- Riverside County, CA (Moreno Valley, CA)
- … System -Medical Center is seeking an Assistant Director of Case Management and Utilization Review to join our UR Case Management Department located in Moreno ... nurse or supervisory experience working as a registered nurse in an accredited acute care...acute care hospital. Professional experience in case management and utilization review in a hospital is preferred.… more
- EvergreenHealth (Kirkland, WA)
- …provides intervention to facilitate patient care in an optimal timeline. Oversees utilization review process including education, support, and training of team ... for equipment, and arrange for additional services in the community. Utilization Management/Case Management Nurses provide clinical information to our payers and… more
- Lifepoint Health (Louisburg, NC)
- Description Registered Nurse ( RN ) Utilization Review Job Type: Full Time | Day Your experience matters At Maria Parham Hospital, we are driven by a ... as an employee but as a person. As a registered nurse ( RN ) joining our...the responsibilities involved in monitoring adherence to the hospital's utilization review plan, which ensures the appropriate… more
- American Traveler (Washington, DC)
- American Traveler is seeking an experienced RN Case Manager with a DC license and case management or utilization management background for a day shift position. ... rotation according to clinical experience and facility policy, Job Requirements *Active DC RN license required at time of consideration, *Minimum 2 years of recent… more
- AmeriHealth Caritas Health Plan (Philadelphia, PA)
- …judgment, and meaningful collaboration. Lead with Clinical Insight. Whether you're an experienced utilization review nurse , a sharp case manager, or a ... for Medical Director review as needed. We're Hiring for: General UM ( RN ): Mon-Fri, 8 AM-5:30 PM. Occasional evenings/weekends based on need. Pediatric Shift Care… more
- Valley Health System (Paramus, NJ)
- …5 years experience in clinical nursing, minimum of 3 years in case management/ utilization . SPECIAL SKILLS: Registered Nurse , Licensed in State of New ... POSITION SUMMARY: Performs concurrent utilization review activities on all patients...work environment, Ability to work collaboratively within the health- system with patients and families; and with multidisciplinary team… more
- Fort Duncan Regional Medical Center (Eagle Pass, TX)
- …needs. Function as Utilization Review /Denials Manager as required. Qualifications Registered Nurse ( RN ) with a Texas license; relevant certification ... (CCM, ACM, CCM- RN ) preferred. Proven leadership experience in acute care, utilization review , case management. Strong working knowledge of hospital billing,… more
- Geisinger (Wilkes Barre, PA)
- Job Title: RN - Graduate Registered Nurse (Geisinger Wyoming Valley, Wilkes-Barre) Location: Wilkes-Barre, Pennsylvania Job Category: Inpatient RN - ... Summary Geisinger is proud to offer a Graduate Inpatient RN up to $21,000 hiring incentive for eligible candidates!...entire first year as a GN! Job Description: The Registered Nurse assesses plans, organizes, performs, and… more
- Geisinger (Scranton, PA)
- Job Title: RN - Graduate Registered Nurse (Geisinger Community Medical Center, Scranton) Location: Scranton, Pennsylvania Job Category: Inpatient RN - ... from Specialty Training Program-Nursing (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania; Basic… more
- Franciscan Missionaries of Our Lady Health System (Baton Rouge, LA)
- …retrospective case review and reporting quality issues identified during the utilization review process to department leaders. b. Notifies physicians of need ... Graduated from an accredited school of nursing ADN or BSN Licensure: Registered Nurse (Active Louisiana, Mississippi, multistate/compact or APRN) required more
- Corewell Health (Royal Oak, MI)
- …care management, utilization review , home care and/or discharge planning. Preferred Registered Nurse ( RN ) - State of Michigan License Upon Hire ... patients. 1. Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). 2.… more
- US Tech Solutions (Schenectady, NY)
- …and implementation of QM Work Plan Activities Experience: 3+ years of experience as an RN Registered Nurse in state of residence Must have prior ... Prior Authorization? Do you have experience with Utilization Review ? Do you have an Active Registered Nurse License? About US Tech Solutions: US Tech… more
- Team Select Home Care (West Palm Beach, FL)
- …more heart, more flexibility, and more purpose? Join Team Select Home Care as a Registered Nurse ( RN ), where you'll bring comfort and confidence to families ... and start your next chapter with Team Select! A Registered Nurse ( RN ) administers skilled...EMS Plan and the Compliance Plan Participates in clinical record/ utilization review of medical records and quality… more
- Sutter Health (Burlingame, CA)
- …: EDUCATION: Graduate of an accredited school of nursing CERTIFICATION & LICENSURE: RN - Registered Nurse of California Upon Hire CCM certification preferred ... and case management within a managed care environment. Comprehensive knowledge of Utilization Review , levels of care, and observation status. Awareness of… more
- Advocate Aurora Health (Kenosha, WI)
- …progression of care and transitions. Documents discharge planning interventions and utilization review activity per department and medical center standards ... information is developed further in the departmental job standards. License/Registration/Certification: Registered Nurse License issued by the state in which… more
- Children's Mercy KC (Kansas City, MO)
- …and directs the work of Nurse Case Managers, Social Workers, and Utilization Review specialist team members and support staff Analyzes, evaluates, and ... tools and related software applications and implementations. Engages in utilization review committee. Qualifications Master's Degree MSN...and Performance Improvement Leadership One of the following: Licensed RN - MO, Registered Nurse … more
- MedStar Health (Baltimore, MD)
- …and retrospective denial of payments for services provided. Collaborates with physicians, Utilization Review RN 's, Case Managers, revenue cycle personnel ... Candidates with previous Utilization Review or Denials/Appeals experience preferred...years background/experience in hospital audits preferred Licenses and Certifications RN - Registered Nurse -… more
- Doylestown Hospital (Doylestown, PA)
- …skills. Strong organizational and prioritizing skills. Thorough understanding of managed care systems and utilization review criteria. Knowledge of community ... education, experience and other skills. Disciplines to consider are Registered Nurse , Master Level Social Worker and...Recent experience in a hospital, insurance company, or independent review company in utilization , quality review… more
- eTeam, Inc. (White Plains, NY)
- …in an acute care setting Strong knowledge of discharge planning, utilization review , and insurance coordination Excellent communication, critical thinking, ... Job Title: RN Case Manager - 13-Week Contract Location: White...with regulatory and facility standards. Ensure timely and efficient utilization of services while advocating for the patient's best… more
- Esse Health (St. Louis, MO)
- …for keeping patients healthier. Esse Health is currently seeking a full-time Care Manager - Registered Nurse . The RN Care Manager is an integral member of ... activities comply with all applicable federal and state regulations. Preferred Qualifications: Registered Nurse with active licenses in Missouri and Illinois… more
