- University of Washington (Seattle, WA)
- …artistic pursuits, and natural beauty. Requirements: Current license to practice as a Registered Nurse in the State of Washington. Minimum of three years ... benefits for this position, click here (https://hr.uw.edu/benefits/wp-content/uploads/sites/3/2018/02/benefits-summary-classified-staff-greater-than-half-time-20220908\_a11y.pdf) . RN2, Utilization Management Specialist. This is a hybrid … more
- University of Utah Health (Salt Lake City, UT)
- …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** + ... Current license to practice as a Registered Nurse in the State of Utah,...Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of… more
- Beth Israel Lahey Health (Wakefield, MA)
- …care system considered in lieu of degree + Active, unrestricted Massachusetts Registered Nurse License required. Certification in Case Management (CCM) ... in healthy behavior. Working with the healthcare team, the Care Manager, RN monitors appropriate utilization of healthcare resources, promotes quality and… more
- Bassett Healthcare (Cooperstown, NY)
- …needs. The RN contributes to the support of patients through interdisciplinary teamwork. Registered Nurse I: The RN I status is only appropriate for ... after hire. Salary Range: $36.76 - $55.13 per hour Registered Nurse II: The RN ...as measured by periodic random preceptor and supervisory chart review as per probationary appraisal schedule ( RN … more
- Kepro (Indianapolis, IN)
- …other information applicable to the position assignment. Required Qualifications/Experience: + Active Registered Nurse ( RN ) or Licensed Practical Nurse ... partner for health solutions in the public sector. Acentra is currently looking for a Utilization Management Appeals Nurse - LPN/ RN to join our growing team.… more
- HCA Healthcare (Round Rock, TX)
- …Science in Nursing (BSN) - preferred** **Licenses and Certifications** + **Current State of Texas Registered Nurse ( RN ) license or Compact Registered ** + ... management/administrative team to ensure staff productivity and appropriate resource utilization to achieve high quality patient care while meeting...encourage you to apply for our Registered Nurse Supervisor House PRN opening. We review … more
- Universal Health Services (Temecula, CA)
- …The Southwest Healthcare Regional office in Temecula, CA is seeking Two (2) Full-Time RN Central Utilization Review Nurses who will be responsible for ... correct payer source for hospitalization and communication. + Ensures compliance of utilization review practices as required by payers, external regulatory… more
- Humana (Columbus, OH)
- …hours per week **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the (appropriate state) (compact RN ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...to assist with social determinants and closing gaps + Review UM inpatient admission and clinical information to determine… more
- Dignity Health (Rancho Cordova, CA)
- …skills. - Graduate of an accredited school of nursing. - Clear and current CA Registered Nurse ( RN ) license. **Preferred Qualifications:** - 7 years UM ... **Overview** This position is hybrid in-office and work from home.** Dignity Health...and supervision of the department Manager/Director, the Supervisor of Utilization Management is responsible and accountable for coordination of… more
- Dignity Health (Rancho Cordova, CA)
- …vital to maintaining excellence in care and service. **Responsibilities** This position is hybrid in-office and work from home. Office space will be available in ... position will involve rotating Saturday coverage.** **Position Summary:** The Manager of Utilization Management (UM) is responsible for managing the day to day… more
- Centene Corporation (Austin, TX)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... - Must be license in the state of Texas** ** RN , LCSW, LMHC, PLC, LMFT, LMHP** **Position Purpose:** Performs...abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with… more
- Kepro (Chicago, IL)
- …Supervising and managing the day-to-day activities of the assigned case management and utilization review teams. + Mentoring, coaching, and training team members ... public sector. Acentra seeks a Clinical Operations Manager - RN ( Hybrid within Illinois) to join our...Supervises, mentors, coaches, trains, and develops the: o Case review and utilization review teams… more
- Centene Corporation (Sacramento, CA)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... Treatment Plans preferred. Knowledge of ABA services and BH utilization review process preferred. Experience working with...holidays, and a flexible approach to work with remote, hybrid , field or office work schedules. Actual pay will… more
- Humana (Columbus, OH)
- …skills to make an impact** **Required Qualifications** + An active, unrestricted Virginia Registered Nurse ( RN ) or Behavioral Health clinician license such ... + Supervises utilization management personnel and oversee all utilization management functions, including inpatient admissions, concurrent review , prior… more
- Centene Corporation (Raleigh, NC)
- …related experience. Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or ... perspective on workplace flexibility. **Position Purpose:** Supervises Prior Authorization, Concurrent Review , and/or Retrospective Review Clinical Review … more
- Centene Corporation (Oklahoma City, OK)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... on workplace flexibility. **Position Purpose:** Manages the behavioral health (BH) utilization review clinicians to ensure appropriate care to members.… more
- Kepro (Charleston, WV)
- …Certification is preferred. + 5 years of clinical experience, with a focus on utilization review for at least 3 years, demonstrated expertise in optimizing ... partner for health solutions in the public sector. Position Overview As a RN Clinical Operations Manager, you will lead the charge in overseeing Clinical Operations,… more
- Kepro (New Martinsville, WV)
- …community. + Ensure day-to-day processes are conducted in accordance with the Utilization Review Accreditation Commission (URAC) and other regulatory standards. ... health solutions in the public sector. Acentra seeks an RN Complex Case Manager in West Virginia da to...NOTE: ** This is a full-time, direct hire, exempt, Hybrid opportunity with Benefits. ** The selected candidate is… more
- Humana (Jackson, MS)
- …phone calls **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) compact licensure with no disciplinary action ... Utilization Management Nurse 2/Home Health Utilization Management: + Review cases using clinical...is a plus **Work-At-Home Requirements** To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided… more
- Centers Plan for Healthy Living (Margate, FL)
- RN Care Manager ( Hybrid ) 5297 W...other providers involved in the member's care. + Initiates utilization review for preauthorization and post service ... setting + Experience working within a managed care environment We offer: + Hybrid schedule (for employees who qualify) Care Solutions is committed to leveraging the… more