- Trinity Health (Springfield, MA)
- …program. BSN graduate preferred, Master's preferred + **Licensure** : Current Licensure as a Registered Nurse RN in Massachusetts. + **Certification** : BLS ... Shift **Description:** Requires BSN At **Mercy Medical Center** the ** Utilization Review /Appeals & Denials** ** RN **...criteria, and assists the physician, bedside Registered Nurse , ICC and Social Worker with utilization … more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …us transform healthcare? Bring your true colors to blue. The Role The Clinical Utilization Reviewer is responsible for facilitating care for members who may have ... personas: eWorker, mobile and resident. The Team The Clinical Utilization Reviewer is part of a highly...+ Behavioral Health professional with an active Massachusetts license: Registered Nurse , LICSW, LMHC + 3-5 years… more
- University of Virginia (Charlottesville, VA)
- …2 years acute care hospital experience. Licensure: Licensed to Practice as a Registered Nurse in the Commonwealth of Virginia required. PREFERRED QUALIFICATIONS: ... Under general direction: The Utilization Management RN serves as a...in determining what cases to refer for second level review to external physician consultants and internal UVA UR… more
- Ascension Health (Tulsa, OK)
- …initiatives. + Develop systems and processes for prospective, concurrent and retrospective utilization review for all self-funded and fully insured clients to ... codes for all clients. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Oklahoma Board of Nursing obtained… more
- Pipeline Health System, LLC (Toast, NC)
- …- Behavioral Health Unit/FT/Days Job Summary: This Utilization Review (UR) Registered Nurse ( RN ) position supports the Mission of Pipeline Health ... Job Title: Utilization Review Registered ...care to our patients. This position is responsible for utilization review , assessment of discharge planning needs… more
- Trinity Health (Livonia, MI)
- …Type:** Part time **Shift:** Rotating Shift **Description:** **JOB SUMMARY** The Clinical Nurse Reviewer 's chief responsibility is to collect and submit reliable ... of all eligible cases for the hospital. The Clinical Nurse Reviewer also works closely with the...CRNA preferred B. Licensure + Licensed in Michigan as registered nurse C. Training and Experience +… more
- MetroHealth (Cleveland, OH)
- …customer service standards of the MHS.** Qualifications: Bachelor's degree in nursing. Current Registered Nurse License State of Ohio. Minimum of 5 years ... and Milliman Health Management Guidelines. Current working knowledge of, utilization management, case-management, performance improvement, and managed care reimbursement.… more
- Wellpath (Fort Lauderdale, FL)
- …and point of care support. **How you make a difference** The Utilization Review Coordinatorwill perform admission and continued-stay reviews. This position ... care setting, preferably inpatient preferred. + Minimum one (1) year clinical or utilization review or case management preferred. + Knowledge of managed care… more
- Mohawk Valley Health System (Utica, NY)
- Registered Nurse - Utilization Review Nurse - Full Time - Days Department: CASE MANAGEMENT Job Summary Reports to and is under direct supervision of ... compliance. Education/Experience Requirements Required: + Minimum of two (2) years utilization review /case management experience or social work experience.… more
- Crouse Hospital (Syracuse, NY)
- Utilization Management Registered Nurse has well-developed knowledge and is proficient with standard Utilization Review processes. The Utilization ... workload in a fast-paced, rapidly changing regulatory environment. The Utilization Management RN works collaboratively with a.../ LICENSURE + Required: + Currently licensed as a Registered Professional Nurse in New York State.… more
- HCA Healthcare (Houston, TX)
- …growth, we encourage you to apply for our Registered Nurse RN PACU PRN opening. We review all applications. Qualified candidates will be contacted ... Do you have the PRN career opportunities as a(an) Registered Nurse RN PACU PRN...all practices in the PACU. + Proficient in the utilization of specialized skills to provide care to patients… more
- Lancaster General Health (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 ... American Nurses Association standards of nursing practice. The Clinical Nurse 2 Colleague is an RN that... registered nurse holds a current temporary practice… more
- HCA Healthcare (Richmond, VA)
- …**Are you passionate about delivering patient-centered care?** Submit your application for Case Manager Registered Nurse RN position and spend more time at ... in this role is to Performs admission and concurrent review for all payers and maintains legible documentation as...career! We are interviewing candidates for our Case Manager Registered Nurse RN opening. **Apply… more
- Lancaster General Health (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 ... registered nurse holds a current temporary practice permit.... nurse is practicing. + All Clinical Nurse 1 RN 's will be required to successfully… more
- HCA Healthcare (Pasadena, TX)
- …career path, we encourage you to apply for our Registered Nurse RN PACU PRN opening. We review all applications. Qualified candidates will be contacted ... **Introduction** Do you have the career opportunities as a(an) Registered Nurse RN PACU PRN...all practices in the PACU. + Proficient in the utilization of specialized skills to provide care to patients… more
- HCA Healthcare (Richmond, VA)
- …encourage you to apply for our Outpatient Psychiatric Registered Nurse RN PRN opening. Our team will promptly review your application. Highly qualified ... their positions. Join our Team as a(an) Outpatient Psychiatric Registered Nurse RN PRN and...Completes nursing admission assessments + Has working knowledge of utilization management functions and performs these functions as assigned… more
- Lancaster General Health (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. + Educates...area or unit where the graduate registered nurse is practicing. + For Magnet designated RN… more
- HCA Healthcare (Rochester, NH)
- …growth, we encourage you to apply for our Registered Nurse RN PACU PRN opening. We review all applications. Qualified candidates will be contacted ... Do you have the PRN career opportunities as a(an) Registered Nurse RN PACU/Recovery you...needs and problems in an efficient manner with appropriate utilization of resources. + Evaluates and documents nursing care… more
- Centers Plan for Healthy Living (Margate, FL)
- …for Full Time Registered Nurse without experience. The Utilization Management Clinical Reviewer works within a multidisciplinary team to help ... in their home to improve their quality of life. Utilization Management Clinical Reviewer will assess and...education, and preventative interventions are maintained. Qualifications: + Active RN license, entry level RN welcome +… more
- Magellan Health Services (Baton Rouge, LA)
- …Social Worker - Care Mgmt, LPCC - Licensed Professional Clinical Counselor - Care Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care ... clinical staff. + Provides training, interpretation and support for QI Clinical Reviewer staff. + Audits and validates internal audit results and/or corrective… more