- Munson Healthcare (Traverse City, MI)
- …families, interdisciplinary team members, payers and external case managers Why work as a Utilization Review Specialist at Munson Healthcare? + Our dynamic ... 5 years of start date. + Current licensure as Registered Nurse in the State of Michigan....+ Minimum of three years clinical experience required. Previous utilization review and/or case management in a… more
- HCR Home Care (Rochester, NY)
- Role and Responsibilities The Utilization Review Specialist is responsible for performing utilization review activities including technical audit of ... corrective action as needed. + Provide staff training for new Utilization Review initiatives and monitors the performance of assigned branches. + Participate… more
- BayCare Health System (St. Petersburg, FL)
- …a foundation of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior responsibilities include:** + ... + Community discounts and more Equal Opportunity Employer Veterans/Disabled **Position** Utilization Review Specialist Senior **Location** St Petersburg… more
- Medical Center Hospital (Odessa, TX)
- Position Summary: The Utilization Review Specialist /Outcomes Specialist conducts concurrent and retrospective review functions in support of the ... hospital Utilization Review Program and makes appropriate referrals to designated Physician...Advisors. Education: Holds a current Texas license as a Registered Nurse . Training and Experience: Three years… more
- WestCare Foundation (Henderson, NV)
- Utilization Review Specialist Job...required Education: + Associates or Bachelors level LPN or RN and/or Bachelors or Masters level CADC/LADC with 2 ... years utilization review experience, preferred experience working with individuals with psychiatric or substance use disorder Experience and Competencies: +… more
- HonorHealth (Scottsdale, AZ)
- …of communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors ... 1 year experience in UR/UM or Case Management Required Licenses and Certifications Registered Nurse ( RN ) State And/Or Compact State Licensure Required more
- CaroMont Health (Gastonia, NC)
- …RAC for reversal of original determination. May serve on the Medical Record/ Utilization Review Committee, providing detailed logs of denial activity and appeal ... practice in NC (NC license or multi-state (compact) license). Certification in Utilization Review / Management, Quality and/or Case Management preferred. Minimum… more
- Desert Parkway Behavioral Healthcare Hospital (Las Vegas, NV)
- The UR Specialist reviews and monitors patients' utilization of health care services with the goal of maintaining high quality, cost-effective care. The duties ... include providing the medical and utilization expertise necessary to evaluate the appropriateness and efficiency of medical services and procedures. + Performs… more
- CareFirst (Baltimore, MD)
- …Qualifications** **PURPOSE:** Utilizing key principles of utilization management, the Utilization Review Specialist will perform prospective, concurrent ... coverage. Leveraging clinical expertise and critical thinking skills, the Utilization Review Specialist , will analyze...in addition to the required work experience. **Licenses/Certifications:** + RN - Registered Nurse -… more
- LifePoint Health (Hickory, NC)
- * Registered Nurse ( RN ), Clinical...outcome of care management as prescribed in the initial Utilization Review Plan with regard to resources, ... as an employee, but as a person. As a * registered nurse ( RN )* joining our...the lives of those we serve.** *Connect with our RN recruiting specialist * Not ready to complete… more
- LifePoint Health (Henderson, NC)
- Registered Nurse ( RN ) Case Manager Up to $20,000 Commitment Bonus Job Type: Full Time| Weekend Coverage Schedule Requirement: Friday-Monday (4 10-hour ... as an employee but as a person. As a registered nurse ( RN ) joining our...skills. Requires a working knowledge of community resources and Utilization /Quality Review standards and activities conducted by… more
- AdventHealth (Daytona Beach, FL)
- …or RN Diploma degree + State of Florida license as a Registered Nurse + Two (2) years of medical/hospital nursing experience **Preferred qualifications:** ... Medical Parkway, Daytona Beach, FL 32117 **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses,… more
- MyFlorida (Chattahoochee, FL)
- REGISTERED NURSE SPECIALIST - F/C - 67056731 APD/ DDDP CHATTAHOOCHEE, FL Date: Dec 13, 2024 The State Personnel System is an E-Verify employer. For more ... 837602 Agency: Agency for Persons with Disabilities Working Title: REGISTERED NURSE SPECIALIST - F/C...as a member of the DDDP Behavior Analysis Local Review Committee, Support Planning Committee, and treatment team. Performs… more
- MyFlorida (Macclenny, FL)
- REGISTERED NURSE SPECIALIST OPS - 60955422 Date: Dec 21, 2024 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... Requisition No: 772103 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST OPS -...Nurse Practice Committee. Knowledge, skills and abilities, including utilization of equipment, required for the position: Ability to… more
- Northwell Health (Melville, NY)
- …level of care decisions and billing status and ensures compliance with the Utilization Review standard and regulations. Performs concurrent and retrospective ... entry date. + Current License to practice as a Registered Professional Nurse in New York State...certifications as needed. + Prior experience in Case Management, Utilization Review , and Appeals/Denials, highly preferred. *Additional… 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 ... that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates,...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- MyFlorida (Port Saint Lucie, FL)
- …that all verbal orders, including telephone orders from attending physicians, are reviewed by a registered nurse . + If no RN is available, receive all ... SENIOR REGISTERED NURSE SUPV Date: Dec 26,...resident's status and providing supervision and guidance to the RN , LPN, CNA, and other Allied Health Care Professionals.… more
- MyFlorida (Port Charlotte, FL)
- …that all verbal orders, including telephone orders from attending physicians are received by a registered nurse . If no RN is available, receive all telephone ... SENIOR REGISTERED NURSE SUPV - 50009026 Date:...current status and providing supervision and guidance to the RN , LPN, CNA, and other Allied Health Care Professionals.… more
- Katmai (Usaf Academy, CO)
- …from the Commission on Collegiate Nursing Education accredited college or university. + Registered Nurse shall possess a current, active, full and unrestricted ... Registered Nurses ( RN ) licensed in Colorado or be...contract at no expense to the Government. + The registered nurse must have a minimum of two-years… more
- Sanford Health (Fargo, ND)
- …Range:** $27.50 - $38 **Department Details** We are seeking a dedicated and detail-oriented Utilization Management Specialist RN to join our team. In this ... for Nursing Commission for Nursing Education Accreditation (NLN CNEA). Currently holds an unencumbered registered nurse ( RN ) license with the State Board of… more