- Aequor (New York, NY)
- …York State Prefer minimum of 1-3 years relevant experience in case management, utilization review and/or quality assurance Experience in acute episodic care, ... wellness care and counseling of adults Proficiency in use of electronic medical record keeping systems desirable BLS certification required Case Management and… more
- Careerbuilder-US (Atlanta, GA)
- Job Title: Utilization Review Nurse I Location: 100% Remote Duration: 3 months (Possibility of extension) Shift timings: 8:00 AM to 5:00 PM EST (Mon-Fri) Pay ... the Utilization Management team primarily responsible for inpatient medical necessity/ utilization review and other utilization management activities… more
- Supplemental Health Care (Syracuse, NY)
- …visit Supplemental Health Care Job ID #1164260. Posted job title: Registered Nurse Utilization Review .About Supplemental Health CareAt Supplemental Health ... Supplemental Health Care is seeking a travel nurse RN Utilization Review ...offers a wide variety of industry-leading benefits including:- Full medical , dental, vision, life, and even pet insurance to… more
- TalentBurst, Inc (Irving, TX)
- …insurance providers and vendors to obtain approved certification for services. The RN Utilization Review Nurse collaborates as necessary with other members ... with tax-free stipend amount to be determined. Posted job title: Registered Nurse Utilization Review \ 1366About TalentBurst, IncTalentBurst Health… more
- HumanEdge Travel Nursing and Allied Health (Hartford, CT)
- HumanEdge Travel Nursing and Allied Health is seeking a travel nurse RN Utilization Review for a travel nursing job in Hartford, Connecticut.Job Description ... 13 weeks40 hours per weekShift: 8 hoursEmployment Type: TravelImmediate need for Utilization Review RNs for a Connecticut Healthcare Network. After orientation,… more
- US Tech Solutions, Inc. (Columbia, SC)
- …practices. . May provide any of the following in support of medical claims review and utilization review practices: Performs medical claim reviews ... reviewed using the individual patient's benefits contract and our medical policies. The nurse would read through...indicated protocol sets or clinical guidelines. Provides support and review of medical claims and utilization… more
- MUSC (Charleston, SC)
- …Prior leadership experience preferred. One year of case management and/or utilization review work experience preferred. Required Licensure, Certifications, ... Job Description Summary The Nurse Case Manager (NCM) I reports to the...as a clinical expert related to discharge planning, resource utilization , and case management.Entity Medical University Hospital… more
- Kaiser Permanente (Fontana, CA)
- …general and specialized principles, practices, techniques and methods of Utilization review /management, discharge planning or case management.Working knowledge ... Kaiser Permanente is seeking a Registered Nurse (RN) Case Management for a nursing job...risk and/or patient safety which are identified during case review or other activities.Reviews, analyses and identifies utilization… more
- MUSC (Charleston, SC)
- …Prior leadership experience preferred. One year of case management and/or utilization review work experience preferred. Case Management certification preferred. ... the patient's/family's self-care abilities and supporting their consumer rights.Entity Medical University Hospital Authority (MUHA)Worker Type EmployeeWorker Sub-Type RegularCost… more
- Community Health Plan of Washington (Medford, OR)
- …environment. About the Role The Level I Utilization Management Clinician performs utilization review for medical or behavioral health requests using ... utilization review criteria, technologies, and tools. Identifies, coordinates, and implements...identified variances within the case against criteria utilized for medical review . * Regularly communicates with the… more
- MUSC (Charleston, SC)
- …Prior leadership experience preferred. One year of case management and/or utilization review work experience preferred. Required Licensure, Certifications, ... the patient's/family's self-care abilities and supporting their consumer rights.Entity Medical University Hospital Authority (MUHA)Worker Type EmployeeWorker Sub-Type PRNCost… more
- Saint Francis Health System (Tulsa, OK)
- …of adverse physiological trends, assurance of appropriate prophylactic strategies, and medical chart review . Virtually evaluates patients, educates the patient ... Saint Francis Health System is seeking a Registered Nurse (RN) Virtual Care for a nursing job...location (not a remote position)Will perform admit, discharge chart review and other patient care duties from an office… more
- ResCare Community Living (Canton, OH)
- …and submit to State Health Services Director and Assigned Director, Clinical Practice* Review utilization report at least monthly to ensure adequate hours on ... meetings* Chairs committees as applicable (eg safety, infection control, incident/accident review , human rights, etc.).* Participates in the development of the… more
- Pine Rest Christian Mental Health Svc (Grand Rapids, MI)
- …leader, delegating/coordinating staff assignments and promoting staff development.Responsible for the utilization and continued review of patient care protocols, ... of this incredible work.What Will You Do?As a Registered Nurse at Pine Rest, you'll be part of tight-knit...is onsite and may require both weekend and holiday hours.Benefits: Medical , dental, vision & life insurance plans403(b) retirement match… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …strategies and interventions, consultation with members on their medications and durable medical equipment, review member care plans, address home care needs, ... Job Category:Nursing - Registered Nurse Work Shift/Schedule:8 Hr Morning - AfternoonNortheast Georgia...Contracting, pay for performance) and measures related to efficient utilization and cost.Participates in the development/ review /revision of… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …but are not limited to, consultation with members on their medications and durable medical equipment, review member care plans, address home care needs, and ... Job Category:Nursing - Registered Nurse Work Shift/Schedule:8 Hr Morning - AfternoonNortheast Georgia...Contracting, pay for performance) and measures related to efficient utilization and cost.Participates in the development/ review /revision of… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …team members as needed to ensure services will be covered.Coordinate and communicate with Utilization Review Nurse on a daily, consistent basis to ensure ... Job Category:Nursing - Registered Nurse Work Shift/Schedule:8 Hr Morning - AfternoonNortheast Georgia...patient needs; Works collaborate with the Physicians, patient/family, nursing, utilization review and other members of the… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …of their caseloads, provides coverage to Intake department, and assists with Utilization Review , Quality Assurance, and Performance Improvement activities as ... Job Category:Nursing - Registered Nurse Work Shift/Schedule:12 Hr Morning - EveningNortheast Georgia...with emphasis on care of adults in acute care medical and surgical areas/home care preferred.Other: Preferred Job QualificationsPreferred… more
- Saint Francis Health System (Tulsa, OK)
- Saint Francis Health System is seeking a Registered Nurse (RN) Telemetry for a nursing job in Tulsa, Oklahoma.Job Description & RequirementsSpecialty: ... click HERE to login and apply.Full Time7a - 7pJob Summary: The Clinical Nurse I assesses, plans, implements and evaluates nursing care, utilizing the nursing process… more
- UT Health Tyler (Tyler, TX)
- …to $20,000 Join our team as a full-time, day shift, Case Manager Registered Nurse in Tyler, TX. Fulfilling your purpose begins here: People First, Always. Here's how ... we take care of our people: Medical , vision, dental health insurance, health savings account /...of patients across the continuum promoting quality care, effective utilization of resources and assuming a leadership role with… more
