• Utilization Management Clinical Consultant…

    CVS Health (Charleston, WV)
    …to make health care more personal, convenient and affordable. This is a fully ** remote ** Utilization Review Clinical Consultant with a schedule of ... Virginia state licensure (LCSW, LPCC, LMFT, LPAT) or a Registered Nurse ( RN ) with active...some weekends **Preferred Qualifications** + Managed care experience + Utilization review experience + Ability to multitask,… more
    CVS Health (11/07/24)
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  • Clinical Review Nurse

    Actalent (Atlanta, GA)
    Actalent is currently hiring for Remote Utilization Review RNs! Job Description: + Reviewing authorization requests + Utilizing evidence-based criteria and ... applicable. Qualifications: + Active RN License + Prior Utilization management/Concurrent review experience + Experience with MCG Why Actalent? + Work with… more
    Actalent (11/14/24)
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  • Utilization Review RN Temp…

    LifePoint Health (Henderson, NC)
    …minimal supervision. **Job:** **Nursing* **Organization:** ** **Title:** * Utilization Review RN Temp ( Remote )* **Location:** *NC-Henderson* **Requisition ... *Monitors adherence to the hospital's utilization review plan to ensure appropriate...Preferred Required Skills Certifications: Basic Life Support (BLS) Licenses: RN Requires critical thinking skills, decisive judgment and the… more
    LifePoint Health (11/23/24)
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  • Utilization Review Clinician (Non-…

    Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
    POSITION TITLE: Utilization Review Clinician REPORTS TO (TITLE): Director of Utilization Review DESCRIPTION OF POSITION: Work as member of ... party payers. + Recordkeeping: Maintains appropriate records of the Utilization Review Department. + Training: Provide staff...+ Current license as an LCSW, ASW, MFT, LMFT, RN , LPT, LVN or LPC + Preferred; Master's degree… more
    Sacramento Behavioral Healthcare Hospital (11/13/24)
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  • Registered Nurse ( RN ) Case…

    LifePoint Health (Las Cruces, NM)
    …**Nursing* **Organization:** **Memorial Medical Center* **Title:** * Registered Nurse ( RN ) Case Manager - UM - PRN ( Remote )* **Location:** *New Mexico-Las ... resources in the development of care, discharge planning and Utilization Review . * Utilization Management...is desirable. * Current New Mexico licensure as a Registered Nurse . * Certification as CCM or… more
    LifePoint Health (09/15/24)
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  • Registered Nurse ( RN ), Care…

    Beth Israel Lahey Health (Charlestown, MA)
    …care system considered in lieu of degree + Active, unrestricted Massachusetts Registered Nurse License required. Certification in Case Management (CCM) ... in healthy behavior. Working with the healthcare team, the Care Manager, RN monitors appropriate utilization of healthcare resources, promotes quality and… more
    Beth Israel Lahey Health (11/23/24)
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  • REMOTE | Care Manager II Registered

    AmeriHealth Caritas (Florence, SC)
    ** REMOTE | Care Manager II Registered Nurse (BSN) - Foster Care Program -SC** Location: Florence, SC Primary Job Function: Medical Management ID**: 34390 ... Counties preferred are York, Florence, Darlington, Williamsburg and Horry. RN required. ** Remote to qualified candidates living...is required and must hold a current and unrestricted ** Registered Nurse ( RN )** license in… more
    AmeriHealth Caritas (10/24/24)
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  • Registered Nurse 13 - IC…

    State of Michigan (Westland, MI)
    Registered Nurse 13 - IC Nurse... in the maintenance of effective Infection Control and Utilization Review Programs. To be considered for this ... Apply  Registered Nurse 13 - IC Nurse Salary $38.22 - $52.78 Hourly Location Westland, MI Job Type Permanent… more
    State of Michigan (11/24/24)
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  • Pre-Authorization Registered Nurse

    Humana (Enid, OK)
    …supports the goal to put health first? The Prior Authorization, Registered Nurse , RN , Intern will review prior authorization requests for appropriate ... or remote based opportunities. The Prior Authorization, Registered Nurse , RN , Intern will...using clinical judgment and refers to internal stakeholders for review depending on case findings. + Educates providers on… more
    Humana (11/23/24)
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  • Registered Nurse (Infection Control)

    Veterans Affairs, Veterans Health Administration (Leeds, MA)
    …the EDRP application. Former EDRP participants ineligible to apply. Responsibilities This Registered Nurse (Infection Control) position is located in the Nursing ... week. Included but are not limited to: The Infection Prevention and Control Registered Nurse is accountable to the Associate Director Patient Care Services/Chief… more
    Veterans Affairs, Veterans Health Administration (11/23/24)
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  • Registered Nurse Community Living…

