- Prisma Health (Greenville, SC)
- …include clinical problem solving and decision making skills. Collaborates with clinical nurse educators to support new staff orientation and training. Maintains ... Nurse Manager in maintaining unit budget by appropriate allocation and utilization of unit resources. Shares accountability with Nurse Manager for… more
- 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
- ERP International (Vandenberg AFB, CA)
- **Overview** ERP International is seeking a full-time **Registered Nurse (RN) Utilization Management** in support of the30th Medical Group at Vandenberg AFB, ... services as identified in the TO. * Conduct research in support of improved practice and patient outcomes. **Qualifications** **Minimum Qualifications:**… more
- The Arora Group (Bethesda, MD)
- Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/LVN) - Utilization Review in Bethesda, ... Services will be required on Federal holidays. DUTIES OF THE LICENSED PRACTICAL NURSE (LPN/LVN) - UTILIZATION REVIEW: + Initiate, perform and complete assigned… more
- CVS Health (Trenton, NJ)
- …convenient and affordable. **Position Summary** This is a full-time remote Utilization Management Nurse Consultant opportunity. Utilization management ... what we deliver. Our Heart At Work Behaviors (TM) support this purpose. We want everyone who works at...include weekends and holidays and evening rotations. As a Utilization Management Nurse Consultant, you will utilize… more
- Veterans Affairs, Veterans Health Administration (Bay Pines, FL)
- Summary The Emergency Department Utilization Management (ED-UM) Registered Nurse (RN) is responsible for providing competent, evidence-based practices within the ... clinical staff regarding documentation requirements for medical necessity/patient status to support the level of care requested. Interacts regularly with physicians… more
- Crouse Hospital (Syracuse, NY)
- Utilization Management Registered Nurse has well-developed knowledge and is proficient with standard Utilization Review processes. The Utilization ... based on their appropriate admission status. This individual will support the Utilization Management process by maintaining...+ Required: + Currently licensed as a Registered Professional Nurse in New York State. + Associates Degree +… more
- 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 ... what we deliver. Our Heart At Work Behaviors (TM) support this purpose. We want everyone who works at...coordinate, document and communicate all aspects of the utilization /benefit management program. + Utilizes clinical experience and skills… more
- Veterans Affairs, Veterans Health Administration (Johnson City, TN)
- Summary Position shared between Utilization Management (UM) and Accreditation. UM uses evidence-based practices to create guidance on admission, continued stay ... criteria and best clinical documentation to ensure efficient resource utilization . Accreditation deals with external quality assurance processes, inspections and… more
- Humana (Boise, ID)
- …community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently… more
- Actalent (Omaha, NE)
- Job Title: Utilization Management Nurse Qualifications + Bachelor's degree in Nursing + Compact RN License + 2+ years experience in medical review or ... managed care (preferred). Job Description We are seeking a dedicated and detail-oriented Utilization Management Nurse to join our team. The ideal candidate will… more
- 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 ... what we deliver. Our Heart At Work Behaviors (TM) support this purpose. We want everyone who works at...health care more personal, convenient and affordable. **Position Summary:** Utilization Management is a 24/7 operation and work schedules… more
- CVS Health (Columbus, OH)
- …is just as important as what we deliver. Our Heart At Work Behaviors (TM) support this purpose. We want everyone who works at CVS Health to feel empowered by ... convenient and affordable. **Position Summary** This is a fulltime remote Utilization Review opportunity. Working hours are four 10hr days **including every… more
- US Tech Solutions (Chicago, IL)
- …Medicare). + Independently coordinates the clinical resolution with internal/external clinician support as required. + Processes and evaluates complex data and ... 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior...in state of residence + Must have prior authorization utilization experience + Experience with Medcompass **Skills:** + MUST… more
- CVS Health (Raleigh, NC)
- …is just as important as what we deliver. Our Heart At Work Behaviors (TM) support this purpose. We want everyone who works at CVS Health to feel empowered by ... to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal...Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN… more
- CVS Health (Austin, TX)
- …is just as important as what we deliver. Our Heart At Work Behaviors (TM) support this purpose. We want everyone who works at CVS Health to feel empowered by ... health care more personal, convenient and affordable. **Position Summary** Utilization management is a 24/7 operation. Work schedules will...zone + 3+ years of experience as a Registered Nurse + 1+ years of clinical experience in acute… more
- Travelers Insurance Company (Buffalo, 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 provided ... Is the Opportunity?** This position is responsible for conducting in-house utilization review with emphasis on determining medical necessity for prospective,… more
- CVS Health (Boston, MA)
- …is just as important as what we deliver. Our Heart At Work Behaviors (TM) support this purpose. We want everyone who works at CVS Health to feel empowered by ... opportunities to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal and external… more
- CVS Health (Santa Fe, NM)
- …is just as important as what we deliver. Our Heart At Work Behaviors (TM) support this purpose. We want everyone who works at CVS Health to feel empowered by ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Utilizes clinical experience and skills in a collaborative… more
