- CareFirst BlueCross BlueShield (Baltimore, MD)
- …experience is required in addition to the required work experience. Licenses/Certifications: Health Services\ RN - Registered Nurse - State Licensure and/or ... strategic business partners. This role encompasses six distinct units: Commercial UM intake and call center, Commercial outpatient medical pre-authorization review,… more
- CareFirst (Baltimore, MD)
- …work experience is required in addition to the required work experience.Licenses/Certifications:Health Services\ RN - Registered Nurse - State Licensure ... strategic business partners.This role encompasses six distinct units: Commercial UM intake and call center, Commercial outpatient medical pre-authorization review,… more
- AmeriHealth Caritas (Charlotte, NC)
- ** RN Clinical Care Reviewer, UM , Exchange...**Job Brief** Must be a graduate from an accredited Registered Nurse program. Diploma or Associate's Degree ... license. 3+ years of clinical practice experience as a RN in acute care setting. UM exp...**Education/Experience:** + Must be a graduate from an accredited Registered Nurse program. Diploma or Associate's Degree… more
- Molina Healthcare (New York, NY)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... with data collection/reports** **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **NY… more
- Molina Healthcare (Los Angeles, CA)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... of illness and the site of service. **We are seeking a candidate with a RN license and managed care UM experience-required. Prior Inpatient review experience and… more
- LifePoint Health (Las Cruces, NM)
- …Professionals or InterQual is desirable. * Current New Mexico licensure as a Registered Nurse . * Certification as CCM or ACM desired. *_EEOC Statement_*: ... local law./ **Job:** **Nursing* **Organization:** **Memorial Medical Center* **Title:** * RN Case Manager - UM - PRN*...Medical Center* **Title:** * RN Case Manager - UM - PRN* **Location:** *New Mexico-Las Cruces* **Requisition ID:**… more
- ERP International (Corpus Christi, TX)
- **Overview** ERP International is seeking a ** Registered Nurse ( RN )** **Utilization Manager** for a full-time position in support of the **Naval Health ... Program (UMP) and ensure that the UMP meets established Utilization Management ( UM ) standards of care. Assist in coordinating a multidisciplinary team to meet… more
- United Methodist Communities (Camden, NJ)
- …| Camden, NJ, USA | Hourly | Per Diem RN : Registered Nurse UMC -...and orientation process is quick and easy Abo ut UM C: + Our Mission is to serve our ... have flexibility to work as little or as much as you choose. Requirements for an RN : Registered Nurse : + Cover an open shift as assigned and agreed upon +… more
- ProMedica Health System (Sylvania, OH)
- …applicable nursing experience License: A current, active, and unrestricted licensure as a Registered Nurse in the state of practice is required. Certification: ... Position Summary: The RN Acute Care Navigator is responsible for direct...Care Coordination Plan, updates as appropriate. 12. Collaborates with UM team, as appropriate and applies clinical understanding of… more
- ERP International (Corpus Christi, TX)
- **Overview** ERP International is seeking a ** Registered Nurse ( RN )** **Case Manager** for a full-time position in support of the **Naval Health Clinic ... Management Specialist (CDMS) o Association of Rehabilitation Nurses: Certified Rehabilitation Registered Nurse (CRRN) o American Board for Occupational Health… more
- Magellan Health Services (Honolulu, HI)
- …State Licensure - Care Mgmt, PT - Physical Therapist, State Licensure - Care Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care ... policies and processes. Also oversees the health plans 24/7 Nurse Line program and the clinical management of crisis...reports with audit results. Presents findings at provider, customer, UM and CM meetings as needed. + Audits and… more
- United Methodist Communities (Collingswood, NJ)
- 75 per visit | Posted 06-Sep-2024 (EST) | Collingswood, NJ, USA | Other | Per Diem RN : Registered Nurse - Home Care Visiting Nurse Serving clients in ... Streamlined orientation process + Supportive and encouraging team! Requirements: RN 's must be Covid vaccinated and boosted and have...and valid Driver's License is also required. Abou t UM C: + Our Mission is to serve our… more
- Commonwealth Care Alliance (Boston, MA)
- …procedures, and facilities under the provisions of CCA's benefits plan. 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 ensuring CCA meets… more
- Actalent (Santa Barbara, CA)
- Non-profit healthcare network is looking for a utilization management registered nurse to join their team on a contract basis! Opportunity to gain experience ... Health Plan Nurse Coordinator (HPNC) is a Registered Nurse who is assigned to one...as Mental/Behavioral Health services. These sub-specialized programs require the RN to perform UM or CM activities… more
- Molina Healthcare (Long Beach, CA)
- …interpersonal skills **Job Qualifications** **Required Education:** Completion of an accredited Registered Nurse ( RN ) Program **Required Experience:** + ... Marketplace programs. **We are seeking a candidate with a RN license and UM experience. Prior Case...Review experience **Required Licensure or Certification:** Active, unrestricted State Registered Nurse ( RN ) License in… more
- Ciena Healthcare (Ovid, MI)
- …and strong teamwork abilities. Responsibilities + Supervises nursing care provided by Registered Nurses ( RN ), Licensed Practical Nurses (LPN), Certified Nursing ... Are you an RN looking for a leadership role? Do you...for leading and teaching other skilled nursing staff? The RN Unit Manager provides, plans, coordinates or manages nursing… more
- University of Michigan (Ann Arbor, MI)
- …in the care and management of patients receiving extracorporeal photopheresis. The Registered Nurse ( RN ) supports professional nursing practice across ... REGISTERED NURSE : Ambulatory Care Services (C&W...Specific Info** Salary & Nursing Framework Level: This UMPNC RN posting is posted as Nursing Framework LEVEL C.… more
- Point32Health (Canton, MA)
- …Mentor staff **Qualifications - what you need to perform the job** Registered Nurse , Leadership experience. Health Plan experience preferred **Compensation & ... at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** Manage UM Clinicians in day to day operations of the... Clinicians in day to day operations of the UM Process **Key** **Responsibilities/Duties** **- what you will be… more
- The Arora Group (Twentynine Palms, CA)
- Registered Nurse Case Manager Nurse Currently recruiting a Registered Nurse ( RN ) Case Manager near Palm Springs, California, to provide care to ... 80 hours per two week period. DUTIES OF THE REGISTERED NURSE CASE MANAGER ( RN ):...monitoring. + Integrate case management (CM) with utilization management ( UM ) and disease management as needed. Integrate nursing case… more
- Centers Plan for Healthy Living (Margate, FL)
- …Plan For Healthy Living is currently accepting applications for Full Time Registered Nurse without experience. The Utilization Management Clinical Reviewer works ... UM Clinical Reviewer 5297 W Copans Rd, Margate,...education, and preventative interventions are maintained. Qualifications: + Active RN license, entry level RN welcome +… more