    Veterans Affairs, Veterans Health Administration (Salem, VA)
    …education, self-management, and customer satisfaction throughout the continuum of care. Responsibilities Registered Nurse ( RN ) is responsible for providing ... Summary Come Join The Team! Salem VA Medical Center is looking for a Registered Nurse for our Community Living Center (CLC). The Registered Nurse assumes… more
    Veterans Affairs, Veterans Health Administration (11/23/24)
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  • Registered Nurse Clinical Appeal…

    Medical Mutual of Ohio (OH)
    …Ohio State Nursing Board. Bachelor's degree preferred + 3 years' experience as a Registered Nurse in acute care, critical care, emergency medical or medical ... medical coding or medical documentation investigation preferred Professional Certification: + Registered Nurse with current State of Ohio unrestricted license… more
    Medical Mutual of Ohio (11/15/24)
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  • Registered Nurse - Community Care…

    Veterans Affairs, Veterans Health Administration (Sioux Falls, SD)
    …The Sioux Falls Veteran's Affair Healthcare System (SFVAHCS) Community Care (CC) Registered Nurse ( RN ) Clinical Coordinator who functions independently ... Falls Veteran's Affair Healthcare System (SFVAHCS) Community Care (CC) Registered Nurse ( RN ) Clinical Coordinator...RN Clinical Coordinator is responsible for providing clinical review and have the expertise for the coordination of… more
    Veterans Affairs, Veterans Health Administration (11/16/24)
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  • Registered Nurse -CLC Units

    Veterans Affairs, Veterans Health Administration (Bedford, MA)
    …considered and referred as vacancies become available. This OCA may be used to fill a Registered Nurse ( RN ) position that is located in the one of following ... VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities VA offers a...CLC-2C CLC-62C CLC-62D CLC-78C The Community Living Center (CLC) Registered Nurse ( RN ) is responsible… more
    Veterans Affairs, Veterans Health Administration (11/01/24)
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  • Care Manager II Registered Nurse

    AmeriHealth Caritas (Greenville, SC)
    …Bachelor of Science in Nursing (BSN) is required and must hold a current and unrestricted Registered Nurse ( RN ) license in good standing in South Carolina or ... **Care Manager II Registered Nurse (BSN) - Foster Care...Bachelor of Science in Nursing (BSN) and an unrestricted RN license in South Carolina (or a compact state).… more
    AmeriHealth Caritas (11/23/24)
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  • Registered Nurse Safety Manager,…

    Veterans Affairs, Veterans Health Administration (Tucson, AZ)
    Summary The Registered Nurse ( RN ) Safety Manager (PSM) ,Supervisor executes position responsibilities that demonstrate leadership, experience, and creative ... throughout the continuum of care for Quality and Patient Safety. Responsibilities The Registered Nurse ( RN ) Safety Manager (PSM) ,Supervisor executes… more
    Veterans Affairs, Veterans Health Administration (11/23/24)
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  • Registered Nurse - Dialysis

    Veterans Affairs, Veterans Health Administration (Albany, NY)
    … of the EDRP application. Former EDRP participants ineligible to apply. Responsibilities The Dialysis Registered Nurse ( RN ) is a professional nurse with ... BSN 3-5 Years Med/Surg or Critical Care experience At least 1 year of registered nurse dialysis experience Caring for acute, chronic and peritoneal dialysis… more
    Veterans Affairs, Veterans Health Administration (11/17/24)
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  • Pre-Authorization Registered Nurse

    Humana (Frankfort, KY)
    …to make an impact** **Required Qualifications - What it takes to Succeed** + Licensed Registered Nurse ( RN ) in the state of Kentucky with no disciplinary ... for review depending on case findings. Educates providers on utilization and medical management processes. Enters and maintains pertinent clinical information in… more
    Humana (11/20/24)
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  • Acute Care Inpatient Staff Registered

    Veterans Affairs, Veterans Health Administration (Bay Pines, FL)
    …leadership, experience, and creative approaches to management of complex client care. The Registered Nurse ( RN ) is responsible for providing competent, ... the VHA Education Loan Repayment Services program office after review of the EDRP application. Responsibilities Responsible and accountable...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
    Veterans Affairs, Veterans Health Administration (11/23/24)
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  • Registered Nurse (Discharge Planner)

    Veterans Affairs, Veterans Health Administration (Loma Linda, CA)
    …by possessing and exemplifying the core competencies of the High-Performance Model. The registered nurse provides care and counseling of persons or in the ... Summary The Discharge Planner is a registered professional nurse , qualified by education...and timeliness of services provided. Responsibilities The Discharge Planner RN is aligned within the Office of Nursing and… more
    Veterans Affairs, Veterans Health Administration (11/21/24)
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