- State of Connecticut, Department of Administrative Services (Middletown, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 240830-5613FP-001 Location Middletown, CT Date Opened 9/5/2024 12:00:00 AM Salary ... Hospital - is accepting applications for one (1) full-time Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=)… more
- Travelers Insurance Company (Buffalo, NY)
- …**What Is the Opportunity?** This position is responsible for conducting in-house utilization review with emphasis on determining medical necessity for ... do and where you do it. **Job Category** Claim, Nurse - Medical Case Manager **Compensation Overview** The annual...to the compensable injury and for adhering to multi-jurisdictional Utilization Review criteria. **What Will You Do?**… more
- Lowe's (Charlotte, NC)
- …clinical position. + 3-5 Years of Experience as a Case Manager or Utilization Review Nurse in worker 's compensation + Experience in a clinical position + ... including psychosocial factors, for catastrophic and complex cases on workers ' compensation injuries. Responsible for ensuring that employees receive appropriate… more
- Lincoln Financial Group (Columbus, OH)
- …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position...in a career at Lincoln, we encourage you to review our current openings and apply on our website.… more
- Sutter Health (Burlingame, CA)
- …and case management within a managed care environment. Comprehensive knowledge of Utilization Review , levels of care, and observation status. Awareness of ... acute care patient experience. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the… more
- Veterans Affairs, Veterans Health Administration (San Francisco, CA)
- Summary The Patient Flow Utilization Management/ Utilization Review Consultant RN functions with advanced knowledge and skills to provide clinical ... with a collaborative, inter-disciplinary practice setting. Responsibilities The Patient Flow Utilization Management/ Utilization Review Consultant RN is… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …NJ State Professional Registered Nurse License or NJ Licensed Social Worker **Job ID** _2024-150722_ **Department** _CC Utilization Review_ **Site** _HMH ... caseload. Collaborates with the attending LIP, Clinical Case Manager, nurse , and other members of the treatment team, ACCESS...a case by case basis. Applies case management and utilization review principles in monitoring the delivery… more
- Billings Clinic (Billings, MT)
- …starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Utilization Review RN Billings Clinic ... - 44.18 Under the direction of department leadership, the Utilization Review / Management RN. This position is...complex patients/situations and communicate to the CM and/or Social Worker as appropriate Priority 5: Escalation Refers cases that… more
- Hartford HealthCare (Torrington, CT)
- …the Inpatient Nurse Director & Social Work Supervisor, the Inpatient Psychiatric Utilization Review Social Worker will work collaboratively with the IP ... Psychiatry Patient Care Team to assure Utilization Review activities on a 17 bed...care requirements and effectively obtain authorizations. This UR Social Worker will also provide comprehensive clinical social worker… more
- SSM Health (WI)
- …calling** WI-REMOTE ** Worker Type:** Regular **Job Highlights:** + **Department:** Utilization Review + **Schedule:** Full Time, Day Shift, 8:30am-5:00pm; ... MO, WI, and OK)._ **Candidate** **must** **have prior hospital utilization review experience** **and** **2 years inpatient...improvement in standard work. + As an SSM Health nurse , I will demonstrate the professional nursing standards defined… more
- The Mount Sinai Health System (New York, NY)
- **JOB DESCRIPTION** The Utilization Review Manager for the Selikoff Centers for Occupational Health is responsible for the management of program operations ... records, and internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with multiple professionals to support and… more
- Centene Corporation (Springfield, IL)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... licensed in Illinois, and have experience in various mental health settings and utilization management / review . **Position Purpose:** Performs a clinical … more
- Sedgwick (Columbus, OH)
- …and consult review ; and two (2) years of experience in daily application of nurse auditing, utilization review and bill review . **Skills & ... of education and experience required to include two (2) years workers ' compensation/bill review experience in multi-state jurisdiction; prior experience… more
- Centene Corporation (Tallahassee, FL)
- …assess ABA Treatment Plans preferred. Knowledge of ABA services and BH utilization review process preferred. Experience working with providers and healthcare ... Analyzes BH member data to improve quality and appropriate utilization of services + Interacts with BH healthcare providers...teams to review care services related to Applied Behavior Analysis Services… more
- The Mount Sinai Health System (New York, NY)
- **JOB DESCRIPTION** ** Utilization Review Admission Specialist (OR Scheduler), Operating Room Surgical Scheduling, Mount Sinai West - Full Time, Days** The ... Utilization Review Specialist coordinates scheduling of all...and operating room procedures. Seeks the assistance of the Nurse Manager in identifying cases, which require pre admission… more
- Prime Healthcare (Lynwood, CA)
- …Us! (https://careers-primehealthcare.icims.com/jobs/174454/rn-case-mgr-8hr-union sfmc- utilization - review /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum… more
- Prime Healthcare (Lynwood, CA)
- …With Us! (https://careers-primehealthcare.icims.com/jobs/171837/case-manager%2c-rn utilization - review /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- About The Role Brighton Health Plan Solutions (BHPS) provides Utilization Review /Medical and Case Management services for Group Health and Workers ' ... and other Casualty clients. The Workers ' Compensation Nurse Case Reviewer collaborates with medical care providers, employers,...disability services for timely return to work. + Provides utilization review , continued stay reviews, and … more
- Centene Corporation (Columbus, OH)
- …RESIDE IN STATE OF OHIO **Position Purpose:** Performs a post-service retrospective review of member medical records and assessing care related to behavioral health ... cost efficiency and within compliance. + Performs a post-service retrospective review of member's medical records provided against guidelines to determine if… more
- Stanford Health Care (Palo Alto, CA)
- …records to ensure the necessity and appropriateness of care provided. 3. Utilization Review : Conduct thorough utilization reviews, applying evidence-based ... onsite Stanford Health Care job.** **A Brief Overview** The Utilization Management Registered Nurse (UM RN) will...utilization management principles. + Experience in case management, utilization review , or related healthcare roles. +… more