- US Tech Solutions (RI)
- …+ MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE 1 YEAR OF UTILIZATION ... MANAGEMENT EXP, pref. knowledge of Milliman/MCG. + MUST HAVE 6 months of Prior Authorization. **Education:** + RN with current unrestricted state licensure **About US Tech Solutions:** US Tech Solutions is a global staff augmentation firm providing a wide… more
- CVS Health (Columbus, OH)
- …we do it all with heart, each and every day. **Position Summary** This Clinical Consultant position is with Aetna's Utilization Management ( UM ) team and is a ... Behavioral Health clinician (LISW, LPCC, LMFT) or a Registered Nurse (RN) with unrestricted state license in Ohio, and...Behavioral Health clinician (LISW, LPCC, LMFT) or a Registered Nurse (RN) with unrestricted state license in Ohio +… more
- The Arora Group (Bethesda, MD)
- Registered Nurse Case Manager Nurse Currently recruiting a Registered Nurse (RN) Case Manager to work the Directorate of Healthcare Operations (DHO) at ... two-week period will be provided one month in advance. DUTIES OF THE REGISTERED NURSE CASE MANAGER (RN): The contracted RN shall provide the following services and… 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
- ERP International (Port Hueneme, CA)
- **Overview** ERP International, LLC is seeking a **Registered Nurse - Case Manager** for a full-time position supporting **Branch Health Clinic Port Hueneme, CA** in ... and databases for community resources. * Integrate CM and utilization management ( UM ) and integrating nursing case management with social work case management. *… more
- University of Miami (Miami, FL)
- …a system that elevates any abnormal results (non - critical values) to the nurse who in turn will contact the physician accordingly 5. Ens ures that patients ... patient/family teaching using available resources and tools. 12. Acts as consultant to clinical staff in assisting with unfamiliar procedures/treatments. 13.… more
- University of Miami (Miami, FL)
- …Employees Include Percent of Effort): Meets requirements of Clinical Trials Chemotherapy Nurse 50% Works closely with the medical director and the pediatric nursing ... protocol and clinical practice standards. Provides documentation to the Research Nurse / Nurse Coordinators, and/or Research Staff/Data Managers. Meets study… more
- Albany Medical Center (Albany, NY)
- …patient/significant others/family and payers by functioning as a clinician, consultant , advocate and educator for assigned service. Principal Position ... financial constraints. c. Provides collaborative care management with the primary nurse in assessing for discharge planning needs, coordinating appropriate resources… more
- LA Care Health Plan (Los Angeles, CA)
- …required to achieve that purpose. Job Summary The Supervisor of Utilization Management ( UM ) RN is responsible for executing the day-to-day operations of the UM ... overall performance metrics. The Supervisor ensures all functions of the UM department are operating in accordance with the organization's mission, values… more
- Bassett Healthcare (Cooperstown, NY)
- …admission order and validates status and level of care matches order Collaborates with UM Nurse to assure that all payor and status requirements are aligned ... align care team towards discharge goals Serves as a consultant and educator with medical staff regarding status, placement,...on discharge needs/barriers for all patients; initiates intervention by UM Nurse as needed Identifies need for… more
- Veterans Affairs, Veterans Health Administration (Aurora, CO)
- …care outcomes by collaborating with members of the interdisciplinary team. The nurse functions as a Clinical Documentation Integrity Consultant within Clinical ... Director for Access at Eastern Colorado Health Care System (ECHCS). The Nurse perform chart reviews, identifies and collects data, communicate with providers and… more
- Alameda Health System (Oakland, CA)
- …tracking variances based on critical timelines. + Develops and provides statistical UM information and reports to appropriate committees and in conjunction with the ... and/or techniques. + Review cases regularly with staff; acts as clinical consultant regarding care management issues; guides clinical staff with review of… more
- Veterans Affairs, Veterans Health Administration (Albuquerque, NM)
- …for all admissions and oversight of screening process; collaborates with the hospital UR/ UM team to maximize as appropriate patient movement from the hospital to the ... at the CLC; collaborate with nursing leaders and QI nurse to prepare for Ascellon survey and maintain survey...care team members to maximize revenue. Serve as a consultant , collaborator, and contributor to the CLC interdisciplinary team… more