• CHRISTUS Health (Tenneryville, TX)
    …within the scope of labor laws. Discovers opportunities to improve resource utilization . Implements changes in role consistent with scope of practice. Anticipates ... and plans for admission/discharge/transfer needs to facilitate patient flow. Resolves conflicts in a wide variety of situations, such as workload or resource allocation, patient and family concerns, patient through-put and capacity needs, associate engagement… more
    JobGet (11/04/24)
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  • Prisma Health (Greenville, SC)
    Nurse Manager in maintaining unit budget by appropriate allocation and utilization of unit resources. Shares accountability with Nurse Manager for ... with compassion. Be the difference.Job SummaryIn collaboration with the nurse manager, supervises staff and unit operations and provides...a variety of patient care activities in a charge nurse capacity to ensure the delivery of safe and… more
    JobGet (11/01/24)
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  • Prisma Health (Columbia, SC)
    …(TJC, DHEC, CMS). Provides care within the scope of the South Carolina Nurse Practice Act.The acute inpatient setting usually requires staff to be scheduled for ... clarify ideas-implementing and evaluating teaching plan (encourages patient/family involvement/participation)-Micromedex utilization -Computer resourcesCommunicates the patient/family's need for education/teaching to others… more
    JobGet (11/01/24)
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  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply  UTILIZATION REVIEW NURSE ... and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center,...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
    The County of Los Angeles (09/30/24)
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  • Utilization Management Nurse

    CVS Health (Trenton, NJ)
    …convenient and affordable. **Position Summary** This is a full-time remote Utilization Management Nurse Consultant opportunity. Utilization management ... may include weekends and holidays and evening rotations. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document… more
    CVS Health (11/01/24)
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  • Utilization Management Nurse

    CVS Health (Columbus, OH)
    …and work schedules may include weekends, holidays, and evening hours_ As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... coordinate, document and communicate all aspects of the utilization /benefit management program. + Utilizes clinical experience and skills in a collaborative process… more
    CVS Health (11/01/24)
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  • Post Acute Utilization Management…

    Humana (Boise, ID)
    …a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and… more
    Humana (10/29/24)
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  • Utilization Review Nurse

    Martin's Point Health Care (Portland, ME)
    …has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of a team responsible for ensuring ... for retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use appropriate governmental policies as well as specified… more
    Martin's Point Health Care (09/24/24)
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  • Utilization Management Nurse

    Actalent (Omaha, NE)
    Job Title: Utilization Management Nurse Qualifications + Bachelor's degree in Nursing + Compact RN License + 2+ years experience in medical review or ... (preferred). Job Description We are seeking a dedicated and detail-oriented Utilization Management Nurse to join our team. The ideal candidate will be… more
    Actalent (10/30/24)
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  • Utilization Management Nurse

    CVS Health (Jefferson City, MO)
    …sign up to work one major and one minor holiday yearly. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document ... to make health care more personal, convenient and affordable. **Position Summary:** Utilization Management is a 24/7 operation and work schedules may include… more
    CVS Health (10/26/24)
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  • Utilization Management Nurse , Prior…

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    …Role BHPS provides Utilization Management services to its clients. The Utilization Management Nurse - Prior Authorization performs medical necessity reviews ... any time with or without notice. Primary Responsibilities * Perform prospective utilization reviews and first level determinations for members using evidenced based… more
    Brighton Health Plan Solutions, LLC (10/18/24)
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  • Utilization Management Nurse (RN)

    Elevance Health (Louisville, KY)
    ** Utilization Management Nurse (RN)** **$3,000 SIGN ON BONUS OFFERED** **Location** : Remote opportunity. Must reside in the state of Kentucky. The ** ... Utilization Management Nurse (RN)​** is responsible to collaborate with healthcare providers and members to promote quality member outcomes, to optimize member… more
    Elevance Health (10/24/24)
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  • RN Utilization Management Nurse Sr.…

    Elevance Health (Tampa, FL)
    RN Utilization Management Nurse Sr. (Medicaid-InPatient) JR130851 **Location:** Must be within 50 miles / 1 hour commute of Tampa or Miami, FL offices. This is ... 4/10 hour shifts to include a weekend day. The ** Nurse Medical Management Sr** serves as T **eam Lead**...Requires minimum of 5 years acute care clinical experience, utilization management or managed care experience; or any combination… more
    Elevance Health (10/01/24)
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  • Registered Nurse - Utilization

    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 Case ... Education/Experience Requirements Required: + Minimum of two (2) years utilization review/case management experience or social work experience. Preferred: +… more
    Mohawk Valley Health System (10/28/24)
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  • Utilization Management Nurse

    CVS Health (Charleston, WV)
    …personal, convenient and affordable. **Position Summary** This is a fully remote Utilization Management Nurse Consultant opportunity. The schedule is Monday ... opportunities to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal and external… more
    CVS Health (10/31/24)
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  • Utilization Management Nurse

    Elevance Health (Washington, DC)
    The Utilization Management Nurse is responsible to collaborate with healthcare providers and members to promote quality member outcomes, to optimize member ... minimum of 2 years acute care clinical experience. + Minimum 1 year Utilization Management experience preferred. For candidates working in person or remotely in the… more
    Elevance Health (09/24/24)
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  • Utilization Management - Registered…

    Crouse Hospital (Syracuse, NY)
    Utilization Management Registered Nurse has well-developed knowledge and is proficient with standard Utilization Review processes. The Utilization ... on their appropriate admission status. This individual will support the Utilization Management process by maintaining effective and efficient processes for… more
    Crouse Hospital (08/31/24)
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  • Licensed Practical Nurse (LPN)…

    The Arora Group (Bethesda, MD)
    Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/LVN) - Utilization Review in Bethesda, ... be required on Federal holidays. DUTIES OF THE LICENSED PRACTICAL NURSE (LPN/LVN) - UTILIZATION REVIEW: + Initiate, perform and complete assigned duties in… more
    The Arora Group (08/23/24)
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  • Registered Nurse - Utilization

    Veterans Affairs, Veterans Health Administration (Iowa City, IA)
    …Health Care System (ICVAHCS) is currently recruiting for one (1) Full-Time Registered Nurse - Utilization Management position. This position is only open to ... basic reviews while developing technical and clinical competencies. The nurse is a novice with limited experience with the...to utilize the nursing process in real situations. The nurse brings principles and theory with limited application of… more
    Veterans Affairs, Veterans Health Administration (11/02/24)
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  • Utilization Review Registered Nurse

    Pipeline Health System, LLC (Toast, NC)
    Job Title: Utilization Review Registered Nurse - Behavioral Health Unit/FT/Days Job Summary: This Utilization Review (UR) Registered Nurse (RN) position ... and compassionate care to our patients. This position is responsible for utilization review, assessment of discharge planning needs and coordination of effective… more
    Pipeline Health System, LLC (10/26/24)
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