- Cognizant (Salem, OR)
- …have to be considered** + Educational background - Registered Nurse ( RN ) + 2-3 years combined clinical and/or utilization management experience with ... **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
- Highmark Health (Harrisburg, PA)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... setting **Preferred** + Experience in UM/CM/QA/Managed Care + Medical/Surgical experience + Utilization Management (UM) or (UR) Utilization Review experience… more
- CVS Health (Phoenix, AZ)
- …a meaningful difference in the lives of patients? Join Mercy Care as a Utilization Management Clinical Consultant and become part of a mission-driven team that's ... Monday-Friday 8:00am-5:00pm AZT (No weekends or holidays) Location: 100% Remote (Must have Arizona RN license or...in ER, ICU, or Critical Care preferred. + Managed Care/ Utilization Management experience. + Experience with Claims… more
- Banner Health (AZ)
- …and innovative employment options by offering remote and hybrid work settings. The Registered Nurse RN Medical Management Services is required to ... payers, community agencies, provider networks, and regulatory agencies. MINIMUM QUALIFICATIONS Requires Registered Nurse ( RN ) licensure in the state of… more
- Ochsner Health (New Orleans, LA)
- …discharge plans based on patient's individualized needs. Registered Nurse ( RN ) Case Manager - Case Management OMC Jefferson Highway PRN To perform ... experience in discharge planning, case management or utilization review. **Certifications** Required - Current registered ...or utilization review. **Certifications** Required - Current registered nurse license in state of practice.… more
- AccentCare, Inc. (Middlebury, CT)
- …Hospice Location: Middlebury, CT Position: Admissions Registered Nurse / RN , Hospice Position Type: Part Time Remote /Virtual Position: No Coverage Area: ... Overview Admissions Registered Nurse / RN ,...and external partners, ensuring timely updates, interventions, and resource utilization + Provide patient and caregiver education, document care… more
- Bon Secours Mercy Health (VA)
- …of Primary Function/General Purpose of Position** In the capacity of a Care Transition Nurse / Registered Nurse ( RN ), provide and facilitate coordination ... in Nursing (required) Bachelor's Degree in Nursing (BSN) (preferred) **Licensing/ Certifications:** Registered Nurse with active License in State of Patient Care… more
- Bon Secours Mercy Health (Norfolk, VA)
- …clinical and operational excellence. **Summary of Primary Function** In the capacity of a Registered Nurse ( RN ), the Ambulatory Care Manager will provide ... clinical care management services to identified eligible patients; coordinating care to...Nursing Bachelor's Degree (preferred) Specialty/Major- Nursing (BSN) **Licensing/ Certification** Registered Nurse with active License in State… more
- Geisinger (Danville, PA)
- …shift differential for evening, night, and weekend shifts! Job Duties The Registered Nurse assesses plans, organizes, performs, and evaluates nursing activities ... Specialty Training Program-Nursing (Required) Experience Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania;… more
- Geisinger (Danville, PA)
- …Specialty Training Program-Nursing (Required) Experience Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania; ... Job Summary Geisinger is proud to offer a full time Inpatient RN up to $24,000 hiring incentive for eligible candidates! $41.00 minimum hiring rate with increased… more
- Veterans Affairs, Veterans Health Administration (Huntington, WV)
- Summary The Remote Patient Monitoring Home (RPM) Telehealth (TH) Registered Nurse ( RN ) Responsible and accountable for all elements of the nursing ... for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care....level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Providence (Irvine, CA)
- … Utilization Management , medical necessity, and patient status determination. The Utilization Management RN must effectively and efficiently manage a ... **Description** ** RN Utilization Review at Irvine, CA....Qualifications:** + Associate's Degree Nursing. + Upon hire: California Registered Nurse License + 2 years experience… more
- Providence (Mission Hills, CA)
- … Utilization Management , medical necessity, and patient status determination. The Utilization Management RN must effectively and efficiently manage a ... must empower them. **Required Qualifications:** + Associate's Degree in Nursing. + California Registered Nurse License upon hire. + 2 years of experience working… more
- Trinity Health (Mishawaka, IN)
- …approach This is NOT a remote position.** **_About the job:_** The licensed Registered Nurse ( RN ) plans & provides professional nursing services & ... in one of the following: Certified Acute Care Virtual Registered Nurse (CAVRN), Acute/critical care nursing (CCRN),...Nurse (CEN), Cardiac Medicine (CMC), Certified Med Surg RN (CMSRN), Certified Neuroscience RN (CNRN), Certified… more
- Humana (Jackson, MS)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Penn Medicine (Lancaster, PA)
- …6:30am-9am. No holidays _Penn Medicine Lancaster General Health is looking for an experienced RN to join our Utilization Management Specialist team! In this ... we'd love to hear from you!_ **Summary** : The Utilization Management Specialist - Admissions is responsible...assigned. **Minimum Required Qualifications:** + Current licensure as a Registered Nurse , issued by the Pennsylvania Board… more
- Community Health Systems (Naples, FL)
- … skills to prioritize tasks in a dynamic environment. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact State ... IS NOT A REMOTE POSITION **Job Summary** The Care Manager - RN is responsible for coordinating and overseeing discharge planning, transitions of care, and case… more
- Actalent (Rancho Cordova, CA)
- Job Title: Utilization Review Nurse Job Description The Registered Nurse will review cases for medical necessity across all levels of care, ensuring that ... review. + Collaborate with healthcare teams to facilitate effective utilization management . + Employ MCG criteria and...+ Work independently and within a team in a remote setting. Essential Skills + Acute care and inpatient… more
- Alight (IA)
- …Alight to support the company's operational and financial goals. **Requirements** + Be a Registered Nurse with a BSN and equivalent experience required. + Have ... Nurse (OCN), Oncology Nursing Certification Corporation (ONCC), Certified Pediatric Hematology/Oncology Nurse (CPHON). + Have RN Compact State Nursing License… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of ... productivity and gain efficiencies for performance improvement opportunities in the Utilization Management Department. + Assists in updating departmental… more