- Surgery Partners (Bryan, TX)
- Job Summary: We are seeking a Part-Time Utilization Review Nurse to join our dedicated healthcare team. In this role, you will play a critical part in ... must be worn. Qualifications, Knowledge & Ability: Current Registered Nurse (RN) license in the state of practice Experience...(RN) license in the state of practice Experience in utilization review , acute hospital case management, or… 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 ... services. Discover more about us at www.amerihealthcaritas.com. Join a mission-driven Utilization Management team where your clinical expertise helps shape better… more
- Medical Solutions (Omaha, NE)
- …is seeking its next amazing RN (Registered Nurse ) to work in Case Management ( Utilization Review ). Read on if this sounds like your perfect fit! Nurses and ... allied healthcare professionals are in high demand nationwide, and our team of industry-leading, traveler-favorite recruiters can get you where you want to go - personally and professionally. Wherever you may roam, travel healthcare helps you hone your skills… more
- HEALTH FIRST CAREERS (Melbourne, FL)
- Job Requirements POSITION SUMMARY The Utilization Review (UR) nurse performs medical necessity reviews on all payer admissions to determine appropriate ... information that relates to insurance reimbursement in appropriate reviews. The UR Nurse utilizes advanced clinical skills to facilitate the provision of care… 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
- Geisinger (Wilkes Barre, PA)
- Job Title: RN - Graduate Registered Nurse (Geisinger Wyoming Valley, Wilkes-Barre) Location: Wilkes-Barre, Pennsylvania Job Category: Inpatient RN - Registered ... Nurse , Nursing and Nursing Support Schedule: Rotation Work Type:...focused on the specialized practice setting Free Princeton NCLEX Review Questions (on-line, self paced)! Temporary Practice Permit (TPP)… more
- Geisinger (Scranton, PA)
- Job Title: RN - Graduate Registered Nurse (Geisinger Community Medical Center, Scranton) Location: Scranton, Pennsylvania Job Category: Inpatient RN - Registered ... Nurse , Nursing and Nursing Support Schedule: Rotation Work Type:...focused on the specialized practice setting Free Princeton NCLEX Review Questions (on-line, self paced)! Temporary Practice Permit reimbursement… more
- Fort Duncan Regional Medical Center (Eagle Pass, TX)
- …department budget, staffing, and training needs. Function as Utilization Review /Denials Manager as required. Qualifications Registered Nurse (RN) with a ... review , and transitions to prevent readmissions. Liaise with medical staff, utilization review , social services, payors, and community providers. Track and… more
- Wellstar Health System (Austell, GA)
- …participate in interdisciplinary rounds, and patient/family educationCollaborates effectively with the utilization review nurse , patient's physicians and the ... the patient's needs, manage the length of stay and promote efficient utilization of resources. Overall, the role integrates and coordinates care facilitation, care… more
- Boston Childrens Hospital (Boston, MA)
- Job Posting Description Department Summary: The UM Case Managers at Boston Children's review documentation within 1 business day of patient admission to assess for ... of payer denials. They identify and implement initiatives to manage utilization trends, collaborating with the hospital's discharge planning case managers,… more
- Mount Sinai Hospital (New York, NY)
- Job Description Job Title: Nurse Practitioner-Rheumatology - Mount Sinai Hospital-Full Time - Day A nurse practitioner (NP) as described in Title VIII, Article ... nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and...to the plan of care. Performs a patient record review with the collaborating physician in a timely fashion… more
- Valley Health System (Paramus, NJ)
- POSITION SUMMARY: Performs concurrent utilization review activities on all patients within the assigned caseload. Collaborates and educates the medical staff on ... appropriate utilization review guidelines and documentation in accordance...clinical nursing, minimum of 3 years in case management/ utilization . SPECIAL SKILLS: Registered Nurse , Licensed in… more
- Kaiser Permanente (Los Angeles, CA)
- …the general and specialized principles, practices, techniques and methods of Utilization review /management, discharge planning or case management. Working ... during case review or other activities. Reviews, analyses and identifies utilization patterns and trends, problems or inappropriate utilization of resources… more
- Mindful Care (Hoboken, NJ)
- We are seeking Board Certified Psychiatric Mental Health Nurse Practitioners (PMHNP) to expand access to behavioral health care in your area. If you're passionate ... by the American Nurses Credentialing Center (ANCC) or the American Association of Nurse Practitioners (AANP) as a PMHNP-BC is necessary-new graduates may apply, but… more
- Software Placement Group (White Plains, NY)
- …health team members. Document activities as per department requirements and perform utilization review activities per department policy. Contribute to department ... Registered Nurse Care Manager The role of the RN...in progress for those hired after 1/1/18. Active Registered Nurse (RN) license in NYS. PRI Certification or obtained… more
- Kaiser Permanente (Sacramento, CA)
- …Experience Minimum three (3) years of home care nursing experience or quality utilization review experience. Education Bachelors degree in nursing or related ... Job Summary: Coordinates quality, utilization and risk management activities for the Home...of important aspects of patient care through ongoing chart review with pre-established criteria. Reports all occurrences which may… more
- Northwestern Memorial Healthcare (Lake Forest, IL)
- …our employees. Ready to join our quest for better? Job Description The Registered Nurse BSN embodies the attributes of the Relationship Based Care model and performs ... values of NM, adheres to the State of Illinois Nurse Practice Act, the organization's Code of Ethics and...regular basis, and through participation in clinical case peer review . Works collaboratively with all hospital services to responsibly… more
- Tenet Health (Glendale, AZ)
- …and staffing Assists the physician as follows, but not limited to Utilization Review , Quality Assurance, Program Evaluation, Infection Control, Safety Committee ... of nursing: Master's degree in nursing; completion of a state acceptable Nurse Practitioner's program Certification : Advanced Nurse Practitioner license to… more
- AdventHealth (Altamonte Springs, FL)
- …to nurses, physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge Planning and care ... (as permitted by the patient) as well as a review of the current and past inpatient and outpatient...avoidable days, and facilitates progression of care. Collaborates with Utilization Management staff for collaboration on patient status changes… more
- LHC Group, Inc. (Trumbull, CT)
- Job Description The Registered Nurse in Home Health provides and directs provisions of nursing care to patients in their homes as prescribed by the physician and in ... compliance with applicable laws, regulations, and agency policies. The Registered Nurse coordinates total plan of care with other health care professionals involved… more
