- 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
- Robert Half Office Team (Monterey Park, CA)
- Description The Utilization Management Nurse Specialist LVN promotes the quality and cost effectiveness of medical care by applying clinical acumen and ... review depending on case findings. Functions & Job Responsibilities * The Utilization Management Nurse Specialist LVN will facilitate, coordinate, and… more
- Robert Half Office Team (Los Angeles, CA)
- …* Facilitate, coordinate and approve medical referrals that meet specific criteria as a Utilization Management Nurse Specialist RN * Ensure timely ... Description We are seeking a UM Review Nurse to ensure the quality and cost-efficiency of...Function as a department guide for medical service requests/referral management and procedures * Handle incoming calls from providers,… more
- Kelsey-Seybold Clinic (Pearland, TX)
- …Review Specialist (LVN)** **Location: Pearland Administrative Office** **Department:** ** Utilization Management ** **Job Type: Full Time** **Salary Range: ... **Responsibilities** The Utilization Review Specialist (LVN) is responsible for conducting medical reviews, benefit verification, and applying criteria to… 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 (Bemidji, MN)
- …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
- Corewell Health (Caledonia, MI)
- …and continued stay. Educates medical staff/other health care professionals regarding utilization management and quality requirements. Makes recommendations and ... provides financial and utilization management (UM) information to other members...multiple clinical settings, or related experience Required + Registered Nurse (RN) - State of Michigan required Primary Location… 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: May 19, 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
- 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 (Gainesville, FL)
- REGISTERED NURSE SPECIALIST -F/C OPS - 60957239 Date: May 23, 2024 Location: GAINESVILLE, FL, US, 32641 The State Personnel System is an E-Verify employer. For ... No: 815370 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST -F/C OPS - 60957239 Position Number:...knowledgeable of and utilize the principles of Total Quality Management . The employee in this position spends a minimum… more
- United Therapeutics (CA)
- …and pulmonary diseases, and other orphan diseases. **How you'll contribute** The Regional Nurse Specialist (RNS) is an educational resource deployed to help ... with superior financial performance and our communities with earth-sensitive energy utilization . Our company was founded by an entrepreneur whose daughter was… more
- MyFlorida (Macclenny, FL)
- REGISTERED NURSE SPECIALIST OPS - 60955422 Date: May 3, 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
- 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
- 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
- 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
- Alameda Health System (San Leandro, CA)
- Care Management Clinical Appeals Specialist + San Leandro, CA + Finance + Patient Financial Svcs - Facil + Full Time - Day + Business Professional & IT + Req ... Resource Management issues, other issues including concerns involving under/over utilization , avoidable days and quality issues. 13. Responsible for all incoming… more