- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist LVN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist LVN II will facilitate, coordinate and… 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 ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will facilitate, coordinate, and… more
- Cleveland Clinic (Weston, FL)
- …the Miami-Fort Lauderdale metro area and remains a top hospital in Florida. As a Utilization Management (UM) Specialist , you will work under the general ... *Achieves a minimum of 85% on IRR quarterly. *Completes Utilization Management for assigned patients with a...accredited school of nursing with licensure as a Registered Nurse (RN) in the State of Florida. *Bachelor of… more
- University of Washington (Seattle, WA)
- …. RN2, Utilization Management ... This position will have partial/variable involvement with Harborview's Emergency Department. The Utilization Management Specialist RN2 is responsible for the… more
- BayCare Health System (Cotton Plant, AR)
- …responsibility and clinical excellence. **BayCare Health System** is currently seeking a ** Utilization Review Specialist Senior** to join our outstanding and ... compassionate team. **The Utilization Review Specialist Senior responsibilities include:** +...Nursing RN. **Certifications and Licensures:** + Required RN (Registered Nurse ) + Preferred ACM (Case Management ) +… more
- Sanford Health (Sioux Falls, SD)
- …Conduct level of care medical necessity reviews within patient's medical records. Performs utilization management (UM) activities in accordance with UM plan to ... utilization and potentially, prior authorization. Assists the department in monitoring the utilization of resources, risk management and quality of care for… more
- HonorHealth (Scottsdale, AZ)
- …communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization ... in an acute care setting. Required 1 year experience in UR/UM or Case Management Required Licenses and Certifications Registered Nurse (RN) State And/Or Compact… more
- Trinity Health (Ann Arbor, MI)
- …Type:** Full time **Shift:** Day Shift **Description:** Exceptional opportunity for a **Clinical Nurse Specialist ** to support our vision and serve with us as ... a compassionate and transforming healing presence in our community. The Clinical Nurse Specialist (CNS) functions as an advanced practice registered nurse … more
- MyFlorida (Chattahoochee, FL)
- REGISTERED NURSE SPECIALIST -F/C - 60005305 Date: Jun 17, 2024 Location: CHATTAHOOCHEE, FL, US, 32324 The State Personnel System is an E-Verify employer. For more ... No: 823737 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST -F/C - 60005305 Pay Plan: Career...knowledgeable of and utilize the principles of Total Quality Management . Nursing will provide guidance in the care and… more
- Immigration and Customs Enforcement (IN)
- …an industry certification related to billing, coding, and utilization /case management [e.g., MCG Care Guideline Specialist , Certified Professional Medical ... and external stakeholders (eg, Customs and Border Patrol, Veterans Affairs) regarding utilization management (UM) processes, trainings, and principles to ensure… more
- Hackensack Meridian Health (Hackensack, NJ)
- …to transform healthcare and serve as a leader of positive change. The **Appeal Nurse Specialist ** will be responsible for the timely review and submission of ... Management ). **Responsibilities** A day in the life of a **Appeal Nurse Specialist ** at **Hackensack Meridian** **_Health_** includes: + Reviews all… more
- MyFlorida (Macclenny, FL)
- REGISTERED NURSE SPECIALIST OPS - 60955422 Date: Jun 1, 2024 Location: MACCLENNY, FL, US, 32063 The State Personnel System is an E-Verify employer. For more ... . Requisition No: 772103 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST OPS - 60955422 Position Number: 60955422 Salary: $45.00… more
- MyFlorida (Chattahoochee, FL)
- REGISTERED NURSE SPECIALIST -F/C OPS - 60953529 Date: Jun 12, 2024 Location: CHATTAHOOCHEE, FL, US, 32324 The State Personnel System is an E-Verify employer. For ... No: 817418 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST -F/C OPS - 60953529 Pay Plan:...knowledgeable of and utilize the principles of Total Quality Management . The employee in this position spends a minimum… more
- Bon Secours Mercy Health (Richmond, VA)
- …Masters degree from an accredited school of Nursing. + Currently registered as a Clinical Nurse Specialist , licensed as a Nurse Practitioner or eligible to ... excellence. Job Description **Primary Function/General Purpose of Position** The Advanced Practice Nurse (APN) at St. Mary's Hospital is a professional nurse … more
- The Cigna Group (Phoenix, AZ)
- **Summary** The Nurse Case Management Lead Analyst is an integral member of the Care Management department as part of Evernorth Care Group (ENCG) primary ... on the management of high- and rising-risk, disease burdened members. The Nurse Case Management Lead Analyst utilizes clinical skills to assess, plan,… more
- AdventHealth (Orlando, FL)
- …125,000 outpatients each year **The role you'll contribute:** **The Care Transitions Registered Nurse ensures that a care plan is carried out in partnership with the ... various other teams, including but not limited to Care Management nurses and social workers, nursing, home care liaisons,...high risk for readmission or for high emergency room utilization . Follows up with patients at location of post… more
- Amergis (Detroit, MI)
- The Utilization Review Specialist is responsible for theassessment and review of the healthcare delivery system with a concentration ontasks that promote ... is not a compact state. Essential Duties and Responsibilities: + Performs utilization review in accordance with all statemandated regulations + Analyzes insurance,… more
- Northwell Health (Manhasset, NY)
- …and transfer of patients to the facility. Job Responsibility + Promotes optimum utilization of hospital beds; conducts rounds and meets with staff regarding bed ... is complete, and ensures hand-off of communication to accepting nurse . + Ensures beds are assigned based on level...of technical experience and 0-2 years of leadership / management experience, required. + Care Escalation Experience is preferred… more
- Lancaster General Health (Lancaster, PA)
- …and deliver educational materials to support nursing staff in the adoption and utilization of new technology tools and workflows. + Provide ongoing training and ... **MINIMUM REQUIRED QUALIFICATIONS:** + Current licensure as a Registered Nurse , issued by the PA State Board of Nursing...as shall be determined at the sole discretion of management , who has the right to amend, modify, or… more
- Amergis (Newington, CT)
- …regarding accessibility of services + Follows State/County mandated guidelines for the nurse case management programs + Participates in outreach activities to ... continuum of care activities for assigned patients and ensuring optimum utilization of resources, service delivery, and compliance with medical regime. Essential… more