• Utilization Manager Nurse

    CVS Health (Austin, TX)
    …to make health care more personal, convenient and affordable. **Position Summary:** This Utilization Management (UM) Nurse Consultant role is fully remote and ... requirement (Saturday and Sunday both) per the needs of the team.** The UM Nurse Consultant job duties include (not all encompassing): + Reviews services to assure… more
    CVS Health (11/27/24)
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  • Nurse Manager - ICU

    Arnot Health (Elmira, NY)
    …areas suitable for nursing research. + Promotes research-based practice. Standard VIII. Resource Utilization The Nurse Manager evaluates and administers the ... DUTIES AND RESPONSIBILITIES: Standards of Care Standard I. Assessment The Nurse Manager develops, maintains, and evaluates patient/client and staff… more
    Arnot Health (10/07/24)
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  • Nurse Care Manager - Primary Care

    University Medicine (Providence, RI)
    …home members to assist the patient to the right level of care and decrease unnecessary utilization . The nurse case manager is an active participant in the ... SUMMARY: Reporting to the Manager of Case Management, the nurse ...from high-risk case management (eg rising risk, frequent ED utilization ). The NCM helps Brown Medicine achieve the triple… more
    University Medicine (11/27/24)
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  • RN - Utilization Review Case Manager

    LifePoint Health (Danville, VA)
    *Registered Nurse , RN - Utilization Review Case Manager * Job Type:Full Time|Days *$10,000 Sign-on Bonus Eligibility for Full-Time, Bedside RNs* ** Must have ... as an employee, but as a person. As a*registered nurse (RN)*joining our team, you're embracing a vital mission...offering safe discharge planning is the use of a Utilization RN and Case Manager RN, in… more
    LifePoint Health (09/10/24)
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  • Case Manager with Utilization Review…

    Beth Israel Lahey Health (Burlington, MA)
    …taking a job, you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital and Medical ... 8:00am-4:30pm Weekend and holiday rotations required **Job Description:** The Inpatient Registered Nurse (RN) Case Manager for Hospital at Home Care Transitions… more
    Beth Israel Lahey Health (11/27/24)
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  • Registered Nurse (RN) Hospice Case…

    Crossroads Hospice & Palliative Care (Chester, PA)
    …principles to ensure continuity of care and appropriate resource utilization Registered Nurse (RN) Hospice Case Manager Schedule & Benefits: + Monday to ... wishes. One of the most important aspects of being a Registered Nurse Case Manager is building trusting relationships with patients and their families. This… more
    Crossroads Hospice & Palliative Care (11/09/24)
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  • RN, Case Manager Registered Nurse

    Crossroads Hospice & Palliative Care (Philadelphia, PA)
    …+ Utilize case management principles to ensure continuity of care and appropriate resource utilization RN, Case Manager Registered Nurse Schedule & Benefits: ... As a Registered Nurse Case Manager , you will provide direct care to patients in their homes or care facilities. Your role goes beyond offering medical… more
    Crossroads Hospice & Palliative Care (11/09/24)
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  • Associate Nurse Mgr / UR Review RN…

    Premier Health (Troy, OH)
    …Upper Valley Medical Center **_*NOTE: THIS IS A COMBINATION POSITION: 24 HOURS/PP ASSOCIATE NURSE MANAGER AND 48 HOURS/PP UTILIZATION REVIEW RN._** The ... Position: ASSOCIATE NURSE MGR/ UTILIZATION REVIEW RN Dept:... (ANM)-Inpatient Unit** serves as an extension of the Nurse Manager (NM) is accountable for the… more
    Premier Health (11/07/24)
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  • RN, Utilization Management Nurse

    Humana (Frankfort, KY)
    …help us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Nurse 2 who will utilize clinical nursing skills to support ... services and/or benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work assignments are varied and… more
    Humana (11/19/24)
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  • Utilization Management Nurse

    LA Care Health Plan (Los Angeles, CA)
    Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates,...implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service,… more
    LA Care Health Plan (11/09/24)
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  • Utilization Review Nurse - Workers'…

    Travelers Insurance Company (Albany, NY)
    …Imagine loving what you do and where you do it. **Job Category** Claim, Nurse - Medical Case Manager **Compensation Overview** The annual base salary range ... Is the Opportunity?** This position is responsible for conducting in-house utilization review with emphasis on determining medical necessity for prospective,… more
    Travelers Insurance Company (11/21/24)
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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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  • Utilization Review Nurse

    US Tech Solutions (Columbia, SC)
    …Identifies and makes referrals to appropriate staff (Medical Director, Case Manager , Preventive Services, Subrogation, Quality of care Referrals, etc.). Participates ... education with members and providers regarding health care delivery system, utilization on networks and benefit plans. May identify, initiate, and participate… more
    US Tech Solutions (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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  • RN Utilization Manager - Surgery,…

    UNC Health Care (Chapel Hill, NC)
    **Description** Surgery, Women's, & Children's Utilization Manager **(part-time: 20 hrs/week)** + Weekends only (Saturday & Sunday) + 8:30a-6:30p + **No Nights** ... care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management… more
    UNC Health Care (11/22/24)
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  • SRS-Inpatient Case Manager II…

    Sharp HealthCare (San Diego, CA)
    …Degree in Nursing; Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse (RN) - CA Board of Registered ... utilization review, care coordination experience + California Registered Nurse (RN) - CA Board of Registered Nursing -REQUIRED...Qualifications** + Master's Degree in Nursing + Certified Case Manager (CCM) - Commission for Case Manager more
    Sharp HealthCare (10/30/24)
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  • Manager , Utilization Management…

    VNS Health (Manhattan, NY)
    OverviewManages the utilization management team to ensure that standards for service delivery and team/staff performance levels are met or exceeded. This includes ... the VNS Health Plans teams on a day- to-day basis for utilization issues, problem resolution, complaint resolution and other service related issues. Manages… more
    VNS Health (10/09/24)
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  • Manager Utilization Management - Day…

    Penn State Health (Hershey, PA)
    …PDF for more detailed steps for assistance._ **Union:** Non Bargained \#LI-TB1 **Position** Manager Utilization Management - DAY SHIFT - Utilization ... OF POSITION:** Position is responsible to thoroughly understand all Utilization Management regulatory requirements for both CMS and DOH,...required + Currently licensed to practice as a registered nurse by Pennsylvania Board of Nurse Examiners… more
    Penn State Health (11/16/24)
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  • Utilization Review Manager -Selikoff…

    Mount Sinai Health System (New York, NY)
    **Job Description** The Utilization Review Manager for the Selikoff Centers for Occupational Health is responsible for the management of program operations ... records, and internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with multiple professionals to support and… more
    Mount Sinai Health System (10/31/24)
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  • Utilization Manager (RN)

    UNC Health Care (Hendersonville, NC)
    …the health and well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and discharge review ... met and care delivery is coordinated. The UM completes utilization reviews in accordance with federal regulations and the...patient data and treatments. Communicates daily with the Care Manager to manage level of care transitions & appropriate… more
    UNC Health Care (11/28/24)
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