- Commonwealth Care Alliance (Boston, MA)
- …clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA ... CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is… 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 ... Overview To be part of our organization, every employee should understand...Of Connecticut Registered Nurse License SPECIAL SKILLS BLS Required Additional Information Med/Surg RN experience… 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 ... Overview To be part of our organization, every employee should understand...For Patients. EXPERIENCE N/A LICENSURE Valid State Of Connecticut Registered Nurse License SPECIAL SKILLS BLS Required… more
- Fresenius Medical Care (Atlanta, GA)
- …while maintaining clinical operations. As the facility leader, you will be part of a close-knit, collaborative team responsible for delivering unique care plans ... looking for, and you want to be a vital part of the future of healthcare, apply today. PRINCIPAL...activities. Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. Manages… more
- Luke Staffing (Glendale, CO)
- …**Will consider Part Time and Full Time Applicants** **POSITION OVERVIEW:** The Registered Nurse ( RN ) will provide on-site professional nursing services ... ** REGISTERED NURSE ** **SITE OF SERVICE:** Department...of Veterans Affairs' Eastern Colorado Healthcare System (ECHCS). The RN will serve in the Office of Community Care… more
- ERP International (San Diego, CA)
- **Overview** ERP International is seeking a full-time ** Registered Nurse ( RN ) Health Educator** supporting **Naval Medical Center San Diego, CA ... of other individuals performing similar services. ? Participate in peer review and performance improvement activities. ? Practice aseptic techniques as necessary.… more
- Stanford Health Care (Palo Alto, CA)
- …affect the processes and outcomes of patient health care **Licenses and Certifications** + Nursing\ RN - Registered Nurse - State Licensure And/Or Compact ... If you're ready to be part of our legacy of hope and innovation,...include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review … more
- Luminis Health (Annapolis, MD)
- …Degree. Required - Cardiopulmonary Resuscitation Required - ACLS Required - Registered Nurse Preferred: CNOR certification Working Conditions, Equipment, ... Luminis Health Title: Team Leader RN - Cardiac OR Reports to: Clinical Nursing...an expert in their service line, is an integral part of the multi-disciplinary team and is required to… more
- BroadPath Healthcare Solutions (Tucson, AZ)
- … RN Appeals Coordinator.** This role collaborates with clinical review staff, medical directors/physician reviewers, network physicians, and network facilities to ... 8:00 AM - 5:00 PM CST (Flexible) **Responsibilities** A. Performs necessary review to ensure compliance with HHSC and other regulatory entities + Collaborate:… more
- Stanford Health Care (Palo Alto, CA)
- …Lead APP also functions under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered Nurse Anesthetist (CRNA), or the ... If you're ready to be part of our legacy of hope and innovation,...under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered Nurse… more
- Stanford Health Care (Palo Alto, CA)
- …their APPs. Also functions under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered Nurse Anesthetist (CRNA), or ... If you're ready to be part of our legacy of hope and innovation,...practice provider: (Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist or Certified Registered Nurse… more
- Stanford Health Care (Palo Alto, CA)
- …affect the processes and outcomes of patient health care **Licenses and Certifications** + Nursing\ RN - Registered Nurse - State Licensure And/Or Compact ... If you're ready to be part of our legacy of hope and innovation,...include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review … more
- Commonwealth Care Alliance (Boston, MA)
- …success. + Conduct regular provider meetings (virtual and in-person) to review performance, discuss program updates, and address operational challenges. + Represent ... Lead the monitoring and analysis of provider performance using utilization , quality, and member experience metrics. + Collaborate with...self-motivated, with the ability to work independently and as part of a team to meet departmental goals. +… more
- Commonwealth Care Alliance (Boston, MA)
- …understanding of CCA's mission, value-based approach, and expectations for quality, utilization , and member experience. - Address provider inquiries related to care ... coordination, utilization management, and program participation, collaborating with internal teams...BH and Health Home providers. - Participate in case review meetings and rounds as needed to enhance coordination… more
- Parexel (Jackson, MS)
- …understanding interdependencies. Define mitigations and drive resolution with cross-functional stakeholders as part of the Risk Management Plan. + Review and ... practices like version control and literate programming. + BSN, RN , RPh, Pharm D, PA, MPH, or other applicable...ensure high-quality, compliant data. + Use surveillance tools to review data at an aggregate level, identifying patterns or… more
- Providence (Mission Hills, CA)
- **Description** ** RN Utilization Review - Remote. This position will work full- time in a 8-hr Day shift.** Provide prospective, retrospective, and ... must empower them. **Required Qualifications:** + Associate's Degree in Nursing. + California Registered Nurse License upon hire. + 2 years of experience working… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse ( RN ) who comprehensively conducts ... this position is able to cover a multitude of utilization review functions through point of entry,...and/or case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
- Penn Medicine (Lancaster, PA)
- …NCLEX within 60 days of starting in their RN role. + A graduate registered nurse may only practice professional nursing under supervision and if the graduate ... that established outcomes are achieved through availability and appropriated utilization + of human, material and financial resources. +...their NCLEX within 60 days of starting in their RN role.A graduate registered nurse … more
- Penn Medicine (Lancaster, PA)
- …placement in position for incumbents who started after 07/01/2020. + A graduate registered nurse may only practice professional nursing under supervision and if ... the graduate registered nurse holds a current temporary practice... nurse is practicing. + All Clinical Nurse 1 RN 's will be required to… more
- Tenet Healthcare (Detroit, MI)
- Registered Nurse ( RN ) - Case...growth and work-life balance. Ready to be a vital part of our mission? Apply today and bring your passion ... dedicated healthcare team where compassion meets innovation! As a Registered Nurse with us, you'll have the...and is determined by employment status Job Description: The RN Case Manager is responsible to facilitate care along… more
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