- Humana (Fort Myers, FL)
- **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 ... of medical services, discharges and/or benefit administration determinations. The Utilization Management Nurse 2 work...determination of the appropriate courses of action at an on- site facility. This position will have a limited hybrid… more
- Veterans Affairs, Veterans Health Administration (Gainesville, FL)
- Summary The Utilization Management (UM) Registered Nurse (RN) is responsible for UM reviews for patients who receive hospital care. Responsibilities An UM ... Registered Nurse is responsible for UM reviews and use of...accreditation standards, and performance measures. Uses emergency and bed management software and utilization data to manage… more
- Katmai (Fort Carson, CO)
- …(BSN) is required. + Minimum of two (2) years of prior experience in Utilization Management . + Must possess a current, active, full, and unrestricted Registered ... licensed in Colorado, be able to practice using a nurse compact state license or have a license from...checks. **DESIRED QUALIFICATIONS & SKILLS** + Certification by a Utilization Management -specific program such as Certified Professional… more
- Actalent (Sunrise, FL)
- …The Behavioral Health Utilization Review Specialist conducts comprehensive utilization management activities for behavioral health plan members. This ... assigned. Essential Skills + Proficiency in clinical review and utilization management . + Knowledge of Interqual and...weeks, during which you will shadow a team member on- site and through Teams on other days. Pay and… more
- US Tech Solutions (Columbia, SC)
- … on networks and benefit plans. May identify, initiate, and participate in on- site reviews. Promotes enrollment in care management programs and/or health and ... mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review/case management /clinical/or combination; 2 of 4 years… more
- Beth Israel Lahey Health (Burlington, MA)
- …of three years of medical/surgical nursing care experience. -Two years of Case Management or Utilization Management experience desirable. - Demonstrated ... in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient...to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case management experience, and… more
- Ellis Medicine (Schenectady, NY)
- Basic Function: The Utilization Management Registered Nurse (UM RN) supports daily coordination of care across healthcare continuum with the healthcare team, ... preoperative, concurrent and retrospective reviews in accordance with the utilization management program. The UM RN ensures...field required. Current registration as a Licensed Registered Professional Nurse in New York State. Two (2) to three… more
- UNC Health Care (Raleigh, NC)
- …stay, and discharge reviews in accordance with federal regulations & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is ... of UNC Health._ _We are currently seeking an experienced nurse to join our dynamic team as an RN...management referrals. Initiates appropriate social work referrals. 3. Utilization Management Process - Performs utilization… more
- Children's Hospital Boston (Boston, MA)
- …Posting Title:Per Diem RN Case Manager, Utilization Management /ReviewDepartment:Patient Services-Patient Care OperationsAutoReqId:80451BRStatus:Part-TimeStandard ... + Experience as a Case Manager (Discharge Planning and or Utilization Management ) preferred. Licensure/ Certifications: + Current Massachusetts license… more
- Ochsner Health (New Orleans, LA)
- …as well as efficiently in high pressure situations. Preferred- Experience in Case Management or Utilization Review Business and Financial Knowledge as well as ... discover your future today!** This job is a registered Nurse with a diverse medical background, who is able..._and Washington DC_ **_Ochsner Health endeavors to make our site accessible to all users. If you would like… more
- Ochsner Health (Lafayette, LA)
- …of registered nurse (RN) licensure. Preferred - Certification in Case Management (CCM) or Certified Professional in Healthcare Management (CPHM). **Knowledge ... job manages the daily operations of all assigned divisions within the case management department in collaboration with the case management and social services… more
- ERP International (Camp Pendleton, CA)
- **Overview** ERP International, LLC is seeking a ** Nurse Practitioner** for a full-time position supporting the **Pain Management Clinic** at **Camp Pendleton, ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- The Cigna Group (Sacramento, CA)
- …license in state where you reside. + 3 years' experience in case management or utilization review. **Preferred requirements:** + Bachelors/CCM preferred + ... 12-15 direct reports who are directly responsible for inpatient case management and all associated performance requirements for Cigna. + Interfaces with… more
- Albany Medical Center (Albany, NY)
- …proactively with the Quality Improvement Teams, patient care standards, Social Work, and utilization management to coordinate the appropriate use of resources to ... assigned service. Acute care nursing experience preferred.4. Recent experience in case management , utilization management and/or discharge planning/home care… more
- Veterans Affairs, Veterans Health Administration (Saginaw, MI)
- Summary This job announcement is for a day shift Registered Nurse for the Community Living Center (CLC) who is responsible and accountable for all elements of the ... responsibility for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care. Administers… more
- Louisiana Department of State Civil Service (Reserve, LA)
- …follow-up appointments and treatment are provided. Serves as technical and consultative Nurse Family Partnership (NFP) expert for multi- site or teams. Supervises ... REGISTERED NURSE SUPERVISOR B Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4947288) Apply REGISTERED NURSE SUPERVISOR B Salary… more
- Ochsner Health (New Orleans, LA)
- …Louisiana Registered Nurse (RN) License Preferred - Certification in Case Management (CCM) or Certified Professional in Utilization Review, Utilization ... to all medical necessity audits. **Education** Required - Registered Nurse Diploma Preferred - Associate's or Bachelor's degree in...of patient care as an RN. Experience in Case Management , Utilization Review and/or Discharge Planning .either… more
- Outreach Development Corporation (Brentwood, NY)
- …The nurse provides on call nursing for times when we do not have a nurse on site and serves as the health care coordinator. Job Scope + Conduct and/or ... for residents on topics such as diet, exercise, stress management , smoking cessation, sexually transmitted diseases, etc + Provide...nursing for times when we do not have a nurse on site and serves as the… more
- Mayo Clinic (Rochester, MN)
- …patient plan of care throughout the continuum of care by ensuring appropriate utilization management , care coordination, resource utilization , and clinical ... outcomes. The RN Case Manager provides leadership through education on case management / utilization management concepts, committee work, research, and… more
- The County of Los Angeles (Los Angeles, CA)
- NURSE PRACTITIONER- PEDIATRIC HUB CLINICS/NORTH COUNTY Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2588395) Apply NURSE PRACTITIONER- ... physical abuse, sexual abuse, and/or neglect (with support through on- site consultation with Child Abuse Pediatrician). + Serves as...REQUIRED: + A license to practice as a Registered Nurse and a certificate to practice as a … more