- BayCare Health System (Clearwater, FL)
- …responsibility and clinical excellence. **BayCare Health System** is currently seeking a ** Utilization Review Specialist Senior** to join our outstanding ... and compassionate team. **The Utilization Review Specialist Senior responsibilities...Nursing RN . **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred… more
- Munson Healthcare (Traverse City, MI)
- …families, interdisciplinary team members, payers and external case managers Why work as a Utilization Review Specialist at Munson Healthcare? + Our dynamic ... 5 years of start date. + Current licensure as Registered Nurse in the State of Michigan....+ Minimum of three years clinical experience required. Previous utilization review and/or case management in a… more
- WestCare Foundation (Henderson, NV)
- Utilization Review Specialist Job...required Education: + Associates or Bachelors level LPN or 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: +… 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
- CareFirst (Baltimore, MD)
- …Qualifications** **PURPOSE:** Utilizing key principles of utilization management, the Utilization Review Specialist will perform prospective, concurrent ... coverage. Leveraging clinical expertise and critical thinking skills, the Utilization Review Specialist , will analyze...in addition to the required work experience. **Licenses/Certifications:** + RN - Registered Nurse -… more
- Cleveland Clinic (Vero Beach, FL)
- …from an accredited school of professional nursing. + Current state licensure as a Registered Nurse ( RN ). + Basic Life Support (BLS) certification through ... of the responsibilities of a Utilization Management Specialist include medical record review , providing clinical...to five years of full-time clinical experience as an RN . + Knowledge of medical terminology, anatomy, physiology, diagnosis,… more
- LifePoint Health (Hickory, NC)
- * Registered Nurse ( RN ), Clinical...outcome of care management as prescribed in the initial Utilization Review Plan with regard to resources, ... valued as an employee, but as a person. As a* registered nurse ( RN )*joining our team,...the lives of those we serve.** *Connect with our RN recruiting specialist * Not ready to complete… more
- LifePoint Health (Henderson, NC)
- Registered Nurse ( RN ) