- Kaiser Permanente (Fontana, CA)
- …quality, risk and/or patient safety which are identified during case review or other activities.Reviews, analyses and identifies utilization patterns and ... Kaiser Permanente is seeking a Registered Nurse (RN) Case Management for a...general and specialized principles, practices, techniques and methods of Utilization review /management, discharge planning or case… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …team members as needed to ensure services will be covered.Coordinate and communicate with Utilization Review Nurse on a daily, consistent basis to ensure ... 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… more
- UT Health Tyler (Tyler, TX)
- …a sign on bonus up to $20,000 Join our team as a full-time, day shift, Case Manager Registered Nurse in Tyler, TX. Fulfilling your purpose begins here: People ... and coordinates a comprehensive plan of care using a concurrent integrated review , standard operating procedures, case management tools, and collaborative… more
- Aequor (New York, NY)
- …license in New York State Prefer minimum of 1-3 years relevant experience in case management, utilization review and/or quality assurance Experience in acute ... Position Purpose:Provide case management and clinical services to employees within...transitional (modified) or full return to work assignments. Assist nurse practitioner as needed with patient care activities such… more
- Spectraforce Technologies Inc (Branchburg, NJ)
- …RN on an acute/critical care unit, organ donation/transplant unit, in tissue/blood banking, utilization review and/or case management with critical care ... Job Title: Registered Nurse Location: Branchburg, NJ 08876 Duration: 06 months...international and state regulations during the second level quality review of all tissue donor files for tissue submitted… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …Direct Contracting, pay for performance) and measures related to efficient utilization and cost.Participates in the development/ review /revision of standard work ... Job Category:Nursing - Registered Nurse Work Shift/Schedule:8 Hr Morning - AfternoonNortheast Georgia...RN Lead Care Manager will provide telephonic care and case management to members as part of a multidisciplinary… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …Direct Contracting, pay for performance) and measures related to efficient utilization and cost.Participates in the development/ review /revision of standard work ... Job Category:Nursing - Registered Nurse Work Shift/Schedule:8 Hr Morning - AfternoonNortheast Georgia...The RN Care Manager will provide telephonic care and case management to members as part of a multidisciplinary… more
- Health First (Melbourne, FL)
- …vehicle. **Job:** ** Case Management* **Organization:** **Holmes Regional Medical Center* **Title:** * Utilization Review Nurse - Case Management UR ... *POSITION SUMMARY* The Utilization Review (UR) nurse ...Emergency Department Nursing *Knowledge/Skills/Abilities:*Current working knowledge of care transitions, utilization management, case management and managed care… more
- Lincoln Financial Group (Columbus, OH)
- …proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position...in a career at Lincoln, we encourage you to review our current openings and apply on our website.… more
- Providence (Medford, OR)
- …based on population focus. Duties also include complex discharge planning and utilization review . The Nurse Case Manager must be competent to analyze ... the cognitive, physical, emotional/psychosocial, spiritual, and chronological maturation process. The Nurse Case Manager is accountable for meeting clinical and… more
- Beth Israel Lahey Health (Burlington, MA)
- …Shift:** Day (United States of America) Joint role of Case Manager and Utilization Review Nurse Hospital at Home Full Time Days 8:00am-4:30pm weekend ... and holiday rotations required **Job Description:** The Inpatient Registered Nurse (RN) Case Manager for Hospital at...to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case management… more
- State of Connecticut, Department of Administrative Services (Wallingford, CT)
- Utilization Review Nurse Coordinator Hybrid...utilization review including conducting second level review of cases and case referral to a ... has a full-time (1st shift) job opportunity for a Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=)… more
- Beth Israel Lahey Health (Burlington, MA)
- …Medical Center is now offering up to a $3,500 in signing bonuses for our Utilization Review positions. Important Details: * Signing Bonuses are paid out in three ... Description:** **Job Description:** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate… more
- Beth Israel Lahey Health (Needham, MA)
- …difference in people's lives.** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission ... the level of care being billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records to ensure… more
- Trinity Health (Mason City, IA)
- …its goals **Hours:** Monday-Friday 0630-1430; no weekends or holidays **About The Job** The Utilization Review Case Manager responsibilities include case ... We Are Looking For** Education [formal]: + Licensed registered nurse in the state of Iowa. + Bachelor's Degree...of Iowa. + Bachelor's Degree required. BSN preferred + Utilization management focused certifications that are recognized in the… more
- Martin's Point Health Care (Portland, ME)
- …Point has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of the Utilization ... requiring clinical review prior to payment. The Utilization Review Nurse will use...fast paced, team-oriented environment, able to multi-task from one case type to another. + Assumes extra duties as… more
- Albany Medical Center (Albany, NY)
- …stays, and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and ... Department.* Demonstrates proper use of MCG and documentation requirements through case review and inter-rater reliability studies.* Facilitates removal of… more
- R1 RCM (Pittsburgh, PA)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Utilization Review Nurse ** , you will help our ... review , utilizing client-specific guidelines. Upon identification of a case , you will ensure that appropriate orders and clinical...position. **Here's what you will experience working as a Utilization Review Nurse :** + Perform… more
- Martin's Point Health Care (Portland, ME)
- …been certified as a "Great Place to Work" since 2015. Position Summary Job Description The Utilization Review Nurse works as a member of a team responsible ... retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use...appropriate place and time + Mentors new staff into case management role as assigned. + Assumes extra duties… more
- Milford Regional Medical Center (Milford, MA)
- …1 year Nurse Case Management experience Minimum of 1 year Utilization Review Nurse Experience including solid working knowledge with InterQual ... services to our community with dignity, compassion, and respect. Statement of Purpose: The Utilization Review Nurse is responsible for utilization … more
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