- State of Florida (Orlando, FL)
- …all verbal orders, including telephone orders from attending physicians, are reviewed by a registered nurse . If no RN is available, receive all telephone ... resident's status, and providing supervision and guidance to the Registered ( RN ), Licensed Practical Nurse ...and that the residents are receiving total nursing care. Review shift assignments and ensure that the assignments reflect… more
- South Shore Health (Weymouth, MA)
- …Care or Emergency Department experience highly desirable Required Licenses / Registrations RN - Registered Nurse Required Certifications ACM-Accredited Case ... as a clinical resource to support the Case Manager Specialist in resource utilization and discharge planning...American Heart Association (AHA) (Including courses offered through SSH), RN - Registered Nurse - Board of… more
- NYC Health Hospitals (New York, NY)
- …1. Valid New York State license and current registration to practice as a Registered Professional Nurse ( RN ) issued by the New York State Education ... State license and current registration to practice as a Nurse Practitioner (NP) issuedby the NYSED; and two (2)...Medical Graduate; and, two (2) years of medical records review or utilization and case management experience;… more
- University of Maryland Medical System (Baltimore, MD)
- …Qualifications Education and Experience Masters of Science (MS/MSN) as Clinical Nurse Specialist is required. Licensure as a Registered Nurse in the ... delivery of health care, interpretation of clinical issues, and utilization of the nursing process. Initiates and serves as...and serves as a catalyst in the development and review of standards of care and practice and clinical… more
- Regency Integrated Health Services (Austin, TX)
- …Nursing Center - Austin, TX Position Type Full Time Job Category Nurse Description Primary Responsibilities Responsible for the coordination of the Resident ... and benefit period through regular communications with Regional Care Management Specialist , Business Office and external Case Managers. Gathers information needed… more
- Deaconess (Evansville, IN)
- …improve the quality of documentation by all caregivers. Required: Certifications/Licenses/Experience: Active Registered Nurse ( RN ) in Indiana and Kentucky or ... collaboratively with other departments including Coding, Quality, Compliance, Medical Staff, Utilization Review /Case Management, Medical Records and any other… more
- Generis Tek, Inc. (Mauston, WI)
- …to $93,000.00 Shift Timing : Nights (7:00pm to 7:30am) Position Summary: The Registered Nurse position provides quality, professional, general nursing care to ... this amazing opportunity, reach out to our Talent Acquisition Specialist Aditya Khandelwal at email address ###@generistek.com can be...be reached on # ###. We have Permanent role RN Med/Surg for our client at Mauston, WI. Please… more
- Roper St Francis Healthcare (Summerville, SC)
- …for Primary Charge Nurse I. Experience: At least 2 years' experience as a registered nurse in a direct care patient setting for Primary Charge Nurse ... role. Licensure/Certification: Applicant must be currently licensed as a Registered Nurse in South Carolina or hold...to run effective shift safety huddles, report safety concerns, review device utilization , report staffing concerns, and… more
- Georgia Department of Community Health (Atlanta, GA)
- …federal rules and regulations. Develops, implements and evaluates the surveillance of utilization review process to ensure quality services. Monitors, tracks, ... or any licensed healthcare facility Experience as as a Registered Nurse /LPN, or licensed professional in a...field of mental health or Drug Treatment. Experience in utilization review and/or quality assurance in a… more
- Acadia Healthcare (Wilmington, NC)
- …Bachelor of Science in Nursing from an accredited university. Licensed as a registered nurse in NC. Current certification as a Certified Diabetes Care ... treatment plan is completed upon admission. Demonstrate knowledge and utilization of universal precautions in providing direct patient care....& Education Specialist (CDCES) 1 year experience as a CDCES in… more
- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse ( RN ) who comprehensively ... this position is able to cover a multitude of utilization review functions through point of entry,...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
- Hunterdon Health Care System (Flemington, NJ)
- Position Summary The Utilization Review Specialist monitors adherence to the hospital's utilization review plan to ensure the effective and efficient ... an applicable health insurance plan. Primary Position Responsibilities 1. Performs utilization activities, using Milliman Care Guidelines under the guidance of the… more
- BriteLife Recovery (Englewood, NJ)
- What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is ... responsible for overseeing and coordinating all aspects of utilization review and insurance authorization for clients receiving substance use disorder (SUD)… more
- HonorHealth (AZ)
- …different here -- because it does. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors ... 1 year experience in UR/UM or Case Management Required Licenses and Certifications Registered Nurse ( RN ) State And/Or Compact State Licensure Required more
- Nuvance Health (Danbury, CT)
- …other duties as required. Education: ASSOCIATE'S LVL DGRE Required: 3 Years of Utilization Review experience(or a certification ACMA, MCG, Interqual) Required : ... one weekend per month Summary: The purpose of the Utilization Management Nurse is to support the...CT Registered Nurse License Working Conditions: Manual: significant… more
- Catholic Health Initiatives (Omaha, NE)
- …2 hours of a Commonspirit Health Facility Are you a skilled and experienced Utilization Review Specialist looking for a rewarding opportunity to impact ... Review experience.** Medical Coding experience is a plus! As our Utilization Review RN , you will be responsible for conducting comprehensive reviews of… more
- Amergis (Rancho Cordova, CA)
- …Utilization Management. Apply today to learn more about the current opportunities! The Utilization Review Specialist is responsible for theassessment and ... + Current license for the state in which the nurse practicesif nursing licensure is required by contract +...Degree in Nursing or at least two years'experience in Utilization Review preferred + Certification in … more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services ... healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence...regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse -… more
- Commonwealth Care Alliance (Boston, MA)
- …for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for conducting centralized ... reviews). * Hire, train and mentor UM staff, including nurse reviewers and support personnel. * Act as liaison...Skills & Abilities (must have): * Expertise in managing utilization review processes including prior authorization, concurrent… more
- Children's Mercy Kansas City (Kansas City, MO)
- …Oversees and directs the work of Nurse Case Managers, Social Workers, and Utilization Review specialist team members and support staff + Analyzes, ... and related software applications and implementations. + Engages in utilization review committee. Qualifications + Master's Degree...Performance Improvement Leadership + One of the following: Licensed RN - MO, Registered Nurse … more
