- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: The Utilization Review Clinical Review (CR) 3 Team Lead will assist the Director of UR and Associate Director of UR with daily staff ... and provide input for committees. Other duties as assigned. Minimum Qualifications: NYS Licensed/ Registered (or eligible) RN , Bachelors Degree in Nursing and a… more
- The Arora Group (Bethesda, MD)
- …+ The Contractor shall frequently collaborate with managers of the UBO, Utilization Review Registered Nurse ( RN ) and pre-certification clerk. + The ... Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently...+ Experience: Requires a minimum of 2 years of clinical and utilization review experience… more
- Prime Healthcare (Ontario, CA)
- …Administration, or another relevant field + A minimum of seven (7) years' experience in Clinical Utilization Review or Case Management with a large Health ... Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Responsibilities The Corporate Director of Clinical Utilization Management (UM) provides… more
- Elevance Health (Norfolk, VA)
- …Requirements:** + Requires a HS diploma or equivalent and a minimum of 2 years of clinical or utilization review experience and minimum of 1 year of managed ... **Title:** Licensed Utilization Review II **Location** : This...appropriate and consistent administration of plan benefits through collecting clinical information required to preauthorize services, assess medical necessity,… more
- Elevance Health (Louisville, KY)
- …+ Requires a HS diploma or equivalent and a minimum of 2 years of clinical or utilization review experience; or any combination of education and ... The **Licensed Utilization Review I** is responsible for...appropriate and consistent administration of plan benefits through collecting clinical information to preauthorize services, assess medical necessity, out… more
- CareFirst (Baltimore, MD)
- …is required in addition to the required work experience. **Licenses/Certifications:** + Health Services\ RN - Registered Nurse - State Licensure and/or ... Licensure Upon Hire Required. **Experience:** 8 years' Experience in a clinical and utilization review role. 3 years Management experience. **Preferred… more
- Billings Clinic (Billings, MT)
- …to starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Utilization Review RN Billings ... - 44.18 Under the direction of department leadership, the Utilization Review / Management RN . This...and Certification Healthcare Provider and ACLS CPR certifications Current Registered Nurse license in the state of… more
- Sharp HealthCare (San Diego, CA)
- …+ California Registered Nurse ( RN ) - CA Board of Registered Nursing **OR** California BBS Licensed Clinical Social Worker (LCSW) - CA Board of ... BLS Healthcare) - American Heart Association; California BBS Licensed Clinical Social Worker (LCSW) - CA Board of Behavioral...Therapist (LMFT) - CA Board of Behavioral Sciences; California Registered Nurse ( RN ) - CA… more
- CVS Health (Charleston, WV)
- …health care more personal, convenient and affordable. This is a fully **remote** Utilization Review Clinical Consultant with a schedule of Monday-Friday, ... Virginia state licensure (LCSW, LPCC, LMFT, LPAT) or a Registered Nurse ( RN ) with active...some weekends **Preferred Qualifications** + Managed care experience + Utilization review experience + Ability to multitask,… more
- Munson Healthcare (Traverse City, MI)
- … Nurse in the State of Michigan. + Minimum of three years clinical experience required. Previous utilization review and/or case management in a ... another. + Notifies insurers and third party administrators of clinical review information. + Maintains documentation on...payers and external case managers Why work as a Utilization Review Specialist at Munson Healthcare? +… more
- BAYADA Home Health Care (Elmsford, NY)
- …Experience developing performance improvement plans, field staff orientation, clinical chart review , and utilization review reporting + Strong assessment ... Health Care has an immediate opening for a **Part-Time** ** Clinical Manager/ Educator** in our **Elmsford, NY** home care...Pediatric experience preferred + Minimum two years as a nurse ( RN ) + Minimum one year supervisory… more
- Erickson Living (Parkville, MD)
- …+ Participating in clinical leadership meetings such as Wound Rounds, Clinical Operations Meeting, Utilization Review , and Performance Improvement/Risk ... by Erickson Senior Living Join our team as the Clinical Manager is an active member of the ...care, assisted living or hospital) is required. + Current Registered Nurse license for the state in… more
- Veterans Affairs, Veterans Health Administration (Sheridan, WY)
- … of the EDRP application. Responsibilities The Nurse Referral Coordination Team (RCT) Registered Nurse ( RN ) ) is responsible for executing a streamlined ... possesses intimate knowledge of the internal referral care process, clinical review criteria, utilization management...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Veterans Affairs, Veterans Health Administration (Spokane, WA)
- …by collaborating with members of the team. Responsibilities The Referral Coordination Team (RCT) Registered Nurse ( RN ) ) is responsible for: Executing a ... Possess intimate knowledge of the internal referral care process, clinical review criteria, utilization management...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Pipeline Health System, LLC (Toast, NC)
- …- Behavioral Health Unit/FT/Days Job Summary: This Utilization Review (UR) Registered Nurse ( RN ) position supports the Mission of Pipeline Health ... Job Title: Utilization Review Registered ...communication. Experience: + Minimum two (2) years of previous clinical experience in acute care setting. + Minimum one-year… more
- LifePoint Health (Hickory, NC)
- * Registered Nurse ( RN ), Clinical Case Manager* Fulltime Days * * *Your experience matters* At Frye Regional Medical Center, we are driven by a profound ... outcome of care management as prescribed in the initial Utilization Review Plan with regard to resources,...and harassment in employment." **Job:** **Nursing* **Organization:** ** **Title:** * Registered Nurse ( RN ), Clinical… more
- Bon Secours Mercy Health (Midlothian, VA)
- …create an environment where associates want to work and help communities thrive. ** Registered Nurse ( RN ) - PRN - Clinical Nurse Educator - Physician ... Richmond, VA** **PRIMARY FUNCTIONS/ GENERAL PURPOSE OF POSITION:** The clinical nurse will facilitate the coordinated care...delivery **EMPLOYMENT QUALIFICATIONS:** Must be currently licensed as a Registered Nurse in the State of Virginia… more
- Trinity Health (Syracuse, NY)
- …$10,000 NEW HIRE SIGN ON BONUS **Position Purpose:** The Registered Nurse Utilization Review (UR), Clinical Care Manger (CCM) actively manages the ... utilization review process and patient progression from Admission to Discharge....and works collaboratively with unit staff and support team ( RN , Physician/ Clinical Affiliate, DPA, MSW, CDI, Rehab… more
- Select Medical (Los Angeles, CA)
- …Century City / Los Angeles, CA Case Manager (CM) - Full Time (on-site) Registered Nurse ( RN ) or Licensed Clinical Social Worker (LCSW) **Pay Rate: $50 - ... + Coordinates with other departments, ie: Pre-Admissions, Admissions, Patient Accounts, Utilization Review , PPS Coordinator, etc., to assure positive fiscal… more
- Veterans Affairs, Veterans Health Administration (Bay Pines, FL)
- Summary The Emergency Department Utilization Management (ED-UM) Registered Nurse ( RN ) is responsible for providing competent, evidence-based practices ... healthcare continuum. Performs other duties as assigned. The ED-UM RN performs utilization review activities,...level degree in Nursing may have opportunity to become registered as a nurse with a state… more