- BJC HealthCare (St. Louis, MO)
- … experience performing care for hospitalized patients. + 2 years of utilization review (UR) experience reviewing hospital admissions for medical necessity ... team. This is a great opportunity for a local remote position. **Schedule** PRN (As needed) + Shifts will...in St. Louis. + Have both Missouri and Illinois RN licenses. + If candidate only has one … more
- Ochsner Health (New Orleans, LA)
- …case management or utilization review . **Certifications** Required - Current registered nurse license in state of practice. Basic Life Support (BLS) from ... and implement discharge plans based on patient's individualized needs. Registered Nurse ( RN ) Case Manager...of the conditions of participation as it relates to utilization review and discharge planning. + Maintains… more
- CVS Health (Oklahoma City, OK)
- …contribute to improving the quality and effectiveness of healthcare services and benefit utilization . This position requires close review of both handwritten and ... and every day. **Position Summary** This is a **fully remote role** with a requirement to **reside in Oklahoma**...with a requirement to **reside in Oklahoma** . The nurse in this position uses clinical expertise in a… more
- AdventHealth (Altamonte Springs, FL)
- …injuries and rehabilitation is essential **LICENSURE, CERTIFICATION, OR REGISTRATION REQUIRED:** + Active Registered Nurse ( RN ) license in the state of ... **Location:** Remote **The role you'll contribute:** A Workers Comp Support Registered Nurse is responsible for providing telephonic medical case management… more
- CVS Health (Springfield, IL)
- …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... in a hospital setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- CVS Health (Topeka, KS)
- …care - Perform medical necessity reviews **Required Qualifications** - 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience in ... a hospital setting - A Registered Nurse that holds an active, unrestricted...lower levels of care - 1+ years' experience in Utilization Review - CCM and/or other URAC… more
- ChenMed (Winter Park, FL)
- …or RN with Bachelor's Degree in related field preferred. + Must be a Registered Nurse with over three (3) years of clinical experience. + Compact license ... to join our team. The Supervisor, Intensive Community Care, RN is a multi-market leadership position responsible for leading...of 2 years' onsite case management at ChenMed and/or utilization review or discharge planning in a… more
- Veterans Affairs, Veterans Health Administration (Anchorage, AK)
- Summary The Community Care (CC) Coordinator Registered Nurse ( RN ) is responsible for executing a streamlined approach to receiving, triaging, and directing ... visit https://www.va.gov/ohrm/QualificationStandards/. Preferred Experience: Three to five years of Registered Nurse Experience Case management experience Physical… more
- SSM Health (MO)
- …+ Bachelor's degree in nursing EXPERIENCE + Two years' registered nurse experience and three years' utilization management experience, with two years' ... business processes. + Ensures the quality and accuracy of Utilization Management (UM) review decisions, and the...Professional Regulation (IDFPR) State of Work Location: Missouri + Registered Nurse ( RN ) Issued by… more
- Saint Francis Health System (Tulsa, OK)
- …from ER, ICU, and CTU units. + All private rooms Job Summary: The Registered Nurse I assesses, plans, implements and evaluates nursing care, utilizing the ... therefrom. Licensure, Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License. Work Experience: 0 - 6 months related… more
- Option Care Health (Austin, TX)
- …and/or Experience Requirements:** + Graduate of an accredited school of nursing + Current Registered Nurse ( RN ) licensure in the state of practice + ... relate to telephonic nursing support and management. + Provide excellent communication to nurse colleagues regarding patients on service with review of current… more
- Children's Hospital Boston (Boston, MA)
- … Utilization Management) preferred. Licensure/ Certifications: + Current Massachusetts license as a Registered Nurse ( RN ) + A certification as a Certified ... 80451BRJob Posting Title:Per Diem RN Case Manager, Utilization Management/ReviewDepartment:Patient Services-Patient Care… more
- US Tech Solutions (Columbia, SC)
- **Duration: 3+ Months Contract (Possible Extension)** **Job Description:** + Must be an RN in SC and have an active and unrestricted SC RN license. + ... - M-F 8:30am - 5pm. + Onsite training for the first week. Remote once training is complete. + Experience: Hospital experience, UM experience. + Description:… more
- Catholic Health Initiatives (Omaha, NE)
- … Review experience.** Medical Coding experience is a plus! As our Utilization Review RN , you will be responsible for conducting comprehensive ... **Responsibilities** For remote employment - you must live within 2...Commonspirit Health Facility Are you a skilled and experienced Utilization Review Specialist looking for a rewarding… more
- CVS Health (Boise, ID)
- …without personal distractions to meet quality and metric expectations. **Required Qualifications** + Registered Nurse ( RN ) - active license. + 3+ Years ... heart, each and every day. This position will be remote working from home anywhere in the US. **Schedule...of clinical experience. + 1+ Year of Utilization Review Management and/or Medical Management experience.… more
- CVS Health (Phoenix, AZ)
- …+ Licensed Professional Counselor (LPC) + Licensed Marriage and Family Therapist (LMFT) + Registered Nurse ( RN ) + Associate-level licenses may be considered ... it all with heart, each and every day. **Location:** Remote (Arizona residents only) **Travel:** Occasional travel up to...and adolescents? Join Mercy Care as a Behavioral Health Utilization Management Clinician and become part of a mission-driven… more
- University of Rochester (Rochester, NY)
- …majority of work is remote with some on-site requirements as needed. Qualifications: RN with Utilization Review experience preferred; 3-5 years of recent ... of the individual, and internal equity considerations._ **Responsibilities:** The Utilization Management (UM) RN position spans the...Social Work, Patients, and various insurance companies. The UM RN is responsible for the review of… more
- Trinity Health (Silver Spring, MD)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Job Title:** RN Case Manager - Utilization Management **Employment Type:** Full Time ... Cross Hospital **Position Purpose:** As a Case Manager in Utilization Management, you will be the key to ensuring...care and address clinical documentation needs for accurate case review and status determination. + Oversee the continuity of… more
- Children's Mercy Kansas City (Kansas City, MO)
- …+ Experience in Utilization Review + One of the following: Licensed RN - MO, Registered Nurse Multistate License Missouri required upon hire + ... training oversight of programs and services. Responsible for effective utilization review and proper resource management of...One of the following: Licensed RN - Kansas, Registered Nurse … more
- Centene Corporation (San Antonio, TX)
- …Counselor required or + LMFT - Licensed Marital and Family Therapist required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure ... the Texas BHEC as an LPC, LCSW, or LMFT. Registered Nurse must have direct psychiatric/mental health...preferred. + Knowledge of mental health and substance abuse utilization review process is preferred. + Experience… more