- Hunterdon Health Care System (Flemington, NJ)
- Position Summary The Utilization Review Specialist monitors adherence to the hospital's utilization review plan to ensure the effective and efficient ... an applicable health insurance plan. Primary Position Responsibilities 1. Performs utilization activities, using Milliman Care Guidelines under the guidance of the… more
- BriteLife Recovery (Englewood, NJ)
- What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is ... responsible for overseeing and coordinating all aspects of utilization review and insurance authorization for clients receiving substance use disorder (SUD)… more
- HonorHealth (AZ)
- …different here -- because it does. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors ... 1 year experience in UR/UM or Case Management Required Licenses and Certifications Registered Nurse ( RN ) State And/Or Compact State Licensure Required more
- Nuvance Health (Danbury, CT)
- …Two Years of Utilization Review experience Required : CT Registered Nurse License Working Conditions: Manual: significant manual skills/motor coord & ... 9am-930pm; including every 3rd weekend rotation Summary: The purpose of the Utilization Management Nurse is to support the physician, the interdisciplinary… more
- Catholic Health Initiatives (Omaha, NE)
- **Responsibilities** Are you a skilled and experienced Utilization Review Specialist looking for a rewarding opportunity to impact patient care and optimize ... Review experience.** Medical Coding experience is a plus! As our Utilization Review RN , you will be responsible for conducting comprehensive reviews of… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services ... healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence...regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse -… more
- Commonwealth Care Alliance (Boston, MA)
- …for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for conducting centralized ... reviews). * Hire, train and mentor UM staff, including nurse reviewers and support personnel. * Act as liaison...Skills & Abilities (must have): * Expertise in managing utilization review processes including prior authorization, concurrent… more
- Children's Mercy Kansas City (Kansas City, MO)
- …Oversees and directs the work of Nurse Case Managers, Social Workers, and Utilization Review specialist team members and support staff + Analyzes, ... and related software applications and implementations. + Engages in utilization review committee. Qualifications + Master's Degree...Performance Improvement Leadership + One of the following: Licensed RN - MO, Registered Nurse … more
- LifePoint Health (Louisburg, NC)
- Registered Nurse ( RN ) Utilization Review Job...the lives of those we serve. Connect with our RN recruiting specialist . Do you need more ... 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
- AdventHealth (La Grange, IL)
- …resolution skills . Teamwork principles **EDUCATION AND EXPERIENCE REQUIRED:** . Associates Degree Nursing or RN Diploma degree . Registered Nurse ( RN ) . ... **LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** . State of Illinois registered nurse license **LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:**… more
- LifePoint Health (Johnstown, PA)
- * Registered Nurse ( RN ), Case Manager...team of RN Case Managers, Social Workers, Utilization Review staff, and Discharge Planners assure that ... valued as an employee, but as a person. As a* registered nurse ( RN )*joining our team,...the lives of those we serve.** *Connect with our RN recruiting specialist * Not ready to complete… more
- LifePoint Health (Martinsville, VA)
- …others. Here, you're not just valued as an employee, but as a person. As a registered nurse ( RN ) joining our team, you're embracing a vital mission dedicated ... and harassment in employment." **Job:** **Nursing* **Organization:** **Sovah Health - Martinsville* **Title:** * Registered Nurse ( RN ) - Case Manager - Full… more
- Roper St. Francis (Charleston, SC)
- …Charge Nurse I. Experience: Experience: At least 2 years� experience as a registered nurse in a direct care patient setting for Primary Charge Nurse ... role. Licensure/Certification: Applicant must be currently licensed as a Registered Nurse in South Carolina or hold...to run effective shift safety huddles, report safety concerns, review device utilization , report staffing concerns, and… more
- AdventHealth (Orlando, FL)
- …+ Associate of Science degree in Nursing (ASN) + Current valid license as a Registered Nurse in the state of Florida + Two (2) years of medical/hospital ... St, Orlando, FL 32803 **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social...(as permitted by the patient) as well as a review of the current and past inpatient and outpatient… more
- Geisinger (Danville, PA)
- …and License(s) Basic Life Support Certification - Default Issuing Body; Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE & ... and report to various committees, including but not limited to the Utilization Management and Revenue Cycle committees. + Plans, directs, educates, and assists… 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 ... be provided one month in advance. DUTIES OF THE REGISTERED NURSE CASE MANAGER ( RN ):...Health Nurse (COHN) or Certified Occupational Health Nurse - Specialist (COHN-S). + National Board for Certification… more
- Fresenius Medical Center (Lacey, WA)
- …for the assigned area practicing cost containment strategies as appropriate. + Review balance sheet and income statements regarding revenue growth and commercial ... implementation and achievement of the business plan and key performance indicators. Review analysis of performance including financial and productivity data for area… more
- MyFlorida (Land O' Lakes, FL)
- …that all verbal orders, including telephone orders from attending physicians are received by a registered nurse . If no RN is available, receive all telephone ... SENIOR REGISTERED NURSE SUPV - 50000071 Date:...current status and providing supervision and guidance to the RN , LPN, CNA and other Allied Health Care Professionals.… more
- MyFlorida (Port Saint Lucie, FL)
- …that all verbal orders, including telephone orders from attending physicians, are reviewed by a registered nurse . + If no RN is available, receive all ... SENIOR REGISTERED NURSE SUPV Date: Jun 5,...resident's status and providing supervision and guidance to the RN , LPN, CNA, and other Allied Health Care Professionals.… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates,...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
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