- 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
- System One (Baltimore, MD)
- …and benefit coverage. Leveraging clinical expertise and critical thinking skills, the Utilization Review Specialist , will analyze clinical information, ... is staffing a contract to hire opportunity for a Utilization Management Specialist to support a leading...Hybrid- Baltimore, MD Must have one of the following: RN - Registered Nurse -… 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
- 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
- Sanford Health (SD)
- …from an accredited practical nursing program as a Licensed Practical Nurse (LPN). Registered Nurse ( RN ) preferred. Five years' experience in a clinical ... hospital experience preferred. Preference given to individuals with experience in utilization or with CPT/ICD knowledge. Currently holds an unencumbered Licensed… more
- Amergis (Middletown, CT)
- The Utilization Review Specialist is...+ Current license for the state in which the nurse practices if nursing licensure is required by contract ... + A Bachelor's Degree in Nursing or at least two years' experience in Utilization Review preferred + Certification in Utilization Review or … more
- BayCare Health System (Clearwater, FL)
- …a foundation of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior responsibilities include:** + ... + **On Call:** No **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred...Nursing or Business **Experience:** + Required 2 years in Utilization Review or + Required 2 years… more
- Saint Francis Health System (Tulsa, OK)
- …Potential HYBRID position after 90 days! Job Summary: The Clinical Documentation and Utilization Review Specialist ( RN ) facilitates accurate ... and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License. Certified Clinical Documentation Specialist (CCDS), Certified Document… more
- CaroMont Health (Gastonia, NC)
- …factual arguments to recoup revenue. This position also facilitates collaboration between the Utilization Review Specialist 's, Coding staff, HIM staff, CDI ... and Denial Specialist will work collaboratively with Health Information Management, Utilization Review and Clinical Documentation Specialist to mitigate… more
- Banner Health (Mesa, AZ)
- …your future. If you're looking to leverage your abilities - apply today. **As a Registered Nurse Support Operations Specialist , you will provide support for ... Our Endoscopy Unit maintains 6 procedural rooms, along with utilization of the OR, as needed. Nursing careers are...when applicable** **.** If you are a New Graduate Nurse with less than 12 months of experience, please… more
- AdventHealth (La Grange, IL)
- …skills **.** Teamwork principles **EDUCATION AND EXPERIENCE REQUIRED:** . Associates Degree Nursing or RN Diploma degree . Registered Nurse ( RN ) . ... **LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** **.** State of Illinois registered nurse license **LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:**… more
- LifePoint Health (Johnstown, PA)
- * Registered Nurse ( RN ), Case Manager*...team of RN Case Managers, Social Workers, Utilization Review staff, and Discharge Planners assure that ... valued as an employee, but as a person. As a* registered nurse ( RN )*joining our team,...the lives of those we serve.** *Connect with our RN recruiting specialist * Not ready to complete… 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 (St. Augustine, FL)
- …all verbal orders, including telephone orders from attending physicians, are reviewed by a registered nurse . If no RN is available, receive all telephone ... SENIOR REGISTERED NURSE SUPV - 50950037 Date:...resident's 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
- Stanford Health Care (Palo Alto, CA)
- …their APPs. Also functions under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered Nurse Anesthetist (CRNA), ... and adherence to policy through practice analysis and case review of APPs with physicians. + Investigate and respond...practice provider: (Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist or Certified Registered … more
- Vanderbilt University Medical Center (Nashville, TN)
- …that the appropriate admission status is ordered. Conducts initial admission based on utilization review medical necessity criteria. Refers cases for secondary ... difficulty. * Clinical Applications Systems (Novice): Possesses fundamental proficiency in utilization review systems, clinical support systems and business… more
- Trinity Health (Livonia, MI)
- …Type:** Full time **Shift:** **Description:** Trinity Health at Home is seeking an experienced RN remote Clinical Quality Review Specialist with ICD10 HCS-D ... hire **Trinity Health at Home is seeking an experienced RN Clinical Quality Review Specialist ...strategic aims and top clinical outcomes. **Minimum Qualifications** + ** Registered Nurse with current license from the… more
- Sanford Health (Sioux Falls, SD)
- …for Nursing Commission for Nursing Education Accreditation (NLN CNEA). Currently holds an unencumbered registered nurse ( RN ) license with the State Board of ... level of care medical necessity reviews within patient's medical records. Performs utilization management (UM) activities in accordance with UM plan to assure… more
- AdventHealth (Altamonte Springs, FL)
- …2 years utilizing InterQual and/or MCG . Minimum of three (3) years' experience as Registered Nurse ( RN ) in an acute clinical setting . Clinical experience ... best opportunity for fair reimbursement. The Clinical Denial Management Specialist will adhere to the AHS Compliance Plan and...have at least an Associate's Degree in Nursing) . Utilization Review / Utilization Management experience of… more