- Ascension Health (Tulsa, OK)
- …OR Required professional licensure at time of hire. **Additional Preferences** + 5+ years RN experience + Utilization Review experience preferred **Why Join ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
- Ascension Health (Manhattan, KS)
- …Provide health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
- Community Health Systems (Naples, FL)
- …meet deadlines. + Effective written and verbal communication skills. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact ... **Job Summary** Under the direction of the UR Director/Manager the UR Nurse reviews all admissions for medical necessity, correct orders based on medical condition… more
- LifePoint Health (Louisburg, NC)
- Registered Nurse ( RN ) Utilization Review Job Type: Full Time | Day Your experience matters At Maria Parham Hospital, we are driven by a profound ... as an employee but as a person. As a registered nurse ( RN ) joining our...a valid job field* **Organization:** **Maria Parham Franklin* **Title:** * Registered Nurse Utilization Review… more
- Atlantic Health System (Morristown, NJ)
- …Assists in identification and collection of avoidable days 7. Coordinates with the CM RN and/or CMA to identify and complete the process for CMS required patient ... notices. 8. Completes and documents utilization reviews, physician advisor referrals and other communications related to assigned cases in accordance with department… more
- Crouse Hospital (Syracuse, NY)
- …outreach programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse ( RN ) to track and manage data and client ... requires 6 weekends a year). Utilization Management Registered Nurse ( RN ) Position Responsibilities:...the quality of care. + Demonstrates proficiency with standard Utilization Review processes. + Responsible for concurrent… more
- US Tech Solutions (Canton, MA)
- …required.** **Job Summary The Clinical Reviewer is a licensed professional -a Registered Nurse preferred- that is expected to function independently in her / ... complex caseload of varied requests for services. The Clinical Reviewer is responsible for making the determination of medical...the job** + Bachelor's degree in Nursing, preferred + Registered Nurse with current a and unrestricted… more
- Ascension Health (Baltimore, MD)
- …Provide health care services regarding admissions, case management, discharge planning and utilization review . Responsibilities: + Review admissions and ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
- Commonwealth Care Alliance (Boston, MA)
- …clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring ... Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day… more
- McLaren Health Care (Pontiac, MI)
- …12. Performs other duties as assigned. #LI-KH1 _Required_ + State licensure as a Registered Nurse ( RN ) + Bachelor's degree in nursing from accredited ... **Position Summary:** Responsible for Utilization and Care Management services to the Emergency...on all patients reviewed in the ED. Conducts initial review using InterQual, MCG and other tools, assists provider… more
- BJC HealthCare (St. Louis, MO)
- … experience performing care for hospitalized patients. + 2 years of utilization review (UR) experience reviewing hospital admissions for medical necessity ... in St. Louis. + Have both Missouri and Illinois RN licenses. + If candidate only has one ...medical services provided by the medical team. Ensure appropriate utilization , which includes the evaluation of potential under and… more
- Aspen Medical (Aurora, CO)
- JOB AD: Registered Nurse - Utilization Management Introduction : Aspen Medical has an exciting opportunity for Registered Nurses to partner with us in ... Management (HCQM) through American Board of Quality Assurance and Utilization Review Physicians (ABQARP), Certified Informatics Nursing,...full, active, and unrestricted license to practice as a Registered Nurse as required in the TO… more
- HCA Healthcare (Houston, TX)
- …growth, we encourage you to apply for our Registered Nurse RN PACU PRN opening. We review all applications. Qualified candidates will be contacted ... Do you have the PRN career opportunities as a(an) Registered Nurse RN PACU PRN...all practices in the PACU. + Proficient in the utilization of specialized skills to provide care to patients… more
- Beth Israel Lahey Health (Plymouth, MA)
- …using Interqual criteria. + Integrates clinical knowledge with billing knowledge to review , evaluate, and appeal clinical denials related to the care provided to ... job that may reasonably be required._ **Education/Experience Required:** + Current MA RN licensure + Bachelor's Degree in Nursing or advanced degree in healthcare… more
- HCA Healthcare (Richmond, VA)
- …every year, nurses at Chippenham Hospital have the opportunity to make a real impact. As a ** Registered Nurse RN Case Manager** you can be a part of change. ... and improve positive outcomes for your patients as a Registered Nurse RN Case Manager....a hospital setting preferred.** + **Previous case management or utilization review experience preferred.** CJW Medical Center… more
- Penn Medicine (Lancaster, PA)
- …in position for incumbents who started after 07 01 2020. + A graduate registered nurse may only practice professional nursing under supervision and if the ... graduate registered nurse holds a current temporary practice... nurse is practicing. + All Clinical Nurse 1 RN 's will be required to… more
- HCA Healthcare (Kansas City, MO)
- …step in your career path, we encourage you to apply for our Registered Nurse RN Radiology opening. We review all applications. Qualified candidates will ... **Introduction** Do you have the career opportunities as a(an) Registered Nurse RN Radiology you...most compassionate way. A Diagnostic Imaging Registered Nurse provides patient care through utilization of… more
- Bassett Healthcare (Cooperstown, NY)
- …experience as a Registered Nurse , if experience is not relevant, Registered Nurse II must complete RN residency program, required License/ ... of safe patient care utilizing the nursing process. The RN assesses, plans, delivers, coordinates, integrates, and evaluates nursing...Certification: Current NYS license as a Registered Nurse , required BLS certification will be… more
- HCA Healthcare (Derry, NH)
- …personal growth, we encourage you to apply for our RN Case Manager Registered Nurse PRN opening. We review all applications. Qualified candidates will ... Do you have the PRN career opportunities as a(an) RN Case Manager Registered Nurse ...Qualifications** The Case Manager's primary duties are to provide Utilization Review and Case Management functions for… more
- Catholic Health Initiatives (Lexington, KY)
- …an accredited school of nursing required. BSN preferred. License/Certification: * Active, unencumbered Registered Nurse license * BLS required * ACLS required on ... **Responsibilities** **JOB SUMMARY:** The Bariatric Clinical Reviewer plays a crucial role in ensuring departmental...follow-up data components for the program through the effective utilization of the hospital medical record systems and through… more