- 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
- Katmai (Fort Carson, CO)
- …in Utilization Management. + Must possess a current, active, full, and unrestricted Registered Nurses ( RN ) licensed in Colorado, be able to practice using a ... need for inpatient/outpatient precertification. **ESSENTIAL DUTIES & RESPONSIBILITIES** + Review precertification requests for medical necessity, referring to the...nurse compact state license or have a license from… more
- Stanford Health Care (Palo Alto, CA)
- …Lead APP also functions under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered Nurse Anesthetist (CRNA), ... and adherence to policy through practice analysis and case review of APPs with physicians. . Investigate and respond...under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered … more
- Stanford Health Care (Palo Alto, CA)
- …a licensed advanced practice provider: (Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist or Certified Registered Nurse ... college or university. + Nurse Practitioners, Clinical Nurse Specialists, Certified Registered Nurse ...- Valid state license to practice as a Clinical Nurse Specialist within the United States of… more
- Stanford Health Care (Palo Alto, CA)
- …their APPs. Also functions under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered Nurse Anesthetist (CRNA), ... and adherence to policy through practice analysis and case review of APPs with physicians. + Investigate and respond...practice provider: (Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist or Certified Registered … more
- ERP International (Camp Pendleton, CA)
- **Overview** ERP International, LLC is seeking a **Licensed Vocational / Practical Nurse ** for a full-time position supporting the **Branch Health Clinics** at ... Recognize urgent or emergent patient care situations, seek assistance of the RN and/or MD/DO, and initiate appropriate emergency interventions as directed. - Perform… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Remote PRN Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of ... healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence...regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse -… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse ( RN ) who comprehensively ... this position is able to cover a multitude of utilization review functions through point of entry,...and/or case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
- Medical Center Hospital (Odessa, TX)
- + Position Summary: The Utilization Review Specialist /Outcomes Specialist conducts concurrent and retrospective review functions in support of the ... hospital Utilization Review Program and makes appropriate referrals to designated Physician...A. Education: Holds a current Texas license as a Registered Nurse OR a current Texas Licensed… more
- Hunterdon Health Care System (Flemington, NJ)
- This is an in-person role. Position Summary The Utilization Review Specialist monitors adherence to the hospital's utilization review plan to ensure ... an applicable health insurance plan. Primary Position Responsibilities 1. Performs utilization activities, using Milliman Care Guidelines under the guidance of the… more
- BriteLife Recovery (Englewood, NJ)
- What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is ... responsible for overseeing and coordinating all aspects of utilization review and insurance authorization for clients receiving substance use disorder (SUD)… more
- CaroMont Health (Gastonia, NC)
- …RAC for reversal of original determination. May serve on the Medical Record/ Utilization Review Committee, providing detailed logs of denial activity and appeal ... practice in NC (NC license or multi-state (compact) license). Certification in Utilization Review / Management, Quality and/or Case Management preferred. Minimum… more
- WestCare Foundation (Henderson, NV)
- … RN and/or Bachelors or Masters level CADC/LADC with 2 years utilization review experience, preferred experience working with individuals with psychiatric or ... substance use disorder Experience and Competencies: + Proven experience in conceptualizing a case and creating a clinical impression to present to all involved and approved parties, including managed care representatives + Knowledge of CPT, ICD 9 & ICD 10… more
- BayCare Health System (Tampa, FL)
- …a foundation of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/ RN responsibilities ... + **On Call:** No **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred...Community discounts and more Equal Opportunity Employer Veterans/Disabled **Position** Utilization Review RN **Location** Tampa:St… more
- Deloitte (Los Angeles, CA)
- …degree, or physician assistant required + Current Registered Nurse ( RN ) license required + Certified Clinical Documentation Specialist - CCDS (inpatient) ... registered nurse , physician, physician assistant, case manager, clinical documentation specialist , utilization review , informatics RN , Quality,… more
- Tufts Medicine (Melrose, MA)
- …role is essential in developing and maintaining an infrastructure for the systematic review and management of complex patients. The position will work closely with ... managers, TMIN Practice Optimization Coaches (POMs) and primary care providers to review patient records, analyze data, and identify practice and patient outlier … more
- Veterans Affairs, Veterans Health Administration (Miami, FL)
- Summary The Miami VA medical center is recruiting for a Registered Nurse - Quality Management Specialist within Sterile Processing Service. The Registered ... care based on age specific components. Responsibilities The QM Specialist -RMD RN is assigned responsibility for their...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Beth Israel Lahey Health (Cambridge, MA)
- …to the Director of Quality & Patient Safety, the Quality and Patient Safety nurse specialist plays a role in reviewing publicly reported quality data by ... on the key performance indicators and quality measures, the RN specialist also aims to foster a...reduce serious safety events and improve patient outcomes. The nurse works with clinical staff to review … more
- MyFlorida (St. Augustine, FL)
- …all verbal orders, including telephone orders from attending physicians, are reviewed by a registered nurse . If no RN is available, receive all telephone ... SENIOR REGISTERED NURSE SUPV - 50950032 Date:...resident's status, and providing supervision and guidance to the RN , LPN, CNA, and other Allied Health Care Professionals.… more
- MyFlorida (Land O' Lakes, FL)
- …that all verbal orders, including telephone orders from attending physicians are received by a registered nurse . If no RN is available, receive all telephone ... SENIOR REGISTERED NURSE SUPV - 50000070 Date:...current status and providing supervision and guidance to the RN , LPN, CNA and other Allied Health Care Professionals.… more
