- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring… more
- ERP International (Hurlburt Field, FL)
- **Overview** ERP International is seeking a full time ** Registered Nurse (RN) Case Manager ** in support of the 1st Special Operations Medical Group at ... Management Specialist (CDMS) Association of Rehabilitation Nurses: Certified Rehabilitation Registered Nurse (CRRN) American Board for Occupational Health… more
- ERP International (Twentynine Palms, CA)
- **Overview** ERP International is seeking ** Registered Nurse (RN) Case Managers** for full-time positions in support of the **Naval Hospital Twentynine Palms, ... Management Specialist (CDMS) o Association of Rehabilitation Nurses: Certified Rehabilitation Registered Nurse (CRRN) o American Board for Occupational Health… more
- ERP International (Tinker AFB, OK)
- **Overview** ERP International, LLC is seeking a ** Registered Nurse - Case Manager ** for a full-time position supporting **SHG Clinic** in support of ... Evaluation Unit (THMEU) in San Antonio, Tx. The Case Manager will be required to attend a 1 (one)...or pending adverse actions) to practice nursing as a registered nurse in any US state/jurisdiction. Security**… more
- Battelle Memorial Institute (Norfolk, VA)
- …two years' nursing experience + Current, full, active, and unrestricted license as a Registered Nurse in any US State, the District of Columbia, Guam, Puerto ... (HRA) business line is seeking a highly motivated, full-time ** Nurse Case Manager ** to join our team...professional parameters + Knowledge and skill in using pre-established utilization review criteria to recognize and report actual or… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …Master's degree in Nursing, Health Care Administration, or related field preferred. Current Registered Nurse licensure in the State of California and AHA CPR/BLS ... rewarding. **It's Work That Matters.** **Overview** **Purpose Statement/Position Summary:** The Nurse Care Manager performs complex discharge planning for… more
- Luke Staffing (Yigo, GU)
- …+ **Licensure:** Current, full, active, and unrestricted license to practice as a Practical OR Registered Nurse in any one of the 50 States, the District of ... ** NURSE - REFERRAL MANAGEMENT** **SITE OF SERVICE:** +...experience is required. One year of previous experience in Utilization Management is required. Full time employment in a… more
- Alameda Health System (Oakland, CA)
- …in Nursing preferred. Required License/Certifications: CCRN - Critical Care Registered Nurse is desirable. Required Licenses/CertificationsTPM: ACLS, TNCC, ... department). Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California....Nurse in the State of California. Trauma Program Manager (TPM) minimum experience: Four years as a trauma… more
- Stanford Health Care (Palo Alto, CA)
- …and outcomes of patient health care **Licenses and Certifications** + Nursing\RN - Registered Nurse - State Licensure And/Or Compact State Licensure required . ... include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient charts for timeliness… more
- Stanford Health Care (Palo Alto, CA)
- …and outcomes of patient health care **Licenses and Certifications** + Nursing\RN - Registered Nurse - State Licensure And/Or Compact State Licensure required ... include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient charts for timeliness… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- BlueCross BlueShield of Tennessee \(BCBST\) is seeking a skilled and compassionate Registered Nurse to join our fast\-paced, high\-performing team\. In this ... Medical Case Manager role, you will work exclusively on a single...job requires digital literacy assessment\. **Job Qualifications** _License_ + Registered Nurse \(RN\) with active license in… more
- Commonwealth Care Alliance (Boston, MA)
- …(must have): - Meaningful clinical experience including: - 3+ years' experience as a Registered Nurse in a high-touch clinical environment or home care, OR - ... member of Care Delivery Leadership, the Primary Care Nursing Manager is the nursing leader of the practice. Responsible...management team, shared accountability for reductions in acute care utilization - Attend team meetings and huddles to provide… more
- Prime Healthcare (Weslaco, TX)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/233537/ registered - nurse -case- manager ... Overview KNAPP MEDICAL CENTER IS LOOKING FOR A PRN REGISTERED NURSE CASE MANAGER TO WORK WEEKENDS. WE OFFER: + Competitive PRN Compensation + Medical… more
- Veterans Affairs, Veterans Health Administration (Middleton, WI)
- Summary The Revenue Utilization Review (RUR) nurse is under the supervision of the Nurse Manager and ANM. The RUR nurse is an active member of the ... equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion… more
- Beth Israel Lahey Health (Plymouth, MA)
- …the denial management, documentation, and appeals process. + Collaborates with UR Manager and/or physician advisor regarding cases that do not meet established ... years recent, broad clinical experience in the hospital setting + Experience with utilization management within the last 3 years required + An understanding of the… 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, observation progression...management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure --… more
- Corewell Health (Grand Rapids, MI)
- …experience clinical nursing and or case management/managed care or related field Preferred + Registered Nurse (RN) - State of Michigan Upon Hire required + Basic ... prior authorizations, initial reviews, continuous stay reviews and appeals. Nurse Care Manager - Plans and prioritizes care for individuals and population… more
- University of Utah Health (Salt Lake City, UT)
- …Review or Case Management experience. **Licenses Required** + Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 ... advancement, and overall patient outcomes. **Responsibilities** + Applies approved utilization criteria to monitor appropriateness of admissions with associated… more
- Saint Francis Health System (OK)
- …their placement in various levels of care and receipt of necessary services. The Utilization Management (UM) Registered Nurse will communicate with providers ... Nursing. Licensure, Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License. Work Experience: Minimum 2 years of… more
- WellSpan Health (Lebanon, PA)
- … Management, Case Management, or Clinical Nursing Specialty. Preferred **Licenses:** + Licensed Registered Nurse Upon Hire Required or + Registered ... Weekend rotation **General Summary** Performs a variety of duties and applies utilization and case management techniques to determine the most efficient use of… more
