- CVS Health (Austin, TX)
- …to make health care more personal, convenient and affordable. **Position Summary:** This Utilization Management (UM) Nurse Consultant role is fully remote and ... both) per the needs of the team.** The UM Nurse Consultant job duties include (not all encompassing): +...encompassing): + Reviews services to assure medical necessity, applies clinical expertise to assure appropriate benefit utilization ,… more
- Pipeline Health System, LLC (Gardena, CA)
- …Under the general supervision of the CM Director the nurse case manager manages clinical resource utilization and documentation affecting reimbursement, ... Case Manager Registered Nurse RN - Per...Case Manager Registered Nurse RN - Per Diem 8 Hour Day...Introduce, Duration, Explanation, Thank you) patient communication. + Reviews clinical information daily on each patient to determine if… more
- Humana (Frankfort, KY)
- …first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Nurse 2 who will utilize clinical nursing skills to support the coordination, ... determine appropriateness of services. The Utilization Management Nurse 2 will use clinical knowledge, communication...management experience in an acute care, skilled or Rehabilitation clinical setting. + Certified Case Manager (CCM)… 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 ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates,...implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service,… more
- US Tech Solutions (Columbia, SC)
- …mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review/case management/ clinical /or combination; 2 of 4 years ... + Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and… more
- Travelers Insurance Company (Albany, NY)
- …Imagine loving what you do and where you do it. **Job Category** Claim, Nurse - Medical Case Manager **Compensation Overview** The annual base salary range ... Is the Opportunity?** This position is responsible for conducting in-house utilization review with emphasis on determining medical necessity for prospective,… more
- Pipeline Health System, LLC (Toast, NC)
- Job Title: Utilization Review Registered Nurse - Behavioral Health Unit/FT/Days Job Summary: This Utilization Review (UR) Registered Nurse (RN) position ... and compassionate care to our patients. This position is responsible for utilization review, assessment of discharge planning needs and coordination of effective… more
- Elevance Health (Washington, DC)
- The Utilization Management Nurse is responsible to...United States and minimum of 2 years acute care clinical experience. + Minimum 1 year Utilization ... in a cost effective setting according to contract. + Consult with clinical reviewers and/or medical directors to ensure medically appropriate, high quality, cost… more
- Sharp HealthCare (San Diego, CA)
- …Professional (AHA BLS Healthcare) - American Heart Association; California BBS Licensed Clinical Social Worker (LCSW) - CA Board of Behavioral Sciences; California ... (LMFT) - CA Board of Behavioral Sciences; California Registered Nurse (RN) - CA Board of Registered Nursing **Hours**...CA Board of Registered Nursing **OR** California BBS Licensed Clinical Social Worker (LCSW) - CA Board of Behavioral… more
- Beth Israel Lahey Health (Burlington, MA)
- …taking a job, you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital and Medical ... 8:00am-4:30pm Weekend and holiday rotations required **Job Description:** The Inpatient Registered Nurse (RN) Case Manager for Hospital at Home Care Transitions… more
- UNC Health Care (Chapel Hill, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... **Description** Surgery, Women's, & Children's Utilization Manager **(part-time: 20 hrs/week)** + Weekends only (Saturday & Sunday) + 8:30a-6:30p + **No Nights**… more
- Sharp HealthCare (San Diego, CA)
- …Degree in Nursing; Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse (RN) - CA Board of Registered ... patient care areas. This position requires the ability to combine clinical /quality considerations with regulatory/financial/ utilization review demands to assure… more
- 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
- VNS Health (Manhattan, NY)
- …general supervision. Compensation Range:$98,200.00 - $130,800.00 Annual * Reviews specific utilization issues or requests with Clinical Review team, focusing ... OverviewManages the utilization management team to ensure that standards for...and mitigate any discerned risks. * Facilitates and schedules Clinical Rounds to establish best practice and promote creative… more
- Johns Hopkins University (Lutherville, MD)
- …Department of Otolaryngology is seeking a **_CO_** **_Clinical Nurse Manager_** the Clinical Nurse Manager collaborates with the Medical Director and ... to improve workflows. + Resolves scheduling conflicts, monitors room utilization , and maintains clinic patient flow at each clinic...to two years of required nursing experience. Classified Title: Clinical Nurse Manager Job Posting… more
- Trinity Health (Silver Spring, MD)
- …review or closely related area. + Extensive knowledge of payer mechanisms and clinical utilization management is required. + Knowledge of pertinent regulatory, ... **Employment Type:** Full time **Shift:** **Description:** The Interim Manager of Care Management & Utilization ...applicable):** + State of Maryland license as a Registered Nurse + RN with BSN or RN with >… more
- CenterWell (Avon, IN)
- …a part of our caring community and help us put health first** The RN ** Clinical Manager ** coordinates and oversees all direct care patient services provided by ... clinical personnel. $10,000 Sign on Bonus available + Develops,... documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates… more
- Select Medical (Los Angeles, CA)
- …City / Los Angeles, CA Case Manager (CM) - Full Time (on-site) Registered Nurse (RN) or Licensed Clinical Social Worker (LCSW) **Pay Rate: $50 - $58.65 ... Rehab have a high discharge to home rate. **Benefits of working as a Case Manager with us:** + Excellent Orientation Program + Paid Time Off (PTO) + Extended Illness… more
- Stanford Health Care (Palo Alto, CA)
- …to delivering evidence-based and patient-centered care. We are seeking a results-driven manager to further develop the framework for clinical , operational, and ... Here, your leadership, coaching, and mentoring would further develop our robust, Utilization Management team. Are you driven by health care innovation, partnerships,… more
- UT Health (Houston, TX)
- Nurse Manager - Clinical Research...and nursing staff to ensure adequate coverage and maximum utilization of manpower. + Manages the duty assignments of ... in patient care. That's where you come in. **We are hiring immediately for a Nurse Manager to join the UTHealth Houston, Clinical Research Unit in The Center… more
Related Job Searches:
Clinical,
Clinical Nurse,
Clinical Nurse Manager,
Manager,
Nurse,
Nurse Manager,
Utilization,
Utilization Manager,
Utilization Nurse,
Utilization Nurse Manager