- Katmai (Fort Carson, CO)
- …or American Red Cross. + Three (3) years within the last four (4) years as a registered nurse in utilization management. + One (1) year of experience in ... **SUMMARY** Provide a comprehensive utilization review (UR) and utilization...full, active, and unrestricted license to practice as a registered nurse . + Must be a graduate… more
- Alameda Health System (Oakland, CA)
- …each individual in the classification. Lead and manage a team of utilization review professionals providing guidance, training, and performance evaluations. ... reviews and determine program improvements. Develop and implement utilization review policies and procedures in accordance...Required Licenses/Certifications : Valid license to practice as a Registered Nurse in the State of California.… more
- Alameda Health System (San Leandro, CA)
- …Follows AHS (Alameda Health System) and Behavioral Health Department Alameda County Utilization Review Plan to obtain authorization of acute inpatient services. ... the Emergency Department). Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State ofCalifornia.\ Pay Range $89.32-… more
- ERP International (Luke AFB, AZ)
- **Overview** ERP International is seeking a full time ** Registered Nurse - Case Management** in support of the56th Medical Group at Luke AFB, AZ ... Case Management Society of America (CMSA); American Accreditation Healthcare Commission/ Utilization Review Accreditation Commission (URAC); CAMH; (AAAHC); Health… more
- Stanford Health Care (Palo Alto, CA)
- …affect the processes and outcomes of patient health care **Licenses and Certifications** + Nursing\ RN - Registered Nurse - State Licensure And/Or Compact ... | Stanford Health Care (SHC)? Are you a seasoned RN Case Manager? Here is your opportunity to work...include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review … more
- Commonwealth Care Alliance (Boston, MA)
- …clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA ... CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is… more
- Geisinger (Lewistown, PA)
- Job Title: RN - Registered Nurse - Hospital...call as part of a shared rotation. Don't worry, we'll review this in your interview. At least two (2) years ... the overview below carefully. Location: Lewistown, Pennsylvania Job Category: RN - Registered Nurse , Nursing...of optimizing the patient or member's health status. Manages utilization and practice metrics to further refine the delivery… more
- University of New Mexico - Hospitals (Albuquerque, NM)
- …patient responses to interventions in collaboration with quality assurance and utilization review , maintaining interdependent follow-up as necessary * VARIANCE ... * Subject to an annual contract and performance appraisal * Tuberculosis testing is completed upon hire and additionally as required Department: Registered Nurse more
- Stanford Health Care (Palo Alto, CA)
- …affect the processes and outcomes of patient health care **Licenses and Certifications** + Nursing\ RN - Registered Nurse - State Licensure And/Or Compact ... responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient… more
- NewYork-Presbyterian (Brooklyn, NY)
- …medical/surgical daily admissions that requires risk identification and clinical reviews. A utilization nurse completes no less than 20 initial clinical reviews ... are listed in the following description. Case Manager - RN - Inpatient Units- Brooklyn Methodist - Days Located...is responsible for all aspects of discharge planning and utilization management/ review for an assigned group of… more
- Christus Health (San Antonio, TX)
- …Medicare GMLOS by managing per Milliman/Interqual Care Guidelines. Resource/ Utilization Management/appropriateness: Assess assigned patient population for medical ... Proactively refers cases to physician adviser for P2P, medical necessity review , and denail avoidance. Demonstrates and maintains current knowledge of regulatory… more
- University of New Mexico - Hospitals (Albuquerque, NM)
- …patient responses to interventions in collaboration with quality assurance and utilization review , maintaining interdependent follow-up as necessary* VARIANCE - ... * Subject to an annual contract and performance appraisal * Tuberculosis testing is completed upon hire and additionally as requiredDepartment: Registered Nurse more
- Stony Brook University (Stony Brook, NY)
- …Department may include the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes UR ... cases for authorization for in patient stay. + Staff review short stay, long stay and complex cases to...required. **Qualifications** **Required** : A Bachelor's degree or a nurse working on their degree with an RN… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …knowledge of different claim types is desired. (Preferred) + Current Washington State License: Registered Nurse ( RN ), Advanced Registered Nurse ... bundling edits, and recommend action steps regarding code configuration issues, annual utilization and review analysis. + Maintain current knowledge of coding… more
- Luke Staffing (Glendale, CO)
- …holidays) **Will consider Part Time and Full Time Applicants** **POSITION OVERVIEW:** The Registered Nurse ( RN ) will provide on-site professional nursing ... ** REGISTERED NURSE ** **SITE OF SERVICE:** Department...of Veterans Affairs' Eastern Colorado Healthcare System (ECHCS). The RN will serve in the Office of Community Care… more
- Katmai (Usaf Academy, CO)
- …RESPONSIBILITIES** None. **Job Requirements:** **MINIMUM QUALIFICATIONS** + Associates Degree of Nursing. Registered nurse shall be a graduate from a college or ... those required of any military or government civil service nurse of similar experience and in similar duty assignments....+ Shall possess a current, active, full and unrestricted Registered Nurses ( RN ) licensed in Colorado or… more
- UnitedHealthcare (Kaunakakai, HI)
- …experience * Experience with or exposure to discharge planning * Experience with utilization review , concurrent review and/or risk management * Experience ... may be interested in. Required Qualifications: * Current, unrestricted RN license in the state of Hawaii * 2+...arranging community resources * Experience as a Public Health Nurse * Field-based work experience * Background in managing… more
- University Health (San Antonio, TX)
- …recent, full time hospital experience preferred. Work experience in case management, utilization review , or hospital quality assurance experience is preferred. ... clinicians in the Ambulatory setting by gathering information, coordinating utilization efforts, and reviewing HCC quality indicators, and RAF...of the State of Texas to practice as a registered nurse is required. National certification in… more
- ERP International (San Diego, CA)
- **Overview** ERP International is seeking a full-time ** Registered Nurse ( RN ) Health Educator** supporting **Naval Medical Center San Diego, CA ... of other individuals performing similar services. ? Participate in peer review and performance improvement activities. ? Practice aseptic techniques as necessary.… more
- Battelle Memorial Institute (Tampa, FL)
- …two years' nursing experience + Current, full, active, and unrestricted license as a Registered Nurse in any US State, the District of Columbia, Guam, Puerto ... (HRA) business line is seeking a highly motivated, full-time ** Nurse Case Manager** to join our team in support...professional parameters + Knowledge and skill in using pre-established utilization review criteria to recognize and report… more
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