- Novo Nordisk Inc. (Charlotte, NC)
- …include key opinion leaders (KOL's), academic institutions, physicians, nurse practitioners, diabetes educators, pharmacists, blood bank staff, organized ... providers and IHNs; c) develops appropriate use of NNI products and greater utilization of its services d) supports and assists representatives and managers in… more
- Stanford Health Care (Palo Alto, CA)
- …development of their APPs. The Lead APP also functions under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered Nurse ... clinical competency and adherence to policy through practice analysis and case review of APPs with physicians. . Investigate and respond to patient/family complaints… more
- Stanford Health Care (Palo Alto, CA)
- …growth and development of their APPs. Also functions under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered ... clinical competency and adherence to policy through practice analysis and case review of APPs with physicians. + Investigate and respond to patient/family complaints… more
- Stony Brook University (Stony Brook, NY)
- …Department may include the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes UR ... cases for authorization for in patient stay. + Staff review short stay, long stay and complex cases to...patients who were readmitted within thirty days. Documents over utilization of resources and services. + All Medicare cases… more
- Stony Brook University (Stony Brook, NY)
- …as a healthcare provider in the state of New York (eg, physician, nurse practitioner, or registered physician assistant or equivalent). Five (5) years of full ... developing educational materials, and implementing best practices to enhance EMR utilization . Through collaboration with the CRAFT team, the Director continuously… more
- Access Dubuque (Dubuque, IA)
- …the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call . You will ... The Utilization Management Assistant answers first level calls in Utilization Review for HealthCheck360 participants. They will evaluate certification… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of ... this position is able to cover a multitude of utilization review functions through point of entry,...**LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure -… more
- Beth Israel Lahey Health (Burlington, MA)
- …the medical necessity of the hospital care. Using the concepts of utilization review , clinical documentation improvement and revenue integrity, these specialized ... necessity of the hospital care. Using the concepts of utilization review , clinical documentation improvement and revenue...exceed the base hourly rate depending on shift differentials, call pay, premium pay, overtime pay, and other additional… more
- CDPHP (Latham, NY)
- …who share these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review ... of acute care experience is required as a Registered Nurse . + Minimum of two (2) years Utilization...to provide excellent customer service. + Demonstrated ability to review health care delivery against established criteria. + Must… more
- CVS Health (Columbus, OH)
- …of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review , you'll play a vital role in ... phone, computer, etc. and clinical documentation systems. + 1+ Year of Utilization Review Management and/or Medical Management experience. + Commitment to… more
- Ventura County (Ventura, CA)
- …the general and specialized principles, practices, techniques and methods of utilization review /management, discharge planning or case management. + utilize ... Senior Registered Nurse - Hospital Management Utilization Print...risk and/or patient safety which are identified during case review or other activities; + Reviews, analyses & identifies… more
- UTMB Health (Webster, TX)
- Utilization Review Case Mgr - CMC - Clear Lake Center **Webster, Texas, United States** **New** Nursing & Care Management UTMB Health Requisition # 2506588 The ... or observation in Community Hospitals and UTMB-TDCJ Hospital. + Performs utilization review procedures by prospectively, concurrently, and retrospectively… more
- Providence (Olympia, WA)
- **Description** The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization ... + Bachelor's Degree Or Associate's Degree in Nursing + 3 years of Utilization Review , Care Management, Quality Management, and/or Discharge planning **Why Join… more
- BayCare Health System (Tampa, FL)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN responsibilities include:** + Functions ... time and onsite + **Weekend Requirement:** Occasional + **On Call :** No **Certifications and Licensures:** + Required RN (Registered...Nursing or Business **Experience:** + Required 2 years in Utilization Review or + Required 2 years… more
- Providence (Anaheim, CA)
- **Description** Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost effective ... **Required Qualifications:** + Nursing school graduate. + Upon hire: California Registered Nurse License + 3 years Experience in utilization management and/or… more
- CenterWell (Austin, TX)
- …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to… more
- Humana (Lincoln, NE)
- …Coordinator or discharge planner in an acute care setting + Previous experience in utilization management/ utilization review for a health plan or acute care ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...Plan experience + Previous Medicare/Medicaid Experience a plus + Call center or triage experience + Bilingual is a… more
- MTC (Graceville, FL)
- …medical team who are dedicated to improving people's lives. We are seeking an **On- Call Registered Nurse (RN)** to join our team. **Primary duties:** + Attend ... **Pay:** $42.00 hourly **Employment type** : On- call **Shift:** 7am - 7pm or 7pm-7am **ARE...forms as appropriate. + Practice basic cost containment and utilization management for inmate care and facility operations. +… more
- WellLife Network (South Richmond Hill, NY)
- …location and schedules are subject to change. 5. Attend certification inspections, utilization review and independent professional reviews as needed. 6. Attend ... medical pre-admission evaluations and screening of prospective clients. 2. Review and update persons with disabilities pre-admission evaluation within thirty… more
- Ventura County (Ventura, CA)
- …direction, the Senior Medical Management Nurse is responsible for performing utilization review , case management, and quality improvement functions to ensure ... Duties may include but are not limited to the following: + Performs utilization review with pre-certification, concurrent, retrospective, out of network and… more
