- Actalent (Minnetonka, MN)
- Remote Utilization Management Nurse Job Description As a Utilization Management Nurse for Post Acute care, you will be responsible for ... necessity of post-acute stays. Essential Skills + Expertise in utilization management and utilization review....+ Proficiency in prior authorization processes. + Active, unrestricted RN license in the state of MN or WI.… more
- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in… more
- CVS Health (Phoenix, AZ)
- …a meaningful difference in the lives of patients? Join Mercy Care as a Utilization Management Clinical Consultant and become part of a mission-driven team that's ... Monday-Friday 8:00am-5:00pm AZT (No weekends or holidays) Location: 100% Remote (Must have Arizona RN license or...in ER, ICU, or Critical Care preferred. + Managed Care/ Utilization Management experience. + Experience with Claims… more
- ChenMed (St. Louis, MO)
- …We're rapidly expanding and we need great people to join our team. The Registered Nurse , Care Line, is responsible for providing telephonic triage directional ... and assessments within license and as possible given technology and medium. The registered nurse collaborates with primary caregivers and others on the… more
- Ochsner Health (New Orleans, LA)
- …discharge plans based on patient's individualized needs. Registered Nurse ( RN ) Case Manager - Case Management OMC Jefferson Highway PRN To perform ... experience in discharge planning, case management or utilization review. **Certifications** Required - Current registered ...or utilization review. **Certifications** Required - Current registered nurse license in state of practice.… more
- AccentCare, Inc. (Middlebury, CT)
- …Hospice Location: Middlebury, CT Position: Admissions Registered Nurse / RN , Hospice Position Type: Part Time Remote /Virtual Position: No Coverage Area: ... Overview Admissions Registered Nurse / RN ,...and external partners, ensuring timely updates, interventions, and resource utilization + Provide patient and caregiver education, document care… more
- Banner Health (Phoenix, AZ)
- …of a bachelor's degree in case management or health care. Requires current Registered Nurse ( RN ) license in state worked. For assignments in an ... , acute care and/or home care environments, community resources and resource/ utilization management . Must demonstrate critical thinking skills, problem-solving… more
- Bon Secours Mercy Health (Norfolk, VA)
- …clinical and operational excellence. **Summary of Primary Function** In the capacity of a Registered Nurse ( RN ), the Ambulatory Care Manager will provide ... clinical care management services to identified eligible patients; coordinating care to...Nursing Bachelor's Degree (preferred) Specialty/Major- Nursing (BSN) **Licensing/ Certification** Registered Nurse with active License in State… more
- Geisinger (Danville, PA)
- …Specialty Training Program-Nursing (Required) Experience Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania; ... Job Summary Geisinger is proud to offer a full time Inpatient RN up to $24,000 hiring incentive for eligible candidates! $41 minimum hiring rate with increased rates… more
- Geisinger (Danville, PA)
- …(Required), Bachelor's Degree-Nursing (Preferred) Experience Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania; ... Job Summary Geisinger is proud to offer a full time Inpatient RN up to $24,000 hiring incentive for eligible candidates! $41.00 minimum hiring rate with increased… more
- Tufts Medicine (Melrose, MA)
- …in developing and maintaining an infrastructure for the systematic review and management of complex patients. The position will work closely with PHO medical ... to review patient records, analyze data, and identify practice and patient outlier utilization , and gaps in quality measures for weekly practice and medical director… more
- Trinity Health (Mishawaka, IN)
- …approach This is NOT a remote position.** **_About the job:_** The licensed Registered Nurse ( RN ) plans & provides professional nursing services & ... in one of the following: Certified Acute Care Virtual Registered Nurse (CAVRN), Acute/critical care nursing (CCRN),...Nurse (CEN), Cardiac Medicine (CMC), Certified Med Surg RN (CMSRN), Certified Neuroscience RN (CNRN), Certified… more
- Saint Francis Health System (Tulsa, OK)
- …secure link to patient rooms. Shift: 10a - 10p \#RNSIND Job Summary: The Registered Nurse I (Virtual) assesses, plans, implements and evaluates nursing care, ... works from an on-site office location (not a remote position) Will perform admit, discharge, chart review and...Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License. Work Experience: Minimum 5… more
- SSM Health (OK)
- …Illinois Department of Financial and Professional Regulation (IDFPR) State of Work Location: Missouri + Registered Nurse ( RN ) Issued by Compact State + Or + ... perioperative, and post operative surgical cases. + Performs other utilization management tasks as assigned. + Applies...Registered Nurse ( RN ) - Missouri Division of Professional… more
- Providence (Mission Hills, CA)
- … Utilization Management , medical necessity, and patient status determination. The Utilization Management RN must effectively and efficiently manage a ... must empower them. **Required Qualifications:** + Associate's Degree in Nursing. + California Registered Nurse License upon hire. + 2 years of experience working… more
- Humana (Jackson, MS)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- US Tech Solutions (Columbia, SC)
- **Location: Columbia, SC 29229 ( Remote after training)** **Duration: 3+ Months Contract (Possible temp to hire)** **Job Description:** + Must be an RN in SC and ... have an active and unrestricted SC RN license. + Hours/Schedule - Monday through Friday, 8:30am-5:00pm....8:30am-5:00pm. + Onsite training for the first 1-2 weeks remote position after training. + Reviews and evaluates medical… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of ... productivity and gain efficiencies for performance improvement opportunities in the Utilization Management Department. + Assists in updating departmental… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …to help us transform healthcare? Bring your true colors to blue. The RoleThe RN Utilization Management Reviewer is responsible for facilitating care for ... benefit to provide the best quality care. The TeamThe RN Utilization Management Reviewer is...Mobile, and Resident personas. This position can be fully remote with an in-office requirement to work 1-3x/month at… more
- CVS Health (Austin, TX)
- …+ Requisition Job Description **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and the candidate can live in ... with diverse cultural dynamics of clinical staff and patients. Registered Nurse ( RN ) required. Licensed...late shift 9:30-6CST.** **No travel is required.** As a Utilization Management Nurse Consultant, you… more
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