- Memorial Sloan-Kettering Cancer Center (New York, NY)
- …appeals and acquire authorizations for treatment **Key Qualifications:** + Current NYS Registered Nurse License/Registration and BSN preferred + At least 2-3 ... The MSK Case Management Department is made up of Registered Nurses (RNs), Licensed Practical Nurses (LPNs) and support...years of clinical hospital nursing experience + Managed care/ UR /CM… more
- Alameda Health System (San Leandro, CA)
- …AHA-American Heart Association. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California. **PAY RANGE** ... meet criteria - coordinates denials with the attending physician, and the UR physician advisor. Prepares case reports; documents treatment plan, progress notes and… more
- Cognizant (Washington, DC)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...an impact by performing advanced level work related to clinical denial management and managing clinical denials… more
- Community Health Systems (Franklin, TN)
- …regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact State Licensure ... **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating...with healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence to hospital utilization… more
- Beth Israel Lahey Health (Plymouth, MA)
- …job that may reasonably be required._ **Education/Experience Required:** _Required_ + State of MA Registered Nurse (RN) + 3-5 years acute care nursing + Two ... patient and family/caregiver. Facilitates smooth care transitions by ensuring appropriate clinical follow-up is arranged and referrals to proper post-acute providers… more
- Trinity Health (Fresno, CA)
- …through the effective utilization of the facility's resources. 1. Current licensure as a Registered Nurse (RN) in the state of California is required. 2. Current ... hire into position. 6. Previous experience in at least two (2) areas of clinical specialty in an acute care setting is required. 7. Excellent communication skills,… more
- University of Rochester (Rochester, NY)
- …DECEMBER 31, 2025; WITH POSSIBLE RENEWAL PENDING GRANT POSITION SUMMARY: The Pediatric Registered Nurse (RN) will work daily to implement interventions aimed at ... Weekly Hours: 40 Department: 400081 General Pediatrics Work Shift: UR - Day (United States of America) Range: ...record reviews, and supporting dissemination of results. The Pediatric Nurse will have appropriate clinical knowledge, excellent… more
- Texas Health Resources (Arlington, TX)
- Registered Nurse (RN) Care Transition Manager - Full Time Work location: Texas Health Arlington 800 W. Randol Mill Road TX 76012 Work hours: Full Time - Days ... optimal utilization of resources; promotes cost-effectiveness & efficiency; communicates with UR nurse to confirm appropriateness Refers appropriate cases for… more
- University of Rochester (Clifton Springs, NY)
- …Type: Full time Scheduled Weekly Hours: 40 Department: 500676 CVSL-Region Cardiology Nursing Work Shift: UR - Day (United States of America) Range: UR URCC 214 H ... patient care services and assumes an expanded role which may include charge nurse , preceptor, and committee member responsibilities. Full Time, 40 hours Days … more
- MyFlorida (Fort Walton Beach, FL)
- OPS REGISTERED NURSE - 64853359 Date: Oct 21, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... No: 860498 Agency: Department of Health Working Title: OPS REGISTERED NURSE - 64853359 Pay Plan: Temp...of care to HIV/AIDS clients. Responsible for assuring all clinical services provided are consistent with recommended protocols and… more
- St. James Hospital (Hornell, NY)
- Registered Nurse - Per Diem Hornell, NY (http://maps.google.com/maps?q=7329+Seneca+Rd+N+Hornell+NY+USA+14843-9684) Description Are you looking for the next step ... department and with other departments. C. Communicates appropriately and clearly to Clinical Supervisor, Charge nurse , coworkers and physicians. D. Identifies… more
- HCA Healthcare (Plano, TX)
- …of each individual is recognized. Submit your application for the opportunity below: Registered Nurse Case Manager IP RehabMedical City Plano **Benefits** Medical ... benefits may vary by location._** We are seeking a(an) Registered Nurse Case Manager IP Rehab for.... Prioritizes goals and develops a plan to achieve clinical and fiscal outcomes . Monitors various aspects of… more
- University of Rochester (Rochester, NY)
- …Type: Full time Scheduled Weekly Hours: 40 Department: 500909 Gyn Oncology-Nursing SMH Work Shift: UR - Rotating (United States of America) Range: UR URCC 214 H ... care services and assumes an expanded role which may include charge nurse , preceptor, and committee member responsibilities. FT position available Seeking a… more
- Munson Healthcare (Traverse City, MI)
- …development, simulation education and tuition reimbursement What's Required : + An active Registered Nurse license in the State of Michigan + Certification in ... Traverse City Acute Inpatient Dialysis Nurse Experienced dialysis nurse preferred, will...job. Find collaboration. At Munson Healthcare, nurses are respected clinical experts, mentors, advocates, leaders in practice and central… more
- Munson Healthcare (Traverse City, MI)
- …woods, on the trails or around town after work What's Required : + An active Registered Nurse license in the State of Michigan + Certification in the specialty ... next nursing job. Find collaboration. At Munson Healthcare, nurses are respected clinical experts, mentors, advocates, leaders in practice and central to improving… more
- Munson Healthcare (Traverse City, MI)
- …woods, on the trails or around town after work What's Required : + An active Registered Nurse license in the State of Michigan + Certification in the specialty ... next nursing job. Find collaboration. At Munson Healthcare, nurses are respected clinical experts, mentors, advocates, leaders in practice and central to improving… more
- Beth Israel Lahey Health (Burlington, MA)
- …of the hospital care. Using the concepts of utilization review, clinical documentation improvement and revenue integrity, these specialized case managers analyze ... of the hospital care. Using the concepts of utilization review, clinical documentation improvement and revenue integrity, these specialized case managers analyze… more
- Beth Israel Lahey Health (Plymouth, MA)
- …establish the appropriate level of care using Interqual criteria. + Integrates clinical knowledge with billing knowledge to review, evaluate, and appeal clinical ... improve the denial management, documentation, and appeals process. + Collaborates with UR Manager and/or physician advisor regarding cases that do not meet… more
- CDPHP (Latham, NY)
- …you to be a part of that experience. The Utilization Review ( UR ) Nurse is responsible for the clinical review and documentation for services requiring prior ... coordinating with Medical Directors on denials. In addition, the UR nurse is responsible for completing inpatient...recognized criteria and CDPHP policies, and procedures. QUALIFICATIONS: + Registered Nurse with a current New York… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …may require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review ( UR ) Registered Nurse is responsible for evaluating ... initiatives *Education*: * Attains and maintains current knowledge in UR /UM practices, payer requirements, clinical guidelines, and.../*License/Certifications:*/ * Possession of a valid license as a Registered Nurse issued by the State of… more
