- VitalCore Health Strategies (Hopkinton, MA)
- …Insurance Employee Assistance Program and Discount Center 401K EEO Keywords: Utilization Management , RN, Nurse , Administrative, #INDMA Compensation ... in Correctional Healthcare, has a Full-Time opening for a Utilization Management RN at the Regional Office...treatment plans as indicated by patients' responses and conditions Review all aspects of facility patient care Review… more
- California Practice Staff (Modesto, CA)
- …and staffing Assists the physician as follows, but not limited to Utilization Review , Quality Assurance, Program Evaluation, Infection Control, Safety Committee ... of laboratory tests as part of the physical examination and health management . Perform and oversee testing and other appropriate procedures. Conducts health teaching… more
- University Health (Hondo, TX)
- …Three years recent, full time hospital experience preferred. Work experience in case management , utilization review , or hospital quality assurance experience ... and clinicians in the Ambulatory setting by gathering information, coordinating utilization efforts, and reviewing HCC quality indicators, and RAF scores to… more
- University of New Mexico - Hospitals (Albuquerque, NM)
- …to experience, education, and other business and organizational considerations.Department: Utilization Management - UHFTE: 1.00Full TimeShift: DaysPosition ... patient responses to interventions in collaboration with quality assurance and utilization review , maintaining interdependent follow-up as necessary* VARIANCE -… more
- The Laurels of Fulton (St. Johns, MI)
- …assessments and care plan coordination for guests. The MDS Coordinator supervises the Care Management Nurse , MDS Nurse . The Laurels of Fulton offers one ... Are you an experienced MDS nurse interested in the next step? The MDS...PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management… more
- The Laurels of Fulton (Chesaning, MI)
- …assessments and care plan coordination for guests. The MDS Coordinator supervises the Care Management Nurse , MDS Nurse .The Laurels of Fulton offers one of ... Are you an experienced MDS nurse interested in the next step? The MDS...PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management… more
- University Health (San Antonio, TX)
- …Three years recent, full-time hospital experience preferred. Work experience in case management , utilization review or hospital quality assurance experience ... hire date. LICENSURE/CERTIFICATION Current license from the Board of Nurse Examiners of the State of Texas to practice...the State of Texas to practice as a registered nurse is required. National certification in related field is… more
- VitalCore Health Strategies (Munising, MI)
- …clinical quality and integrity of patient medical care including oversight of utilization and quality management , credentialing, and best practice guideline ... managed healthcare systems, medical quality assurance, quality improvement and risk management is required Must have experience in launching and managing innovative… more
- Katmai (Fort Carson, CO)
- **SUMMARY** Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE eligible beneficiaries within the ... standards for appropriate utilization of services. Perform utilization management / review for medical necessity...within the last four (4) years as a registered nurse in utilization management . +… more
- CVS Health (Austin, TX)
- …the department.** **Rotational late shift 9:30-6CST.** **No travel is required.** As a Utilization Management Nurse Consultant, you will utilize clinical ... Clinical Social Worker (LCSW) preferred. + Requisition Job Description **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100%… more
- CVS Health (Carson City, NV)
- …1 holiday per year). There is no travel expected with this position. As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... And we do it all with heart, each and every day. **Position Summary** **This Utilization Management (UM) Nurse Consultant role is fully remote but must… 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 ... to support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and… more
- Hartford HealthCare (Willimantic, CT)
- …* Three years clinical nursing required. * Two years experience with case management , discharge planning, utilization review and/or home care required. ... **Title:** *Registered Nurse Case Manager (RN) - Utilization Management * **Location:** *Connecticut-Willimantic-Windham Community Memorial (10183)*… more
- CVS Health (Baton Rouge, LA)
- …we do it all with heart, each and every day. **Position Summary** The Utilization Management Nurse Consultant (UMNC) for Prior Authorization conducts ... in quality improvement, policy review , and education related to utilization management . * Serve as a clinical resource for internal and external partners.… more
- CVS Health (Baton Rouge, LA)
- …each and every day. **Position Summary** The Utilization Management Nurse Consultant (UMNC) for NICU Concurrent Review conducts high-acuity, timely, and ... integrity and compliance. * Participate in quality improvement, policy review , and education related to NICU and special populations..., and education related to NICU and special populations utilization management . * Serve as a clinical… more
- CVS Health (Phoenix, AZ)
- …that promote high-quality healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. ... hospitalization and intensive outpatient programs. + At least 1 year of Utilization Management experience in concurrent review or prior authorization. +… more
- McLaren Health Care (Port Huron, MI)
- **Department:** Utilization Review **Daily Work Times:** 8:00am-4:30pm **Hours Per Pay Period:** 40 **Position Summary:** Responsible for determining the ... as Assigned:** 1. Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure that appropriate… more
- Cognizant (Salem, OR)
- …background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management experience with managed health care plan + 3 years' experience ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
- Saint Francis Health System (OK)
- …is not all inclusive nor does it prohibit the assignment of additional duties. Utilization Review Management - Yale Campus Location: Virtual Office, Oklahoma ... levels of care and receipt of necessary services. The Utilization Management (UM) Registered Nurse ...participate in treatment teams, Patient Care Committee, and the Utilization Review Staff Committee by providing data… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Registered Nurse Utilization Management Full Time, 80 Hours Per Pay Period, Day Shifts Covenant Health Overview: Covenant Health is the region's ... Forbes "Best Employer" seven times. Position Summary: The RN Utilization Management I will perform utilization...payors as applicable. + Completes daily work lists for utilization review meeting the time frames set… more
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