- Matrix Providers (Aurora, CO)
- Utilization Review Nurse (RN) Location: Aurora, CO, United States Healthcare Provider Type : Nursing START YOUR APPLICATION ... and fair, reliable schedules. Matrix Providers is hiring a Utilization Review Nurse (RN) to...to serve America-s military family by aligning exceptional healthcare workers like you with rewarding career opportunities. Come home… more
- Lowe's (Charlotte, NC)
- …clinical position. + 3-5 Years of Experience as a Case Manager or Utilization Review Nurse in worker 's compensation + Experience in a clinical position + ... including psychosocial factors, for catastrophic and complex cases on workers ' compensation injuries. Responsible for ensuring that employees receive appropriate… more
- Apex Health Solutions (Houston, TX)
- …Certification requirements, as well as carrying out day today pre-authorization functions. The Utilization Review Nurse will also be responsible for issuing ... Licensed Vocational Nurse required and current unrestricted Certification in Utilization Review / Utilization Management preferred Qualifications: One (1)… more
- Ochsner Health (New Orleans, LA)
- …hospital-based experience in discharge planning, case management or utilization review . **Certifications** Required - Current registered nurse license in ... + Maintains knowledge of the conditions of participation as it relates to utilization review and discharge planning. + Maintains open communication with all… more
- Fallon Health (Worcester, MA)
- … Nurse in a clinical setting required. + 2 years' experience as a Utilization Management nurse in a managed care payer preferred. + One year experience ... on Facebook, Twitter and LinkedIn. **Brief summary of purpose:** The UM Nurse uses a multidisciplinary approach to organize, coordinate, monitor, evaluate and modify… more
- AdventHealth (Shawnee, KS)
- **Inpatient Social Worker OR RN-Case Manager Weekend Worker Program Days** **All the benefits and perks you need for you and your family:** + Vision, Medical & ... time and a half as part of the Weekend Worker Program + 6 weekend shifts off per year...physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge… more
- Ochsner Health (New Orleans, LA)
- …interpersonal and conflict resolution skills. **Job Duties** + Lead and directs Utilization Review (UR) staff and functions, including staffing, staff ... reviews to identify escalation issues regarding Providers, other facility issues, individual utilization review staff skills, payor-based concerns and to provide… more
- Stanford Health Care (Palo Alto, CA)
- …and Abilities** + Knowledge of principles and best practices of case management, utilization review , social work, care coordination and discharge planning. + ... Here, your leadership, coaching, and mentoring would further develop our robust, Utilization Management team. Are you driven by health care innovation, partnerships,… more
- Molina Healthcare (Columbus, OH)
- …for the development, implementation, and delivery of training curriculum for Utilization Management, Case Management, and LTSS staff. Leads and manages classes, ... job. Job Qualifications **REQUIRED EDUCATION** : Completion of an accredited Registered Nurse (RN) Program and an Associate's or Bachelor's Degree in Nursing. **OR**… more
- Prime Healthcare (Lynwood, CA)
- …With Us! (https://careers-primehealthcare.icims.com/jobs/200415/case-manager%2c-rn utilization - review /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum… more
- Trinity Health (Des Moines, IA)
- …**Shift:** **Description:** **_Are you an experienced Director of Care Management & Utilization Review looking for an interim assignment? Join Trinity Health ... organizational goals. **MINIMUM QUALIFICATIONS:** + Current Iowa License Registered Nurse or Social Worker + Master's degree...Current Iowa License Registered Nurse or Social Worker + Master's degree in healthcare related field required.… more
- Ochsner Health (Lafayette, LA)
- …or other related MCO departments/functions. **Certifications** Required - Current registered nurse (RN) license in state of practice. *MSW accepted in lieu ... of registered nurse (RN) licensure. Preferred - Certification in Case Management...Determines appropriate staffing levels and the interviewing, hiring, performance review , and termination of employees within practice unit(s); maintains… more
- Centene Corporation (Cheyenne, WY)
- …on workplace flexibility. **Position Purpose:** Supervises the behavioral health (BH) utilization review clinicians to ensure appropriate care for members ... of BH utilization management team. + Monitors behavioral health (BH) utilization review clinicians and ensures compliance with applicable guidelines +… more
- Sharp HealthCare (San Diego, CA)
- …or clinical experience in area of specialty. + 2 Years clinical experience in Utilization Review , Discharge Planning and/or Case Management in a hospital and/or ... Case Manager (ACM) - American Case Management Association (ACMA); California Registered Nurse (RN) - CA Board of Registered Nursing **Hours** **:** **Shift Start… more
- Prime Healthcare (Inglewood, CA)
- …case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians. Assesses ... tools. Qualifications EDUCATION, EXPERIENCE, TRAINING Required qualifications: 1. CA Registred Nurse 2. Bachelor's of Science in Nursing3. Grandfathered prior to… more
- Veterans Affairs, Veterans Health Administration (Lincoln, NE)
- Summary The Senior Social Worker is assigned to the outpatient mental health clinic under social work supervisor. The Senior Social Worker is a member of a ... incumbent plays an active role on this team which meets weekly to review and discuss clinical cases. The incumbent is accountable for clinical program effectiveness… more
- Trinity Health (Syracuse, NY)
- … is a key stakeholder in the emergency room care transitions team which includes, nurse case managers, utilization review nurses, providers, etc. all who ... time **Shift:** Day Shift **Description:** We are looking for an experienced medical social worker who is both a skilled clinician as well as discharge planner who… more
- Stanford Health Care (Palo Alto, CA)
- …all facets of a patient's admission/discharge or outpatient visit/follow-up; performing utilization review activities, including review of patient ... + Utilization Management: Avoidable Delay Identification, Intervention & Tracking, Utilization Review , Medical Necessity Review , Care Plan Progression,… more
- Ochsner Health (Quitman, MS)
- …efficiently in high pressure situations. Preferred- Experience in Case Management or Utilization Review Business and Financial Knowledge as well as understanding ... Ochsner Health and discover your future today!** This job is a registered Nurse who is able to determine the psychosocial, environmental, family economic dynamics… more
- ChenMed (Newport News, VA)
- …assess and record patients' progress and adjust and plan accordingly. + Understanding utilization review and how to leverage with inpatient staff for possible ... we need great people to join our team. The Nurse Case Manager 1 (RN) is responsible for achieving...experience required. + A minimum of 1 year of utilization review and/or case management, home health,… more