- Novo Nordisk Inc. (Omaha, NE)
- …include key opinion leaders (KOL's), academic institutions, physicians, nurse practitioners, diabetes educators, pharmacists, blood bank staff, organized ... providers and IHNs; c) develops appropriate use of NNI products and greater utilization of its services d) supports and assists representatives and managers in… more
- Commonwealth Care Alliance (Boston, MA)
- …clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA ... CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is… more
- Luke Staffing (Glendale, CO)
- **REGISTERED NURSE ** **SITE OF SERVICE:** Department of Veterans Affairs, Eastern Colorado Healthcare System (ECHCS), 4100 E. Mississippi Ave, Glendale, CO 80246 ... consider Part Time and Full Time Applicants** **POSITION OVERVIEW:** The Registered Nurse (RN) will provide on-site professional nursing services to beneficiaries of… more
- Battelle Memorial Institute (Fort Benning, GA)
- …within legal and professional parameters + Knowledge and skill in using pre-established utilization review criteria to recognize and report actual or potential ... (HRA) business line is seeking a highly motivated, full-time ** Nurse Case Manager** to join our team in support...programs for equal treatment of all staff and full utilization of all qualified employees at all levels within… more
- ERP International (Camp Pendleton, CA)
- **Overview** ERP International, LLC is seeking a **Licensed Vocational / Practical Nurse ** for a full-time position supporting the **Branch Health Clinics** at ... manuals, reports and actively engages patients in their health care. + Review details and expectations regarding referrals with patients. + Provide support to… more
- ERP International (San Diego, CA)
- **Overview** ERP International is seeking a full-time **Registered Nurse (RN) Health Educator** supporting **Naval Medical Center San Diego, CA ... of other individuals performing similar services. ? Participate in peer review and performance improvement activities. ? Practice aseptic techniques as necessary.… more
- Katmai (Fort Carson, CO)
- …same duties as those required of any military or government civil service nurse of similar experience and in similar duty assignments. **ESSENTIAL DUTIES & ... all levels of health care management to include outside agencies. Performs utilization management activities to optimize cost, quality, and access to care. Adhere… more
- Stanford Health Care (Palo Alto, CA)
- …responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient ... other interdisciplinary team members; arranges follow up care as appropriate. + Utilization Review -- Reviews prospectively, concurrently and retrospectively all… more
- Stanford Health Care (Palo Alto, CA)
- …responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient ... provide requested clinical and psychosocial information to assurereimbursement. + Utilization Review -- Reviews prospectively, concurrently and retrospectively… more
- Stanford Health Care (Palo Alto, CA)
- …development of their APPs. The Lead APP also functions under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered Nurse ... and adherence to policy through practice analysis and case review of APPs with physicians. . Investigate and respond...development of their APPs. Also functions under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS),… more
- Stanford Health Care (Palo Alto, CA)
- …growth and development of their APPs. Also functions under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered ... clinical competency and adherence to policy through practice analysis and case review of APPs with physicians. + Investigate and respond to patient/family complaints… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …. The **Care Coordinator - Retrospective** performs prospective review (benefit advisory/ prior authorization) admission, concurrent, and retrospective ... professionals dedicated to ensuring the highest quality of care while managing utilization effectively. + Influence critical decisions that impact patient care and… more
- BroadPath Healthcare Solutions (Tucson, AZ)
- …**UM RN Appeals Coordinator.** This role collaborates with clinical review staff, medical directors/physician reviewers, network physicians, and network facilities ... 8:00 AM - 5:00 PM CST (Flexible) **Responsibilities** A. Performs necessary review to ensure compliance with HHSC and other regulatory entities + Collaborate:… more
- Stony Brook University (Stony Brook, NY)
- …Department may include the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes UR ... cases for authorization for in patient stay. + Staff review short stay, long stay and complex cases to...patients who were readmitted within thirty days. Documents over utilization of resources and services. + All Medicare cases… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …about once every quarter.** **What you will do:** + Performs medical necessity review that includes inpatient review , concurrent review , benefits ... requirements, and ensures these requirements are accurately followed and Utilization Management (UM) decision determinations and timeliness standards are within… more
- Battelle Memorial Institute (Columbus, OH)
- …+ Under the supervision of a licensed psychiatrist, social worker, psychiatric nurse or psychologist, responsible for providing a wide range of behavioral health ... program policy + Coordinate attendance and agenda at Case Review Committee with military and civilian agencies + Coordinate...programs for equal treatment of all staff and full utilization of all qualified employees at all levels within… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW ... comprehensive information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team. Whether you're… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW ... and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
- Emory Healthcare/Emory University (Decatur, GA)
- …development _,_ and leadership programs + And more **Description** We're seeking a **Clinical Utilization Review Nurse Preceptor (Registered Nurse / ... . This individual will be responsible for training, mentoring, and coaching for the Utilization Review Department and must be an expert in the utilization … more
- Martin's Point Health Care (Portland, ME)
- …has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as is responsible for ensuring the receipt ... reviews for retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use appropriate governmental policies as well… more
