- University of Maryland Medical System (Baltimore, MD)
- …care setting; focus on advancing own professional development. Solid knowledge and clinical skills. 2 . Demonstrates highly effective interpersonal, verbal and ... Company Description Experience the highest level of appreciation at UM Baltimore Washington Medical Center - named Top Workplace in the Baltimore area by The… more
- University of Michigan (Ann Arbor, MI)
- …following completion of orientation. The selected candidate will practice as a Neonatal Nurse Practitioner for 2 years in the CS Mott Children's Hospital, ... career opportunity for current registered nurses who have graduated from an accredited Nurse Practitioner program with a Neonatal Specialty. By teaching a wide range… more
- UnitedHealth Group (Los Angeles, CA)
- …directors, nurse coders, and operations team to deliver DRG Clinical Review performance Identifying opportunities expand and optimize program success in ... scale. Join us to start Caring. Connecting. Growing together. Clinical Excellence, a national OptumCare team, is currently seeking...hospital system or payor Experience in chart review (DRG, UM , PA) or prior role as hospital physician advisor… more
- Advocate Aurora Health (Kenosha, WI)
- …Member practices. Level of Education: Bachelor's Degree in Nursing Years of Experience: 2 years of clinical nursing experience. KNOWLEDGE SKILLS AND ABILITIES ... and reporting care coordination, discharge planning and utilization management ( UM ) activities. Collaborates with managers, physicians, medical directors, advisory… more
- MetroPlusHealth (New York, NY)
- …amongst the care team Minimum Qualifications Bachelor's Degree required; BSN preferred. Two ( 2 ) to three (3) years clinical experience in certified home health ... Using the assessments and interview done by the Assessment Nurse , the Care Manager identifies the risk factors, strengths,...face to face the condition of the members. Identify clinical issues that require immediate clinical assessment… more
- Blue Cross and Blue Shield of Minnesota (St. Paul, MN)
- …complete unspecified code and modifier code reviews. Your Responsibilities Applies clinical experience, health plan benefit structure and claims payment knowledge to ... pre- service and retrospective reviews by gathering relevant and comprehensive clinical data through multiple sources. Leverages clinical knowledge, business… more
- Heywood Hospital (Gardner, MA)
- …Utilization Management- Utilization Review and Care Transitions & Coordination Providing clinical information to payers, monitoring length of stay, seeking necessary ... admission against High Risk Screening Criteria and documents outcome within the UM EMR. Completes assessments on re-admissions within 30 days including reasoning for… more
- University of Southern California (Los Angeles, CA)
- …coordinating, monitoring and evaluating care and activities provided by personnel. Clinical Review Oversight: Supervise the clinical review process to ... line with evidence-based guidelines. Develop and implement standards and processes for clinical and non- clinical services provided by Utilization Review team… more
- UnitedHealth Group (Minneapolis, MN)
- …Management experience and/or administrative leadership experience Prior UM experience Clinical experience within the past 2 years *All employees working ... a national organization and team, and collaborate with peers, nurse managers, and non- clinical employees from across...Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool… more
- UNC HEALTH (Raleigh, NC)
- …gynecologic disorders. They are dedicated to offering cutting-edge treatment to patients, clinical trials and provide the same quality of care found at nationally ... communicate with Care Management Assistant (CMA) to share priorities. 2 . CAPP Meeting - Attend and actively participate in...as appropriate. As necessary meet with the Utilization Manager ( UM ) and SW after the meeting to discuss updates… more
- Integra Partners (Troy, MI)
- …and clinical processes + Develop and deliver comprehensive training programs for UM clinical staff on: + Writing clear and concise clinical ... Integra Partners is seeking an experienced nurse educator to join our Operations Training &...+ Current, active RN license EXPERIENCE: + Minimum of 2 years of experience in clinical nursing,… more
- Magellan Health Services (Boise, ID)
- Under general supervision, and in collaboration with other members of the clinical team, authorizes and reviews utilization of mental health and substance abuse ... develops discharge plans and oversee their implementation. + Performs quality clinical reviews while educating and making appropriate interventions to advance the… more
- Humana (Oklahoma City, OK)
- …(PhD/EdD) in the State of Oklahoma without restrictions + 3+ years of post-degree clinical experience in direct patient care. + 2 + years of case management ... one of the following: + An active Licensed Registered Nurse (RN) in Oklahoma/multi-state, without restrictions + A licensed...and/or rehabilitative counseling experience. + 2 + years of clinical supervisory experience. +… more
- Veterans Affairs, Veterans Health Administration (Albuquerque, NM)
- … Care Coordination for Operations Service! Responsibilities The Utilization Management ( UM ) Registered Nurse (RN) executes position responsibilities that ... UM RN is responsible for participating in field UM program review activities and providing advanced clinical...nursing experience in which one year is equivalent to Nurse I, Level 2 ; OR a BSN… more
- University of Miami (Miami, FL)
- …this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . JOB DESCRIPTION UM Title: Senior Registered Nurse Supervisor's ... 2014. Job Summary (Purpose and Function): The Pain Management Nurse will be a professional registered nurse ...and variances to the plan of care. Documents in UM Care program intra-procedure assessment of patient condition. Planning… more
- University of Miami (Miami, FL)
- …Accountabilities (For Non-exempt Employees Include Percent of Effort): Meets requirements of Clinical Trials Chemotherapy Nurse 50% Works closely with the ... and clinical practice standards. Provides documentation to the Research Nurse / Nurse Coordinators, and/or Research Staff/Data Managers. Meets study timelines… more
- University of Miami (Miami, FL)
- …(For Non-exempt Employees Include Percent of Effort): Meets requirements of Clinical Trials Senior Chemotherapy Nurse 30% Administers research study ... protocol and clinical practice standards. Provides documentation to the Research Nurse and/or Data Manager. Meets study timelines and objectives as defined by… more
- University of Miami (Miami, FL)
- …please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Registered Nurse works as a part of a team to ... position include, but are not limited to: Performance Nursing Duties as per Nurse Job Description 100% Perform patient interview and obtains vital signs. Assists… more
- Veterans Affairs, Veterans Health Administration (Reno, NV)
- Summary The Nurse II Utilization Management ( UM ) Registered ...nursing experience in which one year is equivalent to Nurse I, Level 2 ; OR a BSN and ... for providing competent, evidence-based practices within the position. Uses UM Criteria to perform complicated reviews. Responsibilities Major Duties...1 year of professional nursing experience equivalent to the Nurse I, Level 2 ; OR a Master's… more
- Commonwealth Care Alliance (Boston, MA)
- …Reporting to the Manager Utilization Management, the Nurse Utilization Management ( UM ) Reviewer is responsible for day-to-day timely clinical and service ... with Standard Operating Procedures + Ensures accurate documentation of clinical decisions and works with UM Manager...Utilization Management experience in a managed care setting + 2 or more years working in a clinical… more
