- Baptist Memorial (Jackson, MS)
- …referral program Job Summary: Position: 19738 - RN - Utilization Review Facility: MBMC - Hospital Department: HS Case Mgmt Administration Corporate ... Overview Summary The Utilization Review Nurse is responsible...Category: Nurse RN Type: Clinical Work Type: Full Time Work Schedule: Days… more
- 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
- Healthfirst (NY)
- …skills to evaluate the quality and effectiveness of case management and/or utilization review decision-making + Additional duties as assigned **Minimum ... Qualifications:** + NYS LPN or RN license. + HS Diploma or GED...+ Relevant previous work experience such as medical records review ; claims processing; utilization /case management in a… more
- 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 (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 (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
- 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
- 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
- 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 (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
- Elevance Health (New Hyde Park, NY)
- …following standard procedures that do not require the training or skill of a registered nurse . **How you will make an impact** Primary duties include, but ... not issue medical necessity non-certifications. **Minimum Requirements:** + Requires HS diploma or equivalent. + Requires a minimum of...a minimum of 2 years of clinical experience and/or utilization review experience. + Current active, valid… more
- CareFirst (Baltimore, MD)
- …organization or hospital. Demonstrated leadership skills. In Lieu of Education. **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or ... appeals and grievances submitted for resolution. **QUALIFICATIONS:** **Education Level:** High School Diploma or GED OR in...similar clinical experience OR 5 years' experience in Medical Review , Utilization Management or Case Management at… more
- Behavioral Center of Michigan (Detroit, MI)
- …in performance improvement activities. REPORTS TO: Billing Manager QUALIFICATIONS: + High School graduate or equivalent. Associates Degree preferred. + ... records for discharge/transfer. Makes appropriate copies for various departments (Nursing, Utilization Review , Billing, and Partial Hospitalization Program). +… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …in our Hingham, MA office 1-3X a month #LI-HYBRID Minimum Education Requirements: High school degree or equivalent required unless otherwise noted above ... well as regulatory and NCQA requirements. + Refer to RN or PT Clinical Utilization reviewer for...denial of services is identified. + Refer to Physician Review Unit (PRU) for potential denial of prior authorization… more
- Veterans Affairs, Veterans Health Administration (Shreveport, LA)
- …team that generally consists of a primary care provider (MD, NP, PA), registered nurse care manager, clinical associate (LPN or medical assistant/health ... limited to: Coordinates with the patient care team to review the clinic utilization by using various...of the position; OR, (2) Education. One year above high school ; OR, (3) Experience/Education Combination. Equivalent… more
- Commonwealth of Pennsylvania (PA)
- …Email ###@pa.gov + Description + Benefits + Questions THE POSITION Are you a Registered Nurse eager to leverage your expertise in assessing clinical information ... Requirements: + This position requires active authorization to practice as a Registered Nurse in Pennsylvania. + This position requires employees possessing… more
- City of Detroit (Detroit, MI)
- …of this job include but are not limited to those marked with an asterisk. Minimum Qualifications Registered Nurse ( RN ) + Licensed Registered Nurse + ... 01 Indicate your highest level of education completed: + High School Diploma / GED + Associate's...posses? Upload your licensed to your online application. + Registered Nurse ( RN ) + Licensed… more
- Houston Methodist (Houston, TX)
- …and timely manner. Takes messages via telephone/email to forward to the provider/ registered nurse . + Contributes towards improvement of department scores for ... the clinic under the direct supervision of a Physician, Registered Nurse , or clinic leadership procedures. In...duties and responsibilities as the need arises. **EDUCATION** + High School diploma or equivalent education (examples… more
- Community Health Systems (Fort Wayne, IN)
- …regulatory requirements related to patient care and data privacy. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact ... + Directs, coaches, and develops staff members to provide high quality service and to grow in their capabilities....team goals, delegates effectively. + Monitors and ensures effective utilization of equipment and staff within the Transfer Center.… more
- Veterans Affairs, Veterans Health Administration (Albuquerque, NM)
- …two years of experience in clinical documentation improvement; OR, Clinical experience, such as Registered Nurse ( RN ), Medical Doctor (MD), or Doctor of ... extensive interaction with clinical, coding, and other associated staff. Review documentation and facilitate modifications to the health record...coding and the health record, and one year above high school , with a minimum of 6… more