- Southern New Hampshire Health (Milford, NH)
- CLINICAL TEACHER / NURSE EDUCATOR - EMERGENCY DEPARTMENT Who We Are: The Emergency Department of SNHMC provides culturally competent care to the diverse population ... the ED is prepared to accommodate additional patients through utilization of hallway beds and a triage fast-track area....community About the Job: In collaboration with the Unit Director and Manager and as a member of the… more
- Independent Health (Buffalo, NY)
- …perks, benefits and a culture that fosters growth, innovation and collaboration. **Overview** The Utilization Review Nurse (URN) performs clinical review ... and when necessary, will consult with the Associate Medical Director and/or Medical Director for all requests...RN in a varied clinical setting required. + Previous utilization review experience preferred. + Previous experience… more
- Ochsner Health (New Orleans, LA)
- …interpersonal and conflict resolution skills. **Job Duties** + Lead and directs Utilization Review (UR) staff and functions, including staffing, staff ... reviews to identify escalation issues regarding Providers, other facility issues, individual utilization review staff skills, payor-based concerns and to provide… more
- Dartmouth Health (Lebanon, NH)
- …effective patient care. Actively involved in discharge planning process. * Utilization Review with appeal experience preferred. Strong candidate identified. ... These are just a few highlights of being a nurse at Dartmouth Hitchcock Medical Center and Clinics in New Hampshire. * We have loan repayment up to $20,000. * We… more
- Trinity Health (Des Moines, IA)
- …**Description:** **_Are you an experienced Director of Care Management & Utilization Review looking for an interim assignment? Join Trinity Health 's ... and organizational goals. **MINIMUM QUALIFICATIONS:** + Current Iowa License Registered Nurse or Social Worker + Master's degree in healthcare related field… more
- Dartmouth Health (Lebanon, NH)
- Overview Utilization Review - RN Per Diem, Fully Remote Works with physicians and multidisciplinary team members to develop a plan of care for assigned patients. ... UR experience strongly preferred. Responsibilities * Works with Medical Director and appropriate physician(s) to establish Dartmouth-Hitchcock (D-H) ambulatory and… more
- CVS Health (Columbus, OH)
- …**Required Qualifications:** -3+ Years of clinical experience -1+ Year of Utilization Review Management and/or Medical Management experience. -Must have ... in a collaborative process to implement, coordinate, monitor and evaluate medical review cases . Applies the appropriate clinical criteria/guideline to render a… more
- Community Health Systems (Naples, FL)
- …Role ** Comprehensive Benefits **Job Summary** Under the direction of the UR Director /Manager the UR Nurse reviews all admissions for medical necessity, correct ... improvement programs + Addresses facility and departmental communication through daily review of all correspondence, including incoming email messages. + Performs… more
- Ascension Health (Nashville, TN)
- …initiatives. + Develop systems and processes for prospective, concurrent and retrospective utilization review for allself-funded and fully insured clients to ... market. Must be located with in the TN market. We're looking for an experienced Director of Utilization Management to join our team! In this pivotal role, you'll… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
- Prime Healthcare (Ontario, CA)
- …Clinical Utilization Management (UM) provides comprehensive oversight of the Utilization Review process for the self-insured Employee Health Plans, according ... needs. + Provides strategic leadership, development, and supervision to utilization review department, provides interprofessional collaboration with… more
- CoreCivic (Brentwood, TN)
- …out of our Brentwood, TN office location._ The Utilization Management/Case Management Nurse provides Utilization Review and Case Management functions for ... better the public good. CoreCivic is currently seeking a ** Utilization Management/ Case Management Nurse ** located at...Creates plan for care across the continuum. + Performs utilization review ensuring admissions meet criteria for… more
- Prime Healthcare (Inglewood, CA)
- …to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians. Assesses ... credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/200257/ director -of-case-management utilization -management/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityCentinela Hospital… more
- US Tech Solutions (Columbia, SC)
- …mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review /case management/clinical/or combination; 2 of 4 years ... Have Option to Work Remotely. + NICE TO HAVE skill sets/qualities: Utilization management experience and /or Appeals experience /strong clinical skills Behavioral… more
- Katmai (Usaf Academy, CO)
- …Review precertification requests for medical necessity, referring to the Medical Director those that require additional expertise. + Review clinical ... Minimum of two (2) years of prior experience in Utilization Management. + Must possess a current, active, full,...licensed in Colorado, be able to practice using a nurse compact state license or have a license from… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Utilization Review Manager for the Selikoff Centers for Occupational Health is responsible for the management of program operations ... records, and internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with multiple professionals to support and… more
- Stanford Health Care (Palo Alto, CA)
- …and Abilities** + Knowledge of principles and best practices of case management, utilization review , social work, care coordination and discharge planning. + ... Here, your leadership, coaching, and mentoring would further develop our robust, Utilization Management team. Are you driven by health care innovation, partnerships,… more
- RWJBarnabas Health (Newark, NJ)
- Registered Nurse (RN) Director of Patient Care Cardiac Cath Lab FT DaysReq #:0000180082 Category:Leadership Status:Full-Time Shift:Day Facility:Newark Beth ... Job Overview: RWJBarnabas Health is seeking a highly dedicated Director of Nursing for our Cardiac Cath Lab at...American Heart Association (AHA) + Active New Jersey Registered Nurse License or Multistate Compact License Scheduling Requirements: +… more
- Sharp HealthCare (San Diego, CA)
- …or clinical experience in area of specialty. + 2 Years clinical experience in Utilization Review , Discharge Planning and/or Case Management in a hospital and/or ... Case Manager (ACM) - American Case Management Association (ACMA); California Registered Nurse (RN) - CA Board of Registered Nursing **Hours** **:** **Shift Start… more
- Banner Health (Mesa, AZ)
- …the health care transformation, planning the future of Banner Health. As an Associate Director RN for Cardiovasular ICU unit at Banner Desert Medical Center you will ... enjoying your life. If you are a New Graduate Nurse with less than 12 months of experience, please...that includes the da Vinci Surgical System. Becker's Hospital Review named Banner Desert Medical Center as one of… more
