- Houston Methodist (Houston, TX)
- …intensive. This position has achieved an expert level at all objectives delineated in the Utilization Review Nurse and Utilization Review Specialist ... At Houston Methodist, the Sr Utilization Review Specialist Nurse ...to effectively communicate with patients, physicians, family members and co- workers in a manner consistent with a customer service… more
- Lawrence General Hospital (Lawrence, MA)
- …and facilitates appropriate discharge plans. + Works in conjunction with Utilization Review Nurse , Social Worker and Clinical Care Leader to ensure ... As the Complex Care Nurse Manager provides evidence-based assessments, tools, information, and...setting with discharge planning, continuing care, care management, and utilization review . + Five years clinical nursing… more
- University of Utah Health (Salt Lake City, UT)
- …reporting of time and attendance of direct reports. + Functions as Case Manager and/or Utilization Review Nurse as necessary. + Tracks and analyzes Case ... Manager quality of service and utilization statistics. + Works collaboratively with information systems personnel...Required** + Current license to practice as a Registered Nurse in the State of Utah, or obtain one… more
- Ochsner Health (New Orleans, LA)
- …hospital-based experience in discharge planning, case management or utilization review . **Certifications** Required - Current registered nurse license in ... implement discharge plans based on patient's individualized needs. Registered Nurse (RN) Case Manager - Case Management OMC Jefferson...of the conditions of participation as it relates to utilization review and discharge planning. + Maintains… more
- ERP International (Barksdale AFB, LA)
- **Overview** ERP International is seeking a ** Utilization Management Registered Nurse (RN)** for a full-time position supporting the 2d Medical Group, Barksdale ... identification of types ofhealthcare services for which preauthorization or concurrent review will be required.Reviews previous and present medical care practices as… more
- Centene Corporation (Springfield, IL)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... either central or eastern time zone with experience in mental health settings and utilization management / review . * Department: PHCO BH UM supporting IL… more
- Centene Corporation (Tallahassee, FL)
- …assess ABA Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with providers and healthcare ... behavioral analytics (ABA). Additional Details: * Department: Behavioral Health Utilization Management * Business Unit: Corporate / Florida *...teams to review care services related to Applied Behavior Analysis Services… more
- Saint Luke's (Kansas City, MO)
- **Job Description** The Utilization Review RN is responsible for assuring the receipt of high quality, cost efficient medical outcomes through utilization ... using clinical guidelines (InterQual). + Complies with CMS regulation regarding utilization review /management. + Obtains and manages insurance authorizations and… more
- Brighton Health Plan Solutions, LLC (Westbury, NY)
- About The Role Brighton Health Plan Solutions (BHPS) provides Utilization Review /Medical and Case Management services for Group Health and Workers ' ... and other Casualty clients. The Workers ' Compensation Nurse Case Reviewer collaborates with medical care providers, employers,...for timely return to work. + Provides case management, utilization review , continued stay reviews, and based… more
- Virtua Health (Pennsauken, NJ)
- …over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques ... UR Tech and AA to support UR and revenue cycle process.Position Responsibilities: Utilization Management* Utilizes Payer specific screening tools as a resource to… more
- Avera (Cresco, IA)
- …to join us on our mission, apply today! **Position Highlights** POSITION SUMMARY: The Utilization Review Coordinator is a member of the nursing team and ... **Location:** Cresco, IA ** Worker Type:** Regular **Work Shift:** Day Shift (United...oral and written communication skills desired. POSITION QUALIFICATIONS: Registered Nurse from an accredited school of nursing is required.… more
- PeaceHealth (Eugene, OR)
- **Description** PeaceHealth is seeking a RN Admissions Coordinator/ Utilization Review - Psychiatric Unit for a Per Diem/Relief, 0.00 FTE, Variable position. The ... with patients, families, referring facilities, physicians, emergency departments' crisis workers , public safety officers, outside agencies and Behavioral Health… more
- Centene Corporation (Phoenix, AZ)
- …Tempe and/or Tucson offices.** **Position Purpose:** Manages the behavioral health (BH) utilization review clinicians to ensure appropriate care to members. ... within utilization management. + Oversees the behavioral health (BH) utilization review clinicians and ensures compliance with applicable guidelines +… more
- Trinity Health (Syracuse, NY)
- … is a key stakeholder in the emergency room care transition team which includes nurse case managers, utilization review nurses, providers, and etc. whom all ... social work. Licensed to practice as a Licensed Clinical Social Worker (LCSW) OR Licensed Master Social Worker ( LMSW) through the State of New York Participates… more
- Prime Healthcare (Inglewood, CA)
- …managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians. Additionally, ... to lead our dynamic Case Management Team consisting of Registered Nurses, Social Workers , and Clinical Coordinators. This leader will oversee all facets of … more
- Humana (Indianapolis, IN)
- …and external customers and stakeholders. **Preferred Qualifications** + Experience with utilization review process. + Experience with behavioral change, health ... put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes behavioral health knowledge… more
- Zurich NA (Schaumburg, IL)
- …and medical terminology Preferred Qualifications: + 2 or more years' experience in Utilization Review , Case Management, Workers Compensation, or medical bill ... Medical Bill Review Senior Nurse 127127 Zurich Insurance is currently looking for a **Medical Bill Review Senior Nurse ** to work from our Schaumburg, IL… more
- Bassett Healthcare (Oneonta, NY)
- …with no more than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co- worker feedback. + Analyzes ... and cost in managing patient care, as measured by direct supervisory observation and co- worker feedback. + Acts effectively as charge nurse , group leader or… more
- Bassett Healthcare (Little Falls, NY)
- …with no more than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co- worker feedback. + Analyzes ... discuss specific positions in our conversations. What you'll do The Registered Professional Nurse (RN), Acute Care in the Emergency Department is accountable for the… more
- Bassett Healthcare (Delhi, NY)
- …with no more than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co- worker feedback. + Analyzes ... enjoy the best quality of life possible. What you'll do The Registered Professional Nurse I, Acute Care is accountable for the delivery of safe patient care… more