- Magellan Health, Inc. (Frisco, TX)
- Under general supervision, and in collaboration with other members of the clinical team, authorizes and reviews utilization of mental health and substance abuse ... develops discharge plans and oversee their implementation. Performs quality clinical reviews while educating and making appropriate interventions to advance… more
- University of Maryland Medical System (Bel Air, MD)
- …in care of unit specific patient population; independently practices with solid knowledge and clinical skills; engaged in advancing own practice. 2 . Serves as a ... Company Description University of Maryland Upper Chesapeake Health ( UM UCH) offers the residents of northeastern Maryland...1. Demonstrates the ability to function in the charge nurse role. 2 . Participates in teambuilding efforts… more
- University of Maryland Medical System (Baltimore, MD)
- …care setting; focus on advancing own professional development. Solid knowledge and clinical skills. 2 . Demonstrates highly effective interpersonal, verbal and ... Company Description Experience the highest level of appreciation at UM Baltimore Washington Medical Center - named Top Workplace in the Baltimore area by The… more
- UnitedHealth Group (Long Island City, NY)
- …with all the terms of the Landmark Motor Vehicle Safety policy Preferred Qualifications: 2 + years of clinical experience Knowledge of CPT, ICD-9 and HCPC codes ... of the Optum family of businesses, is seeking a Nurse Practitioner or Physician Assistant to join our team...healthcare better for everyone. At Optum, you'll have the clinical resources, data and support of a global organization… more
- Reef Systems (Montgomery, AL)
- …meetings. Identify and notify the Government MTF case manager, Utilization Management ( UM ) nurse or Primary Care Management (PCM) team, as appropriate, ... Licensed Practical Nurse (LPN) - Maxwell AFB, AL Reef Systems...Ambulatory Care Guidelines. Shall have a minimum of two ( 2 ) years broad-based clinical nursing experience in… more
- UnitedHealth Group (Tulsa, OK)
- …with all the terms of the Optum Motor Vehicle Safety policy Preferred Qualifications: 2 + years of clinical NP experience in IM, Geriatrics, Primary Care, ED, ... of the Optum family of businesses, is seeking a Nurse Practitioner or Physician Assistant to join our team...healthcare better for everyone. At Optum, you'll have the clinical resources, data and support of a global organization… more
- Healthcare Staffing Plus (Columbus, GA)
- …Assists the Director of Case Management with collection of data for the UM Committee and other reports Escalates cases appropriately As required, collaborates with ... Associate degree in Nursing required. Bachelor's Degree in Nursing is desirable. The Registered Nurse must possess a license to practice in the state of Georgia. 5+… more
- UnitedHealth Group (Los Angeles, CA)
- …directors, nurse coders, and operations team to deliver DRG Clinical Review performance Identifying opportunities expand and optimize program success in ... scale. Join us to start Caring. Connecting. Growing together. Clinical Excellence, a national OptumCare team, is currently seeking...hospital system or payor Experience in chart review (DRG, UM , PA) or prior role as hospital physician advisor… more
- UNC HEALTH (Raleigh, NC)
- …gynecologic disorders. They are dedicated to offering cutting-edge treatment to patients, clinical trials and provide the same quality of care found at nationally ... communicate with Care Management Assistant (CMA) to share priorities. 2 . CAPP Meeting - Attend and actively participate in...as appropriate. As necessary meet with the Utilization Manager ( UM ) and SW after the meeting to discuss updates… more
- Integra Partners (Troy, MI)
- …and clinical processes + Develop and deliver comprehensive training programs for UM clinical staff on: + Writing clear and concise clinical ... Integra Partners is seeking an experienced nurse educator to join our Operations Training &...+ Current, active RN license EXPERIENCE: + Minimum of 2 years of experience in clinical nursing,… more
- Humana (Oklahoma City, OK)
- …(PhD/EdD) in the State of Oklahoma without restrictions + 3+ years of post-degree clinical experience in direct patient care. + 2 + years of case management ... one of the following: + An active Licensed Registered Nurse (RN) in Oklahoma/multi-state, without restrictions + A licensed...and/or rehabilitative counseling experience. + 2 + years of clinical supervisory experience. +… more
- Veterans Affairs, Veterans Health Administration (Albuquerque, NM)
- … Care Coordination for Operations Service! Responsibilities The Utilization Management ( UM ) Registered Nurse (RN) executes position responsibilities that ... UM RN is responsible for participating in field UM program review activities and providing advanced clinical...nursing experience in which one year is equivalent to Nurse I, Level 2 ; OR a BSN… more
- University of Miami (Miami, FL)
- …this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . JOB DESCRIPTION UM Title: Senior Registered Nurse Supervisor's ... 2014. Job Summary (Purpose and Function): The Pain Management Nurse will be a professional registered nurse ...and variances to the plan of care. Documents in UM Care program intra-procedure assessment of patient condition. Planning… more
- University of Miami (Miami, FL)
- …Accountabilities (For Non-exempt Employees Include Percent of Effort): Meets requirements of Clinical Trials Chemotherapy Nurse 50% Works closely with the ... and clinical practice standards. Provides documentation to the Research Nurse / Nurse Coordinators, and/or Research Staff/Data Managers. Meets study timelines… more
- University of Miami (Miami, FL)
- …(For Non-exempt Employees Include Percent of Effort): Meets requirements of Clinical Trials Senior Chemotherapy Nurse 30% Administers research study ... protocol and clinical practice standards. Provides documentation to the Research Nurse and/or Data Manager. Meets study timelines and objectives as defined by… more
- University of Miami (Miami, FL)
- …please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Registered Nurse works as a part of a team to ... position include, but are not limited to: Performance Nursing Duties as per Nurse Job Description 100% Perform patient interview and obtains vital signs. Assists… more
- Veterans Affairs, Veterans Health Administration (Reno, NV)
- Summary The Nurse II Utilization Management ( UM ) Registered ...nursing experience in which one year is equivalent to Nurse I, Level 2 ; OR a BSN and ... for providing competent, evidence-based practices within the position. Uses UM Criteria to perform complicated reviews. Responsibilities Major Duties...1 year of professional nursing experience equivalent to the Nurse I, Level 2 ; OR a Master's… more
- Commonwealth Care Alliance (Boston, MA)
- …Reporting to the Manager Utilization Management, the Nurse Utilization Management ( UM ) Reviewer is responsible for day-to-day timely clinical and service ... with Standard Operating Procedures + Ensures accurate documentation of clinical decisions and works with UM Manager...Utilization Management experience in a managed care setting + 2 or more years working in a clinical… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... for Medicare and Medicaid Services(CMS) requirements for health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse (RN) - Active,… more
- Veterans Affairs, Veterans Health Administration (Seattle, WA)
- …AND 2 years of professional nursing experience in which one year is equivalent to Nurse I, Level 2 ; OR a BSN and 1 year of professional nursing experience ... alignment with the ANA Standards of Nursing Practice. Applies clinical knowledge/judgment to lead staff involvement in planning, decision-making,...equivalent to the Nurse I, Level 2 ; OR a Master's… more