• RN - Utilization Review

    Baptist Memorial (Jackson, MS)
    Summary The Utilization Review Nurse is...Summary: Position: 19738 - RN - Utilization Review Facility: MBMC - Hospital Department: HS ... appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse...Case Mgmt Administration Corporate Category: Nurse RN Type: Clinical Work Type: Full Time Work Schedule:… more
    Baptist Memorial (02/17/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review RN

    Dignity Health (Glendale, CA)
    …on any documentation deficiencies and revenue loss. Previous patient care experience required. High school graduate or equivalent required. + Reviews cases that ... License required. + Fire Safety card required. + Five years experience in utilization review and discharge planning, case management and managed care. + JCAHO… more
    Dignity Health (02/12/25)
    - Save Job - Related Jobs - Block Source
  • Analyst- Utilization Review

    Ascension Health (Hoffman Estates, IL)
    …individual with an advanced degree inhealthcare related field required. Education: + High School diploma equivalency with 2 years of cumulative experience ... Heart Association or American Red Cross accepted. + Practical/Vocational Nurse credentialed from the Illinois Department of Financial and ProfessionalRegulation… more
    Ascension Health (02/05/25)
    - Save Job - Related Jobs - Block Source
  • RN Nurse Case Management Lead…

    The Cigna Group (Bloomfield, CT)
    …Therapeutic Resource Centers. **QUALIFICATIONS** + Active, unencumbered Registered Nurse ( RN ) license in state of residency. + High School Diploma ... Nurse Clinician - Accredo Job Description Summary The Nurse Clinician - RN is responsible for...years of experience is preferred in prior authorization or utilization review and appeals + Demonstrated proficiency… more
    The Cigna Group (02/15/25)
    - Save Job - Related Jobs - Block Source
  • RN Case Manager - Hospital

    Marshfield Clinic (Rice Lake, WI)
    …stay. **JOB QUALIFICATIONS** **EDUCATION** _For positions requiring education beyond a high school diploma or equivalent, educational qualifications must be ... **Minimum Required:** One year of healthcare experience. **Preferred/Optional:** Discharge Planning, Utilization Review or Case Management experience in a… more
    Marshfield Clinic (02/12/25)
    - Save Job - Related Jobs - Block Source
  • RN Case Manager - Hospital (40 - 36…

    Marshfield Clinic (Marshfield, WI)
    …weekend. **JOB QUALIFICATIONS** **EDUCATION** _For positions requiring education beyond a high school diploma or equivalent, educational qualifications must be ... Three years' experience in a medical facility. **Preferred/Optional:** Discharge Planning, Utilization Review or Case Management experience in a clinic/hospital… more
    Marshfield Clinic (01/15/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse - Multi-Specialty…

    Northern Light Health (Pittsfield, ME)
    …direction and manages workflow and time. Credentials + Required Registered Nurse Education + Required High School Diploma/General Educational Development ... a $10,000 (minus tax) sign on bonus that is paid out incrementally. Summary: The Registered Nurse II is a fully competent practitioner of nursing. The incumbent… more
    Northern Light Health (02/13/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse II - Medical…

    Northern Light Health (Pittsfield, ME)
    …direction and manages workflow and time. Credentials:Essential:* Registered Nurse Education:Essential:* High School Diploma/General Educational ... a $10,000 (minus tax) sign on bonus that is paid out incrementally. Summary:The Registered Nurse II is a fully competent practitioner of nursing. The incumbent… more
    Northern Light Health (12/19/24)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse II - Medical…

    Northern Light Health (Pittsfield, ME)
    …direction and manages workflow and time. Credentials + Required Registered Nurse Education + Required High School Diploma/General Educational Development ... on bonus that is paid out incrementally.** Summary: The Registered Nurse II is a fully competent...care. * Resource Management o Identifies opportunities to improve utilization of resources. * Professional Development o Takes responsibility… more
    Northern Light Health (12/19/24)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse - Emergency…

    Northern Light Health (Pittsfield, ME)
    …direction and manages workflow and time. Credentials + Required Registered Nurse Education + Required High School Diploma/General Educational Development ... on bonus that is paid out incrementally. Summary: The Registered Nurse II is a fully competent...+ Resource Management + + Identifies opportunities to improve utilization of resources. + Professional Development + + Takes… more
    Northern Light Health (02/13/25)
    - Save Job - Related Jobs - Block Source
  • Med Mgmt Clinician Sr (US)

