- Novo Nordisk Inc. (Redding, CA)
- …the DCS I maintains relationships with physicians, physician assistants, nurse practitioners, medical assistants, pharmacists, nurses and other paramedical customers ... by not exceeding the Novo Nordisk points threshold assigned based on review of Motor Vehicle Records. Qualifications Bachelor's or equivalent degree, and/or Pharm… more
- Merck & Co. (MA)
- …channels of drug distribution, Oncology GPO's, wholesalers and specialty pharmacies. Review and evaluate patterns for products purchased and prescribed, outpatient ... and functional areas; ensure integration with the Key Account Manager, Nurse Educator, Field Reimbursement Associate, Medicare Account Executive, and other key… more
- The Arora Group (Bethesda, MD)
- Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/LVN) - Utilization Review in Bethesda, ... required on Federal holidays. DUTIES OF THE LICENSED PRACTICAL NURSE (LPN/LVN) - UTILIZATION REVIEW : + Initiate,...+ The Contractor shall perform pre-cert and authorization of insurance pertaining to patient admission and surgical admission as… 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 NURSE ... technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… 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 a member of a team responsible for ensuring the ... reviews for retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use appropriate governmental policies as well as… more
- HCA Healthcare (Webster, TX)
- …your knowledge and expertise! **Job Summary and Qualifications** We are seeking a Registered Nurse (RN) Quality - Peer Review Coordinator for our facility to ... **Description** **Introduction** Do you have the career opportunities as a(an) RN Peer Review Coordinator you want with your current employer? We have an exciting… more
- Centene Corporation (New York, NY)
- …criteria + Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care + ... care to members + Provides feedback on opportunities to improve the authorization review process for members + Performs other duties as assigned + Complies with… more
- Centene Corporation (New York, NY)
- …discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in ... determinations or provide recommendations based on requested services and concurrent review findings + Assists with providing education to providers on utilization… more
- Humana (Columbus, OH)
- …first** Humana Healthy Horizons in Ohio is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to support the coordination, documentation ... medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation… more
- Ascension Health (Wamego, KS)
- …Health Center, Wamego, Kansas **Benefits** Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans ... health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests within assigned… more
- Actalent (San Antonio, TX)
- Actalent is hiring fully remote Concurrent Review RNs! *Must be located in Texas* Job Description: + Reviewing authorization requests + Utilizing evidence-based ... + Active Compact RN License in Texas + Prior Utilization management/Concurrent review experience + Acute care experience (ER/ICU) + Experience with MCG Why… more
- Guthrie (Towanda, PA)
- Up to a $15,000.00 Sign on Bonus! Summary The Wellness Nurse plays a key role in health promotion and illness prevention of patient populations through ... nursing-patient collaboration and patient education. This nurse performs the Medicare Annual Wellness Visit under the direct supervision of a physician (physician on… more
- Bassett Healthcare (Cooperstown, NY)
- …discuss specific positions in our conversations. What you'll do The Registered Professional Nurse (RN), Acute Care in the Emergency Department is accountable for the ... needs. The RN contributes to the support of patients through interdisciplinary teamwork. Registered Nurse I: The RN I status is only appropriate for a new nurse… more
- NJM Insurance (Trenton, NJ)
- …lines of business by performing prospective and retrospective Utilization Review of medical services/treatment requested or rendered by medical providers/suppliers ... is medically necessary, clinically appropriate and causally related based upon a review of the medical records, regulations, NJM Medical, WC, and PIP Policies,… more
- State of Colorado (Denver, CO)
- Youth Corrections Medical Operations Coordinator ( Nurse V) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4573875) Apply Youth Corrections ... Medical Operations Coordinator ( Nurse V) Salary $108,540.00 - $151,968.00 Annually Location Denver...provides support for performance evaluations. This role also includes review and implementation of preventive health care services, program,… more
- State of Colorado (CO)
- CDOC Registered Nurse ( Nurse I) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4762850) Apply CDOC Registered Nurse ( Nurse I) ... Statewide, CO Job Type Full Time Job Number CAA Nurse I Statewide 01/2025 Department Department of Corrections Division...+ Medical and Dental Health Plans; + Paid life insurance ; + Short and long-term disability coverage; + 11… more
- STG International (Milledgeville, GA)
- STGi is seeking a Licensed Practical Nurse /Licensed Vocational Nurse to provide services to our Georgia War Veterans Home. JOB SUMMARY: The primary purpose of ... FUNCTIONS: + Ensure the facility meets the minimum staffing levels for nurses and nurse aides; complete required posting of nursing staff data as required. + Ensure… more
- State of Colorado (Sterling, CO)
- CDOC Registered Nurse - Part-time - Sterling Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4756062) Apply CDOC Registered Nurse - ... Sterling, CO Job Type Part Time Job Number CAA Nurse I SCF 012/2024 Department Department of Corrections Division...assessment, written performance assessment or it may include a review of your application material and your responses to… more
- State of Michigan (Marquette, MI)
- Registered Nurse Manager 12 Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/4588481) Apply Registered Nurse Manager 12 Salary $39.30 - ... teams of Resident Care Aides and LPN's. As a nurse this individual is also required to perform clinical...as your name and address, is hidden during initial review . Applicants are therefore encouraged to provide detailed education… more
- Spurwink Services (Biddeford, ME)
- …ME, USA | Hourly | Clinical | Full Time The Behavioral Health Nurse Care Manager works in conjunction with multidisciplinary teams to coordinate and provide ... any significant healthcare needs or gaps in care. + Review and monitor HIN and VMS for pertinent participant...required records and documentation. QUALIFICATIONS: Must be a registered nurse ; a psychiatric nurse licensed as a… more
