- AdventHealth (Altamonte Springs, FL)
- …Degree Nursing + Current valid State of Florida or multistate license as a Registered Nurse + 2 years of medical/ hospital nursing experience **Preferred ... **Shift** : 5/8's rotating weekends with 1 Major and 1 Minor holiday * hybrid scheudle possible after training* **Location** : 701 EAST ALTAMONTE DRIVE, Altamonte… more
- Bassett Healthcare (Cooperstown, NY)
- …needs. The RN contributes to the support of patients through interdisciplinary teamwork. Registered Nurse I: The RN I status is only appropriate for ... after hire. Salary Range: $36.76 - $55.13 per hour Registered Nurse II: The RN ...as measured by periodic random preceptor and supervisory chart review as per probationary appraisal schedule ( RN … more
- Henry Ford Health System (Detroit, MI)
- …Two (2) years of Access Transfer Management Office and/or Utilization Review experience. + Previous charge nurse and/or leadership experience preferred. ... Would you like to speak with a Nurse Recruiter? (https://outlook.office365.com/owa/calendar/###@henryfordhealthsystem.onmicrosoft.com/bookings/) At Henry Ford Hospital, all… more
- HCA Healthcare (Round Rock, TX)
- …Science in Nursing (BSN) - preferred** **Licenses and Certifications** + **Current State of Texas Registered Nurse ( RN ) license or Compact Registered ** + ... management/administrative team to ensure staff productivity and appropriate resource utilization to achieve high quality patient care while meeting...encourage you to apply for our Registered Nurse Supervisor House PRN opening. We review … more
- HCA Healthcare (Round Rock, TX)
- …and personal growth, we encourage you to apply for our Registered Nurse Case Manager opening. We promptly review all applications. Highly qualified ... **Introduction** Do you have the career opportunities as a Registered Nurse Case Manager you want with...supporting a balance of optimal care and appropriate resource utilization . + You will provide case management services for… more
- AmeriHealth Caritas (Myrtle Beach, SC)
- …of Science in Nursing **(BSN)** is required and must hold a current and unrestricted ** Registered Nurse ( RN )** license in good standing in South Carolina or ... **REMOTE | Care Manager II Registered Nurse (BSN) - Foster Care...Management ID**: 34390 **Job Brief** Remote to qualified licensed BSN/ RN living in South Carolina w/prior experience in the… more
- AmeriHealth Caritas (Greenville, SC)
- …Bachelor of Science in Nursing (BSN) is required and must hold a current and unrestricted Registered Nurse ( RN ) license in good standing in South Carolina or ... **Care Manager II Registered Nurse (BSN) - Foster Care...Bachelor of Science in Nursing (BSN) and an unrestricted RN license in South Carolina (or a compact state).… more
- AmeriHealth Caritas (Philadelphia, PA)
- **Clinical Care Reviewer, Pediatric Shift Care, Registered Nurse ** Location: Philadelphia, PA Primary Job Function: Medical Management ID**: 34518 Your career ... Pediatric Shift Care services. **Education/ Experience:** + Current, active, and unrestricted Registered Nurse licensure in Pennsylvania. + Graduate from an… more
- New York State Civil Service (Menands, NY)
- NY HELP Yes Agency Workers' Compensation Board Title Registered Nurse 2 (Medical Care) (NY HELPS), WCB Item #2346 Occupational Category Health Care, Human/Social ... rehabilitation, medical/surgical, public health, community health, visiting nursing, occupational health, utilization review , or review of medical records… more
- Elevance Health (Miami, FL)
- …plans for people enrolled in Medicaid and/or Medicare programs in Florida. **Licensed Utilization Review I** **Location:** This is a remote position. The ... on operational needs (holiday and weekend rotation). The **Licensed Utilization Review I** is responsible for working...unrestricted license or certification as a LPN, LVN, or RN to practice as a health professional within the… more
- CareFirst (Baltimore, MD)
- …is required in addition to the required work experience. **Licenses/Certifications:** + Health Services\ RN - Registered Nurse - State Licensure and/or ... who is willing and able to work in a hybrid model. The incumbent will be expected to work...shared during the interview process. Plans, organizes, and manages utilization review programs. Directs the utilization… more
- AmeriHealth Caritas (Philadelphia, PA)
- …program performance and contract adherence. **Education/Experience:** + Bachelor's Degree required. + Registered Nurse required. + 1 to 3 years experience in ... **Long Term Services & Support Utilization Management Clinical Educator, RN ** Location:...www.amerihealthcaritas.com. As part of the Community Health Choices LTSS Utilization Management (UM) Review Team, the [… more
- CareFirst (Baltimore, MD)
- …with members, healthcare professionals, and internal colleagues. **Licenses/Certifications Required Upon Hire:** RN - Registered Nurse - State Licensure ... who is willing and able to work in a hybrid model. The incumbent will be expected to work...standards and federal/state regulations and general principles relating to utilization review . + Computer skills, including Microsoft… more
- Centene Corporation (Baton Rouge, LA)
- …+ Licensed Marital and Family Therapist (LMFT + Licensed Mental Health Professional (LMHP) + RN - Registered Nurse - State Licensure and/or Compact State ... abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with...+ Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse -… more
- Centene Corporation (Tallahassee, FL)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... Treatment Plans preferred. Knowledge of ABA services and BH utilization review process preferred. Experience working with...holidays, and a flexible approach to work with remote, hybrid , field or office work schedules. Actual pay will… more
- Centene Corporation (Columbus, OH)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... STATE OF OHIO **Position Purpose:** Performs a post-service retrospective review of member medical records and assessing care related...holidays, and a flexible approach to work with remote, hybrid , field or office work schedules. Actual pay will… more
- The Cigna Group (Philadelphia, PA)
- The RN Coordinator serves as the key contact point for...as needed 3) 3+ years of experience as a Registered Nurse 4) Proficient level of experience with ... and make specific recommendations based on their goals 4. Review paperwork for patients to ensure it meets all...of the team to manage heath care cost and utilization **Provider Support** 1. Completes telephonic nursing assessments including… more
- AdventHealth (Altamonte Springs, FL)
- …. Develops and implements case management programs and education, including utilization review , transitions of care, disease management, population health ... to ensure quality and consistency. The Senior Manager of Utilization will liaise with RN Case Managers...degree in nursing with 4 years of experience. . Registered Nurse with an active and unrestricted… more
- Centene Corporation (Atlanta, GA)
- … utilization management principles preferred. Prior authorization preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or ... to performance, compliance, quality, and efficiency standards + Collaborates with utilization management team to resolve complex care member issues + Maintains… more
- Trinity Health (Livonia, MI)
- …+ BSN required + MSN/ NP/ CRNA preferred B. Licensure + Licensed in Michigan as registered nurse C. Training and Experience + Required - Minimum five (5) years ... Part time **Shift:** Rotating Shift **Description:** **JOB SUMMARY** The Clinical Nurse Reviewer's chief responsibility is to collect and submit reliable data… more