- Baptist Memorial (Jackson, MS)
- Summary The Utilization Review Nurse is...Summary: Position: 19738 - RN - Utilization Review Facility: MBMC - Hospital Department: HS ... appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse...Case Mgmt Administration Corporate Category: Nurse RN Type: Clinical Work Type: Full Time Work Schedule:… more
- Elevance Health (Norfolk, VA)
- **Title:** Licensed Utilization Review II **Location** : This position will work a remote model, but candidates must live within 50 miles of one of our ... 1 weekend day as discussed with manager. The **Licensed Utilization Review II** is responsible for working...regulatory requirements and standards. **Minimum Requirements:** + Requires a HS diploma or equivalent and a minimum of 2… more
- Providence (Mission Hills, CA)
- …must empower them. **Required Qualifications:** + Associate's Degree in Nursing. + California Registered Nurse License upon hire. + 2 years of experience working ... Management, medical necessity, and patient status determination. The Utilization Management RN must effectively and efficiently...hospice and home care, and even our own Providence High School . Providence is proud to be… more
- CareFirst (Cumberland, MD)
- …technology. + Must possess excellent verbal and written communication skills. **Licenses/Certifications** : RN - Registered Nurse - State Licensure And/or ... **Resp & Qualifications** **PURPOSE:** The Clinical Medical Review Nurse handles day to day...well as any appropriate medical records. **QUALIFICATIONS:** **Education Level:** High School Diploma or GED. **Experience:** 3… more
- Commonwealth of Pennsylvania (PA)
- …I have professional experience performing this Work Behavior as a charge nurse , head nurse , utilization review nurse , quality assurance nurse , or ... + Questions THE POSITION If you are a compassionate registered nurse seeking to advance your career,...Work Behavior as a charge nurse , head nurse , utilization review nurse… more
- Northwell Health (Bay Shore, NY)
- …+ Performs any and all related duties. *ADA Essential Functions Job Qualification + High School Diploma or equivalent, required. Bachelors Degree in Nursing or ... to the Hospital. Job Responsibility + * Performs concurrent review on all patients and share all problematic cases...field, preferred. + Current license to practice as a Registered Professional Nurse in New York State.… more
- Marshfield Clinic (Marshfield, WI)
- …weekend. **JOB QUALIFICATIONS** **EDUCATION** _For positions requiring education beyond a high school diploma or equivalent, educational qualifications must be ... **Minimum Required:** One year of healthcare experience. **Preferred/Optional:** Discharge Planning, Utilization Review or Case Management experience in a… more
- Northern Light Health (Pittsfield, ME)
- …direction and manages workflow and time. Credentials:Essential:* Registered Nurse Education:Essential:* High School Diploma/General Educational ... a $10,000 (minus tax) sign on bonus that is paid out incrementally. Summary:The Registered Nurse II is a fully competent practitioner of nursing. The incumbent… more
- Northern Light Health (Pittsfield, ME)
- …direction and manages workflow and time. Credentials + Required Registered Nurse Education + Required High School Diploma/General Educational Development ... on bonus that is paid out incrementally.** Summary: The Registered Nurse II is a fully competent...care. * Resource Management o Identifies opportunities to improve utilization of resources. * Professional Development o Takes responsibility… more
- Northern Light Health (Pittsfield, ME)
- …direction and manages workflow and time. Credentials + Required Registered Nurse Education + Required High School Diploma/General Educational Development ... Per Week: Variable Hours Work Schedule: Variable Summary: The Registered Nurse II is a fully competent...+ Resource Management + + Identifies opportunities to improve utilization of resources. + Professional Development + + Takes… more
- Kaleida Health (Buffalo, NY)
- …**Buffalo, NY** **Location:** HighPointe **Recruiter:** Angela Mostiller **Minimum or Preferred Qualifications:** HS - High School Diploma or GED required. ... **Auto req ID:** 73821BR **Department:** 21540 - HPTE SNF Utilization Review **Job Description:** This position is...(This requirement only applies to Acute Care setting preferred) Registered Nurse required upon hire. FIM Function… more
- The Cigna Group (Bloomfield, CT)
- …Therapeutic Resource Centers. **QUALIFICATIONS** + Active, unencumbered Registered Nurse ( RN ) license in Pennsylvania + High School Diploma or GED, ... Nurse Clinician - Accredo Job Description Summary The Nurse Clinician - RN is responsible for...years of experience is preferred in prior authorization or utilization review and appeals + Demonstrated proficiency… more
- Hackensack Meridian Health (Neptune, NJ)
- …releases accounts as appropriate. + Verifies admission and discharge date information. + Updates Utilization Review RN needed for payors. + Enters all ... information, inclusive of free text fields, to support the case management, utilization review process. + Retrieves information for the Physician Advisors… more
- CareFirst (Baltimore, MD)
- …**Education Level:** High School Diploma or GED. **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or Compact State ... **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Supervisor ( RN ) directs and coordinates the accurate implementation of...clinical experience OR + 5 years experience in Medical Review , Utilization Management or Case Management at… more
- Baptist Memorial (Memphis, TN)
- Summary Manages the resources for utilization review and case management to achieve the organizational goals. Has direct supervisory accountability for ... delivery of patient care related to case management and utilization review . * Supervises daily operations, activities,...required. * Bachelor's degree or higher degree preferred. * RN required About Baptist Memorial Health Care At Baptist,… more
- Elevance Health (Los Angeles, CA)
- …relatively complex case types that do not require the training or skill of a registered nurse . Acts as a resource for more junior Clinicians. Approval decisions ... a minimum of 6 years of clinical experience and/or utilization review experience. + Current active, valid...review experience. + Current active, valid and unrestricted RN license and/or certification to practice as a health… more
- Elevance Health (Indianapolis, IN)
- …relatively complex case types that do not require the training or skill of a registered nurse . Acts as a resource for more junior Clinicians. Approval decisions ... to train lower-level clinician staff. **Minimum Requirements:** + Requires HS diploma or equivalent. + Requires a minimum of...a minimum of 6 years of clinical experience and/or utilization review experience. + Current active, valid… more
- CareFirst (Baltimore, MD)
- … High School Diploma or GED. **Licenses/Certifications Upon Hire Required:** + RN - Registered Nurse - State Licensure And/or Compact State Licensure ... RN - Registered Nurse in MD, VA or Washington,...experience working in Care Management, Discharge Coordination, Home Health, Utilization Review , Disease Management or other direct… more
- Kepro (Oakland City, IN)
- …community. + Ensure day-to-day processes are conducted in accordance with the Utilization Review Accreditation Commission (URAC) and other regulatory standards. ... in the public sector. Acentra is looking for an RN Complex Case Manager - Hybrid (Southwest Indiana Counties:... license in Indiana (or compact state license). + High School diploma OR GED equivalent. +… more
- MTC (Marion, OH)
- …are documented accurately and completely. **Qualifications:** + Graduation from an accredited ** high school or equivalent (GED).** + **Bachelor's degree in ... use of appropriate sanitation methods. 6. Practice basic cost containment and utilization management for patient care and facility operations. 7. Maintain absolute… more