- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II...on the basis of age for any individual age 40 or older. c. Experience is evaluated on the basis ... Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,161.60 -...of a verifiable 40 - hour week, unless specified otherwise. Prorated part-time experience… more
- Ascension Health (Wamego, KS)
- …Provide health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
- Dartmouth Health (Lebanon, NH)
- Overview Utilization Review (RN) - Remote Works...These are just a few highlights of being a nurse at Dartmouth Hitchcock Medical Center and Clinics in ... country. This all means you can be a happy nurse with more quality time with friends, family, pets...$127,587.20/Yr. * FTE/Hours per pay period:1.00 - 1.00 - 40 hrs/week * Shift:Day * Job ID:29683 Dartmouth Health… more
- Humana (Jackson, MS)
- …a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and… more
- Aspen Medical (Aurora, CO)
- …and Management (HCQM) through American Board of Quality Assurance and Utilization Review Physicians (ABQARP), Certified Informatics Nursing, Ambulatory Care ... JOB AD: Registered Nurse - Utilization Management Introduction : Aspen Medical...in a direct patient care clinical setting. Must have utilization management, utilization review or… more
- Humana (Baton Rouge, LA)
- …interpretation and independent determination of the appropriate courses of action. The Post-Acute Utilization Management Nurse 2: + Review Post-Acute Preauth ... caring community and help us put health first** The Utilization Management Nurse utilizes clinical nursing skills...+ This is a remote position **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a… more
- Texas Health Resources (Arlington, TX)
- **RN/Registered Nurse - Utilization Management, Clinical Reviews** **Work location:** 100% remote but must live in Texas, preferably in the Dallas-Fort Worth ... criteria preferred **Licenses and Certifications** + RN - Registered Nurse Current license to practice professional nursing in the...care team. + Determine working DRG with each initial review via CareConnect1 or other Utilization Management… more
- Kelsey-Seybold Clinic (Houston, TX)
- **Responsibilities** The Utilization Review Specialist (LVN) is responsible for conducting medical reviews, benefit verification, and applying criteria to ... care services requiring authorization prior to services being rendered for members. The Utilization Review Specialist (LVN) serves as a liaison in reviewing… more
- Sutter Health (Sacramento, CA)
- …Graduate of an accredited school of nursing. **CERTIFICATION & LICENSURE:** + RN-Registered Nurse of California OR CNS-Clinical Nurse Specialist + BLS-Basic Life ... Support OR PALS-Pediatric Advanced Life Support OR CNOR-Certified Perioperative Nurse OR NRP-Neonatal Resuscitation Provider **EXPERIENE AS TYPICALLY ACQUIRED IN:**… more
- Ascension Health (Baltimore, MD)
- …salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes ... implement quality review programs and key performance indicators for all utilization review activities. + Interact with medical, nursing, and executive… more
- Community Health Systems (Franklin, TN)
- …nursing experiencePreferred Experience: 3 plus years Utilization review experience + Required License/Registration/Certification: Licensed Practical Nurse ... healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed...of medical services and procedures in the hospital setting. Utilization review is the assessment for medical… more
- Corewell Health (Grand Rapids, MI)
- …continued stay. Educates medical staff/other health care professionals regarding utilization management and quality requirements. Makes recommendations and provides ... financial and utilization management (UM) information to other members of the...centered care plan or related work Required. + Registered Nurse (RN) - State of Michigan Upon Hire required… more
- Covenant Health (Bangor, ME)
- …of the VP of Accountable Care Operations & Population Health Strategy the Utilization Review Case Manager will work collaboratively with other members of ... the healthcare team. The nurse case manager also acts as an advocate for...Manager conducts medical necessity reviews in accordance with the Utilization Management (UM) plan for patients that are housed… more
- ERP International (Nellis AFB, NV)
- …the plan and continually evaluates the impact of implementation. Incorporates applicable utilization review tasks to ensure patients receive the appropriate ... Case Management Society of America (CMSA); American Accreditation Healthcare Commission/ Utilization Review Accreditation Commission (URAC); Comprehensive Accreditation… more
- UNC Health Care (Raleigh, NC)
- **Description** **Full time exempt, 40 hours per week Utilization Manager - Medical necessity review for Surgical admissions** Become part of an inclusive ... organization with over 40 ,000 diverse employees, whose mission is to improve the...through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management… more
- Hackensack Meridian Health (Neptune, NJ)
- …**Hackensack Meridian** **_Health_** includes: + Follows departmental workflows for utilization review activities including admission reviews, admission denials, ... as a leader of positive change. The **Care Coordinator, Utilization Management** is a member of the healthcare team...as required by payer agencies and initiates physician advisor's review as necessary for unwarranted admissions. + Performs chart… more
- Hackensack Meridian Health (Holmdel, NJ)
- …at Hackensack Meridian _Health_ includes: + Follows departmental workflows for utilization review activities including admission reviews, admission denials, ... as a leader of positive change. The **Care Coordinator, Utilization Management** is a member of the healthcare team...as required by payer agencies and initiates physician advisor's review as necessary for unwarranted admissions. + Performs chart… more
- State of Connecticut, Department of Administrative Services (Hartford, CT)
- Head Nurse ( 40 Hour) Office/On-site Recruitment # 250115-4356FL-001 Location Hartford, CT Date Opened 1/22/2025 12:00:00 AM Salary $91,192 - $120,638/year ... DMHAS (https://portal.ct.gov/DMHAS/About-DMHAS/Agency/About-DMHAS) ) is currently recruiting for a Head Nurse (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=4356FL&R1=&R3=) with exceptional attention to detail and a… 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 ... + **Department:** Utilization Management + **Schedule:** Monday - Friday. 40 hours week. + **Hospital:** Ascension Saint Thomas + **Location:** Remote -… more
- University of Rochester (Strong, AR)
- …for all UM customers. Other duties as assigned. **QUALIFICATIONS** + RN with Utilization Review experience preferred; 3-5 years of recent acute hospital ... 14642 **Opening:** Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500009 Utilization Management Work Shift: UR - Day (United… more