- Cognizant (Providence, RI)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Humana (Providence, RI)
- **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 ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state)… more
- Humana (Providence, RI)
- **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 ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) Compact license, with no… more
- Veterans Affairs, Veterans Health Administration (Providence, RI)
- …EDRP application. Former EDRP participants ineligible to apply. Responsibilities This Registered Nurse -Outpatient(PACT) position is located in Primary Care ... hours per week. The Patient Aligned Care Team (PACT) Outpatient Staff Registered Nurse (RN) is responsible for providing competent, evidence-based… more
- Humana (Providence, RI)
- **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 ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse (RN)** in the (appropriate state)… more
- Atrius Health (Easton, MA)
- …Department Chief, Nurse Leader or designee, this registered professional nurse provides practice support to a clinical team, recognizing the patient as ... health and welfare benefit package. **Job:** **Nursing* **Organization:** **Family Practice* **Title:** * Registered Nurse (MNA) Family Medicine - Easton - Full… more
- Prime Healthcare (Woonsocket, RI)
- …work experience post-graduation from an accredited school of nursing and a current state Registered Nurse (RN) license. + Minimum of five years acute care ... + Monitor and evaluate patient care plans to ensure alignment with clinical standards and regulatory requirements. + Facilitate utilization management, including… more
- CenterWell (Providence, RI)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... an impact** **Required Qualifications** + Must be a licensed Registered Compact Nurse license (RN) with no...Lung or Critical Care Nursing experience required + Prior clinical experience preferably in an acute care, skilled or… more
- Humana (Providence, RI)
- …help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the coordination, documentation ... Facilities to obtain sufficient clinical information. The Utilization Management Behavioral Health Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) Compact license, with no… more
- Sharecare (Providence, RI)
- …to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they… more
- Edward M. Kennedy Community Health Center, Inc. (Milford, MA)
- …may require evening, weekend and/or holiday shifts on a rotating basis. Job Requirements: + Registered Nurse License in MA + 1-2 years of clinical experience ... to support this growth. We are currently hiring a Clinical Care Manager based in Milford, MA. The ...patient engagement, reduce risk, and minimize hospital and ER utilization . + Identifies, manages, and coordinates patient care, providing… more
- Charter Care Health Partners (North Providence, RI)
- …Graduate of a School of Nursing (BSN preferred) with current license to practice as a Registered Nurse in the State of Rhode Island or in the nurse 's ... Resource Management; Continuum of Care Management (Discharge planning) and Clinical Documentation Management. Collects data via utilization ...residency if that state is a member of the Nurse Licensure Compact. Five (5) years of clinical… more
- Charter Care Health Partners (North Providence, RI)
- …Graduate of a School of Nursing (BSN preferred) with current license to practice as a Registered Nurse in the State of Rhode Island or in the nurse 's ... Resource Management; Continuum of Care Management (Discharge planning) and Clinical Documentation Management. Collects data via utilization ...residency if that state is a member of the Nurse Licensure Compact. Five (5) years of clinical… more
- Datavant (Providence, RI)
- …clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for...by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well… more
- Highmark Health (Providence, RI)
- …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
- University Medicine (East Providence, RI)
- …endoscopy population of Brown Medicine under the direct supervision of a registered nurse (RN). PRINCIPAL DUTIES AND RESPONSIBILITIES: Consistently applies the ... cleaning and disinfection of equipment. + Demonstrates strong understanding and utilization of infection prevention practices. + Maintains appropriate levels of… more