    Elevance Health (Irvine, CA)
    …relatively complex case types that do not require the training or skill of a registered nurse . Acts as a resource for more junior Clinicians. Primary duties may ... a minimum of 6 years of clinical experience and/or utilization review experience. + Current active, valid...review experience. + Current active, valid and unrestricted RN license and/or certification to practice as a health… more
    Elevance Health (01/24/25)
    - Save Job - Related Jobs - Block Source
  • On-Call Registered Nurse

    MTC (Marion, OH)
    …are documented accurately and completely. **Qualifications:** + Graduation from an accredited ** high school or equivalent (GED).** + **Degree in nursing and ... use of appropriate sanitation methods. 6. Practice basic cost containment and utilization management for patient care and facility operations. 7. Maintain absolute… more
    MTC (02/06/25)
    - Save Job - Related Jobs - Block Source
  • Abstractor-Clinical Review Advanced…

    Baptist Memorial (Memphis, TN)
    …3337 - Abstractor-Clinical Review Advanced Facility: BMHCC Corporate Office Department: HS Cardiac Registry Category: Nurse RN Type: Non Clinical ... the application of strict program inclusion/exclusion criteria. + Demonstrates appropriate utilization of resources necessary to obtain valid, reliable data for… more
    Baptist Memorial (01/25/25)
    - Save Job - Related Jobs - Block Source
  • Licensed Practical Nurse - DDA052 - Mon…

    WellLife Network (South Richmond Hill, NY)
    …Ann Mittasch ICF - South Richmond Hill, NY Position Type Full-Time Education Level High School Salary Range $35.00 - $35.00 Hourly Job Shift Overnight Job ... all work is reviewed and cosigned by an agency Registered Nurse (to be scheduled by clinical...schedules are subject to change. + Attend certification inspections, utilization review and independent professional reviews as… more
    WellLife Network (02/14/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Documentation Integrity Specialist…

    Marshfield Clinic (Marshfield, WI)
    …skills. **JOB QUALIFICATIONS** **EDUCATION** _For positions requiring education beyond a high school diploma or equivalent, educational qualifications must be ... critical care, emergency room, operating room, PACU, case management, or utilization review **OR** Five years hospital inpatient coding. **Preferred/Optional:**… more
    Marshfield Clinic (01/31/25)
    - Save Job - Related Jobs - Block Source
  • Licensed Practical Nurse -DDA050 - Mon 7AM…

    WellLife Network (South Richmond Hill, NY)
    …Details Job Location Ann Mittasch ICF - South Richmond Hill, NY Education Level High School Salary Range $32.96 - $32.96 Hourly Job Description About WellLife ... all work is reviewed and cosigned by an agency Registered Nurse (to be scheduled by clinical...schedules are subject to change. + Attend certification inspections, utilization review and independent professional reviews as… more
    WellLife Network (01/16/25)
    - Save Job - Related Jobs - Block Source
  • Licensed Vocational Nurse (In Office)

    Neogen Care (Ontario, CA)
    …LOCATION: Ontario, CA office location, field as needed POSITION SUMMARY: + Assist in utilization review , complaints review , chart reviews etc + Provide ... Act. + Implement plans of care initiated by the registered nurse . + Provide accurate and timely...to perform blood draws from patients + Must have HS Diploma, or Associate, or Undergraduate degree in Nursing.… more
    Neogen Care (01/30/25)
    - Save Job - Related Jobs - Block Source
  • Case Manager

    Brockton Hospital (Brockton, MA)
    …patient/family, payer based case managers, and appropriate community based providers. High school diploma or equivalent required. Bachelor's Degree required; ... license from Commonwealth of Massachusetts to practice as a Registered Nurse . Minimum of five years clinical...in an acute care facility required. Prior experience in case management, utilization review or discharge planning… more
    Brockton Hospital (02/15/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Appeals Nurse (Remote)

    CareFirst (Baltimore, MD)
    …treatment needs or those with substance disorders and addictions. **Licenses/Certifications** : + RN - Registered Nurse - State Licensure And/or Compact ... procedures, diagnostic entities and their complications. **QUALIFICATIONS:** **Education Level** : High School Diploma or GED **Experience:** 2 years… more
    CareFirst (02/15/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Reviewer…

    Blue Cross Blue Shield of Massachusetts (Hingham, MA)
    …What You Bring : + Behavioral Health professional with an active Massachusetts license: Registered Nurse , LICSW, LMHC + 3-5 years of clinical experience in ... + CCM or other applicable certification(s) desirable #LI-REMOTE Minimum Education Requirements: High school degree or equivalent required unless otherwise noted… more
    Blue Cross Blue Shield of Massachusetts (02/01/25)
    - Save Job - Related Jobs - Block Source