- Yale New Haven Health (Milford, CT)
- …Works Under The Supervision Of The Nurse Manager/Clinical Coordinator. The Registered Nurse ( Rn ) Assesses, Plans, Implements, Evaluates And Supervises ... N/A LICENSURE Valid State Of Connecticut Registered Nurse License SPECIAL SKILLS BLS Required Additional Information Med/Surg RN experience required. more
- Yale New Haven Health (Danbury, CT)
- …Works Under The Supervision Of The Nurse Manager/Clinical Coordinator. The Registered Nurse ( Rn ) Assesses, Plans, Implements, Evaluates And Supervises ... Regarding Care For Patients. EXPERIENCE N/A LICENSURE Valid State Of Connecticut Registered Nurse License SPECIAL SKILLS BLS Required Additional Information… more
- Christus Health (San Antonio, TX)
- …Medicare GMLOS by managing per Milliman/Interqual Care Guidelines. Resource/ Utilization Management/appropriateness: Assess assigned patient population for ... provides expertise and leadership to insure effective resource management for patient care delivery (Conditions of Participation COP 482.30). Case Managers enhance… more
- Lourdes Health (Pasco, WA)
- Registered Nurse ( RN ), House Supervisor Job Type: Full-time Varied Shifts Wage scale: $46.93 - $65.70 per hour Your experience matters At Lourdes Health, we ... as an employee, but as a person. As a registered nurse ( RN ) joining our...environment that encourages professional growth. Initiates weekend case management, Utilization review screening, assists with D/C planning… more
- Lourdes Health (Pasco, WA)
- Registered Nurse ( RN ), House Supervisor Job Type: Full Time Days Wage scale: $46.93 - $65.70 per hour Your experience matters At Lourdes Health, we are ... as an employee, but as a person. As a registered nurse ( RN ) joining our...environment that encourages professional growth. Initiates weekend case management, Utilization review screening, assists with D/C planning… more
- Fresenius Medical Care (Ponca City, OK)
- …a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. As the facility leader, ... auditing activities. Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. Manages clinic financials… more
- Fresenius Medical Care (Fayetteville, NC)
- …all regulatory and FMS policy requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all ... programs. Adheres to all requirements of the FMCNA Compliance Program, and FMS patient care and administrative policies as the clinical leader, has the authority to… 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
- Interim HealthCare (Greenwood, IN)
- …(RNCM) with us, you will need: Licensure: Current unrestricted license to practice as a Registered Nurse ( RN ) in the state associated with this position ... One (1) year of professional experience practicing as a Registered Nurse ( RN ) in home...) in home health or similar setting; previous case management/ utilization review experience preferred. OASIS experience preferred.… more
- CenterWell Home Health (Pittsfield, MA)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... documentation requirements. Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...accredited School of Nursing. Current state license as a Registered Nurse . Proof of current CPR. Valid… more
- Harbor Health Services, Inc. (Mattapan, MA)
- …regulatory entities. Collaborates with Senior Medical Director to resolve complex medical review issues and utilization cases requiring elevation to the Senior ... more than 580 participants. We are currently seeking a Director of Utilization Management & Quality Programs. Harbor Health offers an excellent, comprehensive… more
- St. Peters Health (Helena, MT)
- The Utilization Management RN reports directly to Utilization Review RN Coordinator. The UR RN supports the UR RN Coordinator and other UR ... denials as assigned, and participation in the organizations Utilization Review Committee. In collaboration with the patient /family, physicians, and the… more
- HCA Healthcare (Kissimmee, FL)
- …and improve the patient flow program effectiveness as it relates to utilization review , resource management, and discharge planning and care coordination. + ... leader to physicians and employees as it relates to utilization review , resource management, patient ...obtained within 30 days of employment start date + ( RN ) Registered Nurse + Associate… more
- UNC Health Care (Chapel Hill, NC)
- …through the integrating and functions of point of entry case management, utilization review , and effective patient flow activities. Responsibilities: ... degree in Nursing **Licensure/Certification Requirements:** * Must be licensed to practice registered nurse in the state of North Carolina **Professional… more
- Dartmouth Health (Lebanon, NH)
- …leadership, communication and computer skills desired. Required Licensure/Certifications - Licensed Registered nurse with NH eligibility * Remote:Fully Remote * ... team members to develop a plan of care for assigned patients. Ensures patient is progressing towards desired outcomes by monitoring care through assessments and/or … more
- 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
- McLaren Health Care (Port Huron, MI)
- …related duties as required and directed. **Qualifications:** Required ⦁ State licensure as a registered nurse ( RN ) ⦁ Bachelor's degree in nursing from ... **Department:** Utilization Review **Daily Work Times:** 8:00am-4:30pm...utilization management/case management, critical care, clinical documentation, or patient outcomes/quality management. ⦁ Certification in Case Management Certification… more
- Ventura County (Ventura, CA)
- …Health Care Agency - Ventura County Medical Center/ Santa Paula Hospital APPROXIMATE SALARIES: Registered Nurse II ( RN II): $51.30 - $61.35 per hour ... Registered Nurse II - Emergency Department...as indicated and required. + May participate in quality assurance/ utilization review or other non-direct patient… more
- Beth Israel Lahey Health (Burlington, MA)
- …the medical necessity of the hospital care. Using the concepts of utilization review , clinical documentation improvement and revenue integrity, these specialized ... the medical necessity of the hospital care. Using the concepts of utilization review , clinical documentation improvement and revenue integrity, these specialized… more
- BJC HealthCare (St. Louis, MO)
- … RN experience performing care for hospitalized patients + 2 years of Utilization Review (UR) experience reviewing hospital admissions for medical necessity + ... Must have at least one active MO or IL RN license + If candidate only has one ..., which includes the evaluation of potential under and over- utilization according to patient 's presentation and documentation.… more
