- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day ... service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has...has a key role in ensuring CCA meets CMS compliance standards in the area of service decisions and… more
- Christus Health (San Antonio, TX)
- …for assigned areas; at CHRISTUS St. Patrick Hospital. The nurse manager affects departmental outcomes through interpretation, implementation, and evaluation ... excellence in patient care, patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically… more
- Katmai (Fort Carson, CO)
- …Red Cross. + Three (3) years within the last four (4) years as a registered nurse in utilization management . + One (1) year of experience in UR/UM and ... Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE...full, active, and unrestricted license to practice as a registered nurse . + Must be a graduate… more
- ERP International (Anchorage, AK)
- **Overview** ERP International is seeking a ** Registered Nurse Case Manager** for a full-time position supporting the673d Medical Group, Joint Base ... algorithms, CM software, and databases for community resources. - Integrate CM and utilization management (UM) and integrating nursing case management with… more
- ERP International (San Diego, CA)
- **Overview** ERP International is seeking a temporary ** Registered Nurse ( RN ) Health Educators** supporting **Naval Medical Center San Diego, CA ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- Luke Staffing (Glendale, CO)
- …holidays) **Will consider Part Time and Full Time Applicants** **POSITION OVERVIEW:** The Registered Nurse ( RN ) will provide on-site professional nursing ... ** 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
- Katmai (Usaf Academy, CO)
- …all levels of health care management to include outside agencies. Performs utilization management activities to optimize cost, quality, and access to care. ... **Job Requirements:** **MINIMUM QUALIFICATIONS** + Associates Degree of Nursing. Registered nurse shall be a graduate from...+ Shall possess a current, active, full and unrestricted Registered Nurses ( RN ) licensed in Colorado or… more
- Alameda Health System (Oakland, CA)
- …plans Role Overview: Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight, strategic ... hoc duties as needed. In essence, they orchestrate efficient utilization management to deliver high-quality patient care....Required Licenses/Certifications : Valid license to practice as a Registered Nurse in the State of California.… more
- Katmai (Fort Carson, CO)
- …Nursing (BSN) is required. + Minimum of two (2) years of prior experience in Utilization Management . + Must possess a current, active, full, and unrestricted ... Registered Nurses ( RN ) licensed in Colorado, be...checks. **DESIRED QUALIFICATIONS & SKILLS** + Certification by a Utilization Management -specific program such as Certified Professional… 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 ... Department at its inception. You can put your bedside RN experience to great use in case management...as required; collects, analyzes and reports on data for utilization , quality improvement, compliance , and other areas… more
- Stanford Health Care (Palo Alto, CA)
- …system, analytics and metric management . **Licenses and Certifications** + California Registered Nurse ( RN ) license + American Heart Association Basic ... Overview** The Oncology Research Nursing Professional (ORNP) -is a Registered Nurse ( RN ) who works...directions. + Understand and respond to multiple personalities and work/ management styles. + Resource management / utilization … more
- Stanford Health Care (Palo Alto, CA)
- …to identify trends and make recommendations for improvement. **Licenses and Certifications** + Nursing\ RN - Registered Nurse - State Licensure And/Or Compact ... Care **What you will do** + Inpatient & SNF Utilization Management & Care Coordination: + Support...+ Adheres to safety, P4P's (if applicable), HIPAA and compliance policies. **Education Qualifications** + High School Diploma or… more
- Christus Health (San Antonio, TX)
- …on for more details, and make sure to apply today. The nurse manager affects departmental outcomes through interpretation, implementation, and evaluation of hospital ... excellence in patient care, patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically… more
- Baptist Memorial Health (Southaven, MS)
- …BMH - Desoto Hospital Department: DC Case Management Admin BMH Desoto Category: Nurse RN Type: Clinical Work Type: Full Time Work Schedule: Days Location: ... of patients throughout the continuum of care for appropriate utilization of resources, service delivery and compliance ...Diploma or Associate Degree in Nursing Experience Preferred : RN with 3 years of clinical experience with Case… more
- Highland Hospital (Rochester, NY)
- …771 - Social Work Service **Job Description:** Highland Hospital is seeking an experienced RN to join the Care Management team. Care coordinators are responsible ... of patient progress toward goals for all patients followed 4. Disease specific management to reduce readmissions. 5. Identifies goals and usual patterns of care for… more
- BroadPath Healthcare Solutions (Tucson, AZ)
- …of Texas or compact license + 3+ years Nursing experience + 1+ years Utilization Management and Appeals experience + Excellent verbal, written and computer ... **Overview** BroadPath is seeking a highly motivated and results-driven **UM RN Appeals Coordinator.** This role collaborates with clinical review staff, medical… more
- Katmai (Usaf Academy, CO)
- …with military and civilian healthcare providers and staff and uses Utilization Management (UM) systems support to identify high-risk/high-cost patients ... **SUMMARY:** Performs healthcare coordination and case management activities IAW Medical Treatment Facility (MTF) instructions. **ESSENTIAL DUTIES &… 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 ... their APPs. Also functions under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered Nurse Anesthetist (CRNA), or… more
- Stanford Health Care (Palo Alto, CA)
- …from an accredited college or university. + Nurse Practitioners, Clinical Nurse Specialists, Certified Registered Nurse Anesthetist: Master's or ... licensed advanced practice provider: (Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist or Certified Registered Nurse Anesthetist).… 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 ... a licensed advanced practice provider: (Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist or Certified Registered Nurse Anesthetist). +… more
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