- Trusted Resource Associates (TRA) (Palm Springs, CA)
- Trusted Resource Associates (TRA) is seeking a local contract nurse RN Utilization Review for a local contract nursing job in Palm Springs, California.Job ... Description & RequirementsSpecialty: Utilization ReviewDiscipline: RNStart Date: 09/25/2024Duration: 13 weeks40 hours per...a case by case basis.Schedule: - This is a remote position. - Must be available to work 8… more
- GHR Healthcare (Atlanta, GA)
- …making critical decisions that impact patient care? Join us as a Care Management Coordinator and play a key role in evaluating and authorizing essential healthcare ... business hours) Type: Temp to Hire (Candidates will be remote but need to reside in the tri-state area...a resource for members navigating the healthcare system. Data Management : Maintain accurate records and report trends or issues… more
- Cambia Health Solutions, Inc (Lewiston, ID)
- Care Management Nurse (Future Opportunities)Work from home within Oregon, Washington, Idaho or Utah *Please be advised that this role is part of our candidate ... Degree in Nursing or related field3 years of case management , utilization management , disease ...degree in Behavioral Health preferred for behavioral health care management ); or Registered nurse (RN) license (must… more
- A-Line Staffing Solutions (New York, NY)
- …Case Management , InterQual, Medicare, Medicaid, CMS Guidelines, Utilization Review, Utilization Management , Registered Nurse , MCO, RN, Nurse , ... Chris M. at A-Line! Job Summary: * combination of remote work with field visits in the assigned area....InterQual, Medicare, Medicaid, CMS Guidelines, Utilization Review, Utilization Management , Registered Nurse , MCO,… more
- US Tech Solutions, Inc. (Columbia, SC)
- …. Performs medical reviews using established criteria sets and/or performs utilization management of professional, inpatient or outpatient, facility benefits ... equipment to be prepared. . The position is fully remote after that. . Please list out the top...sets/qualities: I would love to have someone with prior insurance/ utilization review experience, but I know that is not… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …members as needed to ensure services will be covered.Coordinate and communicate with Utilization Review Nurse on a daily, consistent basis to ensure patients ... Job Category:Nursing - Registered Nurse Work Shift/Schedule:8 Hr Morning - AfternoonNortheast Georgia...patient needs; Works collaborate with the Physicians, patient/family, nursing, utilization review and other members of the healthcare team… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- Job Category:Nursing - Registered Nurse Work Shift/Schedule:VariesNortheast Georgia Health System is rooted in a foundation of improving the health of our ... all campuses operated by NGHS. Collaborates with the physicians, patients, families, nursing, utilization review and other members of the health care team to ensure… more
- Pacer Staffing (Atlanta, GA)
- …regulatory requirements, and HIPAA privacy regulations. . Thorough knowledge of Case Management , Utilization Management , HIPAA Privacy and Security ... Job Summary . Provides Disease Management (DM) services to TRICARE beneficiaries. . The... (DM) services to TRICARE beneficiaries. . The DM nurse will collaboratively assess, plan, implement, coordinate, monitor and… more
- Pacer Staffing (Atlanta, GA)
- …direction and build group engagement. Technical Skills: Thorough knowledge of Case Management , Utilization Management , TRICARE policies and procedures, HIPAA ... Shift - Standard | Mon to Fri Location - Remote (Case Manager - serious diagnoses. Children/Pediatric with down syndrome, serious disabilities, physical… more
- Actalent (Knoxville, TN)
- Job Title: Acute Care Utilization Management Nurse ( Remote ) Job Description We are seeking a highly skilled and motivated Acute Care Utilization ... Acute Care RN experience (ICU or Medical Surgical) + Utilization Management + Knowledge of Medicare and...of 28 Weekly. Work Site This is a fully remote position. Work Environment100% REMOTE , MONDAY -… more
- CVS Health (Salem, OR)
- …include weekends, holidays, and evening hours. This Utilization Management (UM) Nurse Consultant role is 100% remote , and the candidate can live in any ... Time Zone or willing to work Pacific Time Zone hours. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document… more
- Insight Global (New York, NY)
- …RN License for the state the consultant resides in - 4-5 years of Remote Utilization Management experience at Payors, inpatient or outpatient - ... Job Description Insight Global is looking for a Pre-Access Utilization Management Registered Nurse to sit remotely with one of their large health insurance… more
- Veterans Affairs, Veterans Health Administration (Johnson City, TN)
- Summary The Utilization Management (UM) Nurse is responsible for providing competent, evidence-based practices within the position. Creating and providing ... on admission and continued stay criteria and best clinical documentation and utilization management practices to ensure efficient resource utilization .… more
- Humana (Louisville, KY)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... services and/or benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work assignments are varied… more
- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...based on a business need + This is a remote position **Scheduled Weekly Hours** 40 **Pay Range** The… more
- Humana (Des Moines, IA)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...based on a business need) + This is a remote position **Scheduled Weekly Hours** 40 **Pay Range** The… more
- CVS Health (Columbus, OH)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Utilizes clinical experience and skills in a ... internal and external constituents in the coordination and administration of the utilization /benefit management function Function in a clinical telephone queue… more
- Elevance Health (Tampa, FL)
- …of Florida. + Requires minimum of 5 years acute care clinical experience, utilization management or managed care experience; or any combination of education ... Senior RN Utilization Review/ Management (Acute InPatient) JR116937 **Location:**...Friday. **2 Holidays** per year and **occasional** weekends. The ** Nurse Medical Management Sr** serves as **team… more
- CVS Health (New Albany, OH)
- …training, position is remote with occasional in office requirement.** Utilization Review - Precertification Nurse is responsible for telephonically ... assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's… more
- Molina Healthcare (Seattle, WA)
- …Experience with the adult behavioral health system in Washington State and** ** Utilization Management experience is highly preferred.** **_Further details to be ... discussed during our interview process._** ** Remote position** **Work schedule M-F 8:30 AM to 5:00...the following: + Completion of an accredited Licensed Vocational Nurse (LVN) + Licensed Practical Nurse (LPN)… more
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