- Tenet Healthcare (Detroit, MI)
- RN Utilization Review - Case ...dedicated healthcare team where compassion meets innovation! As a Registered Nurse with us, you'll have the ... level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as...required. One (1) year hospital acute or behavioral health case management experience preferred. Active and valid RN… more
- Cedars-Sinai (Los Angeles, CA)
- …criteria required **Req ID** : 14141 **Working Title** : Registered Nurse - Utilization Review Case Manager - PER DIEM - 8 Hour Days **Department** : ... **What will you be doing in this role?** The Utilization Review Case Manager validates...Heart Association or American Red Cross required + Certified Case Management RN preferred **Experience:** + A… more
- UTMB Health (Webster, TX)
- Utilization Review Case Mgr -...**_REQUIRED EDUCATION/EXPERIENCE_** **:** + Current Texas licensure as a Registered Nurse ( RN ).with a minimum of ... observation in Community Hospitals and UTMB-TDCJ Hospital. + Performs utilization review procedures by prospectively, concurrently, and...transfers and admissions from the prison facility. + Conducts nurse to nurse conference calls for all… more
- Cedars-Sinai (Los Angeles, CA)
- …Repetitive Motions, Eye/Hand/Foot Coordination **Req ID** : 14355 **Working Title** : Registered Nurse - Utilization Review Case Manager - 8 Hour Days ... America's Best Hospitals. Summary of Essential Duties: + The Utilization Management (UM) Registered Nurse ...accordance with CMS requirements and payer timelines. The UM RN collaborates with physicians, revenue integrity, and payer partners… more
- Community Health Systems (Franklin, TN)
- …discharge planning, and payer requirements. + Documents all utilization review activities in the hospital's case management software, including clinical ... submitting reconsiderations or coordinating peer-to-peer reviews. + Communicates effectively with utilization review coordinators, case managers, and… more
- University of Utah Health (Salt Lake City, UT)
- …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** ... case that surpasses expected LOS, expected cost, or over/under- utilization of resources. + Performs verbal/fax clinical review...+ Current license to practice as a Registered Nurse in the State of Utah,… more
- George C. Grape Community Hospital (Hamburg, IA)
- Quality/ Utilization Review Nurse Position Summary: The Quality/ Utilization Review Nurse is responsible for evaluating the medical necessity, ... payers to resolve care coordination issues. Qualifications: * Education: Registered Nurse ( RN ) license required;...nursing experience (acute care preferred). o Prior experience in utilization review , case management, quality… more
- BriteLife Recovery (Englewood, NJ)
- …assigned What we need from you? + Minimum of 2-3 years of experience in utilization review , case management, or insurance coordination in a behavioral health ... What you will be doing? The Utilization Review (UR) Specialist is a...EHR and UR logs. + Collaborate with clinicians, therapists, case managers, and medical staff to gather accurate and… more
- Georgetown Behavioral Health Institute (Georgetown, TX)
- …Knowledgeable of insurance coverage and billing practices preferred. Previous experience in utilization review or case management desirable. + Knowledge, ... a 118 bed inpatient behavioral health hospital and seeking a full-time Outpatient Utilization Review Coordinator. This position is responsible for working with… more
- Actalent (San Antonio, TX)
- …+ 3+ years of utilization management, concurrent review , prior authorization, utilization review , case management, and discharge planning is must + ... Immediate Hiring for "Remote Clinical Review Nurses" Job Description: + Review approximately...Active RN Compact License is Must If you are Interested ,… more
- Trinity Health (Columbus, OH)
- …5-7 years of clinical nursing experience with at least 2 years experience in utilization review , discharge planning, case management, or disease management ... analysis, audit, provider relations and more. **Position Purpose:** The RN Case Manager MCHP is responsible for...common symptoms they might experience. + Coordinates with the utilization review , case management, discharge… more
- Henry Ford Health System (Detroit, MI)
- …community partners to support patient needs beyond the hospital setting. Qualifications: + Registered Nurse ( RN ) with active licensure + Minimum [number] ... with computers, electronic health records (EHR), database systems, and utilization review / case management documentation systems....work in a fast-paced environment. Licenses and Certifications: + Registered Nurse ( RN ) with a… more
- Hartford HealthCare (Manchester, CT)
- …Manchester Region serves a region of 300,000 people in 19 towns. POSITION SUMMARY: The Utilization Review Case Manager (UR CM) works in collaboration with ... Management* **Organization:** **Manchester Memorial Hospital* **Title:** *Clinical Resource Management Nurse ( RN ) - Case Coordination* **Location:**… more
- Sanford Health (Rapid City, SD)
- …preferred. Experience in medical necessity review preferred. Currently holds an unencumbered registered nurse ( RN ) license with the State Board of ... Hours:** 40.00 **Department Details** Join our team as a Utilization Review and Case Management...Nursing and/or possess multistate licensure if in a Nurse Licensure Compact (NLC) state. Obtains and subsequently maintains… more
- Ellis Medicine (Schenectady, NY)
- …for appropriate Level of Care and status on all patients through collaboration with Utilization Review RN + Contacts the attending physician for additional ... SECTION I BASIC FUNCTION: The RN Case Manager has responsibility for...Case Manager include, but are not limited to, utilization review , case management, care… more
- PruittHealth (Albany, GA)
- …Minimum three years industry experience in a managed care setting focused on experience in utilization review / case management and at least two years case ... with long-term care population **MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:** * Licensed Registered Nurse with current, unrestricted license in state of… more
- University of Miami (Miami, FL)
- …Department of UMHC SCCC Business Operations has an exciting opportunity for a full time Utilization Review Case Manager to work to work remote. The incumbent ... retrospective chart reviews for clinical utilization and authorization. The Utilization Review Case Manager coordinates with the healthcare team for… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …needs across the continuum of care by leveraging member partnership, pre-service clinical utilization review , case and disease management processes, skill ... and Blue Shield of Minnesota Position Title: Care Advocacy Case Manager RN - Bilingual Spanish Location:...of care between settings. Required Skills and Experience * Registered nurse with current MN license and… more
- Mohawk Valley Health System (Utica, NY)
- RN - Case Manager - Full...Education/Experience Requirements Required: + Minimum of two (2) years utilization review / case management experience or ... - Days - 4 - 9.5 Hour Shifts Department: CASE MGMT Job Summary Reports to and is under...filed. + Bachelor's degree is preferred. + Licensed professional nurse may be considered. + Bachelors or Masters Degree… more
- University of Utah Health (Salt Lake City, UT)
- …education in healthcare or a related field. + One year of experience in a utilization review or case management environment. + Basic Life Support Health ... coordination of care activities under the direction of a registered nurse and/or social worker. The incumbent...discharge plans prepared and delegated by social work or nurse case management by coordinating with home… more
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