- CHRISTUS Health (Alamo Heights, 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
- CHRISTUS Health (Tenneryville, TX)
- …operations for assigned areas; at CHRISTUS GSMC - Longview. The nurse manager affects departmental outcomes through interpretation, implementation, and evaluation of ... excellence in patient care, patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically… more
- Novo Nordisk Inc. (Indianapolis, IN)
- …strategies with the FDA to providing medical education and collecting data to support efficacy and new product development, CMR is involved. The one thing that ... further scientific exchange. S/he provides advanced product and scientific and medical field support to Medical, Sales and Marketing, as well as Managed Care and… more
- System One (Baltimore, MD)
- ALTA IT Services is staffing a contract to hire opportunity for a Utilization Management Nurse to support a leading health insurance customer. The UM ... of Peer to Peer reviews. Performs member or provider related administrative support . Qualifications Licenses/Certifications RN - Registered Nurse - State… 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
- Matrix Providers (Aurora, CO)
- Registered Nurse (RN) - Utilization Management Location: Aurora, CO, United States Healthcare Provider Type : Nursing START YOUR APPLICATION ... fair, reliable schedules. Matrix Providers is hiring a Registered Nurse (RN) - Utilization Management to join.... Overview: Serve as a key member of the Utilization Management team, providing comprehensive support to… more
- 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 ... direction, administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one of the… more
- CVS Health (Columbus, OH)
- …to make health care more personal, convenient and affordable. **Position Summary:** This Utilization Management (UM) Nurse Consultant role is fully remote and ... what we deliver. Our Heart At Work Behaviors (TM) support this purpose. We want everyone who works at...is no travel expected with this position. As a Utilization Management Nurse Consultant, you will utilize… more
- CVS Health (Harrisburg, PA)
- …to make health care more personal, convenient and affordable. **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and the ... what we deliver. Our Heart At Work Behaviors (TM) support this purpose. We want everyone who works at...1 per month.** No travel is required. As a Utilization Management Nurse Consultant, you will utilize… more
- Humana (Frankfort, KY)
- …and 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 the coordination, documentation and communication of medical services...benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work assignments are… 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 (Austin, TX)
- …to make health care more personal, convenient and affordable. **Position Summary:** This Utilization Management (UM) Nurse Consultant role is fully remote and ... what we deliver. Our Heart At Work Behaviors (TM) support this purpose. We want everyone who works at...both) per the needs of the team.** The UM Nurse Consultant job duties include (not all encompassing): +… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …and leadership programs + And more **Description** We're seeking a **Registered Nurse , Clinical Utilization Preceptor** responsible for training, mentoring, and ... coaching for the Utilization Review Department. The UR RN Preceptor must be...critical thinking, intuition, and experience. + Facilitate efforts to support compliance and adherence to standard work, policies and… more
- 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: ... County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose....net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates,… more
- Trinity Health (Springfield, MA)
- …care determinations using screening criteria, and assists the physician, bedside Registered Nurse , ICC and Social Worker with utilization management and clinical ... Rotating Shift **Description:** Requires BSN At **Mercy Medical Center** the ** Utilization Review/Appeals & Denials** **RN** performs utilization review with… more
- Ascension Health (Tulsa, OK)
- **Details** + **Department:** Utilization Management + **Schedule:** FT, Monday-Friday, 8am-5pm + **Hospital:** Ascension St. John Medical Center + **Location:** ... Provide strategic direction and oversight of the day-to-day operations of utilization management function within the insurance plan. Responsibilities: + Ensure… more
- CVS Health (Carson City, NV)
- …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 ... in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support … more
- Trinity Health (Syracuse, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** The RN Utilization Management Nurse Coordinator is responsible for both concurrent and ... retrospective inpatient and outpatient services, in accordance with the utilization requirements and 3rd party payor contracts. The UM department is responsible for… 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
- 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 provided ... Is the Opportunity?** This position is responsible for conducting in-house utilization review with emphasis on determining medical necessity for prospective,… more
