SOAZ - Posting ID # 5297 - Medical Review Nurse (Local Only/Mostly Remote /Onsite Trainings) Skills Required: *Medical nursing practice, medical ... times for training once starting position Compliance Items: Active RN License in state of Arizona Fingerprint Clearance Card...case management protocols, quality management and … more
- CVS Health (Albany, NY)
- …do it all with heart, each and every day. **Position Summary** This is a fulltime remote Utilization Management opportunity for RNs with a **New York** state ... Friday, 8:30am - 5pm EST. This role is a registered nurse that utilizes MCG rules and...unrestricted New York state licensure + 1+ year of Utilization review experience + 1+ year of clinical experience… more
- Cognizant (Carson City, NV)
- …have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with ... **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Molina Healthcare (GA)
- …experience. * At least 1 year of health care management /leadership experience. * Registered Nurse ( RN ), Licensed Vocational Nurse (LVN), Licensed ... skills. * Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications * Registered Nurse ( RN ). License must be active and… more
- CVS Health (Little Rock, AR)
- …members. **Position Summary** The Associate Manager is responsible for oversight of Utilization Management staff. This position is responsible for the ... needed. + 3+ years inpatient clinical experience as a Registered Nurse . + 3+ years of Managed...years of Managed Care experience. + 3+ years of Utilization Management experience. + 1+ year Leadership… more
- Molina Healthcare (GA)
- …and experience. * At least 3 years health care management /leadership required. * Registered Nurse ( RN ), Licensed Vocational Nurse (LVN), Licensed ... skills. * Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications * Registered Nurse ( RN ). License must be active and… more
- Humana (Little Rock, AR)
- …and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to support ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse ( RN ) in a… more
- Actalent (Santa Barbara, CA)
- …Nurse Coordinator - REMOTE POSITION Non-profit healthcare network is looking for a utilization management registered nurse to join their team on a ... 3-month contract + Medi-Cal Experience + Utilization Management WHAT'S IN IT FOR YOU: + Remote...Health Plan Nurse Coordinator (HPNC) is a Registered Nurse assigned to one of several… more
- CareFirst (Baltimore, MD)
- …experience is required in addition to the required work experience. **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or Compact ... **Resp & Qualifications** **PURPOSE:** Utilizing key principles of utilization management , the Utilization ...State Licensure Upon Hire Required + CNS-Clinical Nurse Specialist Preferred **Experience:** 5 years Clinical nursing experience.… more
- Actalent (San Antonio, TX)
- …and appropriate setting of care. Qualifications: + 2+ Years of Utilization Management Experience is Mandatory + Active Compact RN License is Mandatory If ... Urgent Hiring for " Remote Clinical Review RN " Job Description: + Perform concurrent reviews to assess member's overall health. + Review the type of care being… more
- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in… more
- ERP International (Vandenberg AFB, CA)
- **Overview** ERP International is seeking a full-time ** Registered Nurse ( RN ) Utilization Management ** for a temporary contract position in support ... AFB, CA (https://www.airforcemedicine.af.mil/MTF/Vandenberg/About-Us/) . **NOTE: This is NOT a Tele-Health/ Remote Practice Opportunity.** **Be the Best!** Join our team… more
- Ascension Health (Baltimore, MD)
- **Details** + **Department:** Utilization Management + **Schedule:** Hybrid work schedule available; 1 week remote , 1 week onsite rotating; Monday-Friday, ... and coordinate compliance to federally mandated and third party payer utilization management rules and regulations. **Requirements** Licensure / Certification… more
- AccentCare, Inc. (Middlebury, CT)
- …Hospice Location: Middlebury, CT Position: Admissions Registered Nurse / RN , Hospice Position Type: Part Time Remote /Virtual Position: No Coverage Area: ... Overview Admissions Registered Nurse / RN ,...and external partners, ensuring timely updates, interventions, and resource utilization + Provide patient and caregiver education, document care… more
- Ochsner Health (New Orleans, LA)
- …discharge plans based on patient's individualized needs. Registered Nurse ( RN ) Case Manager - Case Management OMC Jefferson Highway PRN To perform ... experience in discharge planning, case management or utilization review. **Certifications** Required - Current registered ...or utilization review. **Certifications** Required - Current registered nurse license in state of practice.… more
- Geisinger (Danville, PA)
- …Specialty Training Program-Nursing (Required) Experience Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania; ... Job Summary Please note this is NOT a remote position. Geisinger is proud to offer an Inpatient RN a $41.00 minimum hiring rate with increased rates for… more
- Geisinger (Danville, PA)
- …(Required), Bachelor's Degree-Nursing (Preferred) Experience Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania; ... Job Summary Geisinger is proud to offer a full time Inpatient RN up to $24,000 hiring incentive for eligible candidates! $41.00 minimum hiring rate with increased… more
- CVS Health (Denver, CO)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital… more
- ChenMed (Miami, FL)
- …We're rapidly expanding and we need great people to join our team. The Registered Nurse , Remote Triage, is responsible for providing telephonic triage ... and assessments within license and as possible given technology and medium. The registered nurse collaborates with primary caregivers and others on the… more
- University of Michigan (Ann Arbor, MI)
- …data, educating patients on symptom management , triaging patient virtually. The Registered Nurse will also observe, interpret patient symptoms and report to ... REGISTERED NURSE (PACS- Patient Monitoring at...Nurse Recruitment at ###. **Required Qualifications + Current RN license in the state of Michigan + Two… more
