- Alameda Health System (Oakland, CA)
- …plans Role Overview: Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight, strategic ... hoc duties as needed. In essence, they orchestrate efficient utilization management to deliver high-quality patient care....Required Licenses/Certifications : Valid license to practice as a Registered Nurse in the State of California.… more
- Katmai (Fort Carson, CO)
- …Red Cross. + Three (3) years within the last four (4) years as a registered nurse in utilization management . + One (1) year of experience in UR/UM and ... Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE...full, active, and unrestricted license to practice as a registered nurse . + Must be a graduate… more
- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in… more
- ERP International (Macdill AFB, FL)
- **Overview** ERP International is seeking a ** Registered ** ** Nurse ( RN )** for a Full-Time position in ** Utilization Management ** at MacDill AFB, FL. ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- ERP International (Luke AFB, AZ)
- **Overview** ERP International is seeking a full time ** Registered Nurse - Case Management ** in support of the56th Medical Group at Luke AFB, AZ ... and databases for community resources. - Integrate CM and utilization management (UM) and integrating nursing case...full, active, and unrestricted license to practice as a Registered Nurse , any state. Clinical Certification:** Certified… more
- Christus Health (San Antonio, TX)
- …Medicare GMLOS by managing per Milliman/Interqual Care Guidelines. Resource/ Utilization Management /appropriateness: Assess assigned patient population for ... This position provides expertise and leadership to insure effective resource management for patient care delivery (Conditions of Participation COP 482.30). Case… more
- Luke Staffing (Yigo, GU)
- …of clinical nursing experience is required. One year of previous experience in Utilization Management is required. Full time employment in a nursing field ... of this position, it must be directly related to referral/ utilization management . + **Licensure:** Current, full, active,...and unrestricted license to practice as a Practical OR Registered Nurse in any one of the… more
- Kaiser Permanente (Salem, OR)
- …Skilled Nursing Facilities Hospice Long Term Acute Care Inpatient Rehab Utilization Management Education Successful completion of an RN program by date of ... Diploma or General Education Development (GED) required. License, Certification, Registration Registered Nurse License (Oregon) required at hire Basic Life… more
- ERP International (Hurlburt Field, FL)
- **Overview** ERP International is seeking a full time ** Registered Nurse ( RN ) Case Manager** in support of the 1st Special Operations Medical Group at ... algorithms, CM software, and databases for community resources. - Integrate CM and utilization management (UM) and integrating nursing case management with… more
- Christus Health (San Antonio, TX)
- …for assigned areas; at CHRISTUS St. Patrick Hospital. The nurse manager affects departmental outcomes through interpretation, implementation, and evaluation ... excellence in patient care, patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically… more
- ERP International (Twentynine Palms, CA)
- **Overview** ERP International is seeking ** Registered Nurse ( RN ) Case Managers** for full-time positions in support of the **Naval Hospital Twentynine ... algorithms, CM software, and databases for community resources. - Integrate CM and utilization management (UM) and integrating nursing case management with… more
- ERP International (Tinker AFB, OK)
- **Overview** ERP International, LLC is seeking a ** Registered Nurse - Case Manager** for a full-time position supporting **SHG Clinic** in support of **Tinker ... and databases for community resources. - Integrate CM and utilization management (UM) and integrating nursing case...or pending adverse actions) to practice nursing as a registered nurse in any US state/jurisdiction. Security**… more
- Katmai (Usaf Academy, CO)
- …all levels of health care management to include outside agencies. Performs utilization management activities to optimize cost, quality, and access to care. ... **Job Requirements:** **MINIMUM QUALIFICATIONS** + Associates Degree of Nursing. Registered nurse shall be a graduate from...+ Shall possess a current, active, full and unrestricted Registered Nurses ( RN ) licensed in Colorado or… more
- Rochester Regional Health (Rochester, NY)
- …Schedule: Straight Shift- Days. Every other weekend/holidays. Sign-On Bonus: $15,000 SUMMARY : As a Registered Nurse ( RN ), you're the engine and the heart of ... on 3800 provide direct bedside care, patient education, pain management , post-op recovery support, and discharge planning. The unit...Support - American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse -… more
- Saint Agnes Medical Center (Fresno, CA)
- …the acute care continuum for CVHP members. This includes discharge planning, utilization management , care coordination, and support for resource utilization ... interdisciplinary team to improve patient care through the effective utilization of the facility's resources. The incumbent makes significant...nursing program is preferred. 2. Current licensure as a Registered Nurse in the state of California… more
- Christus Health (Euless, TX)
- …population health management principles is required Licenses, Registrations, or Certifications RN license in the state of employment or compact is required One ... and any qualifications that applicants are expected to have. Summary: The RN Navigator in Population Health is responsible for coordinating and managing patient… more
- Yale New Haven Health (Milford, CT)
- …Works Under The Supervision Of The Nurse Manager/Clinical Coordinator. The Registered Nurse ( Rn ) Assesses, Plans, Implements, Evaluates And Supervises ... N/A LICENSURE Valid State Of Connecticut Registered Nurse License SPECIAL SKILLS BLS Required Additional Information Med/Surg RN experience required. more
- Yale New Haven Health (Danbury, CT)
- …Works Under The Supervision Of The Nurse Manager/Clinical Coordinator. The Registered Nurse ( Rn ) Assesses, Plans, Implements, Evaluates And Supervises ... Regarding Care For Patients. EXPERIENCE N/A LICENSURE Valid State Of Connecticut Registered Nurse License SPECIAL SKILLS BLS Required Additional Information… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …knowledge of different claim types is desired. (Preferred) + Current Washington State License: Registered Nurse ( RN ), Advanced Registered Nurse ... appropriate procedure and diagnosis codes, and support business decisions regarding utilization management activities and guidelines. + Support medical policy… more
- Christus Health (Dallas, TX)
- …role as detailed below, do not wait to send your CV. Summary: The Registered Nurse Navigator Population Health Senior is accountable for coordinating and ... preventive care, and ensuring patients receive appropriate and timely interventions. Registered Nurse Navigator Population Health Senior will work… more
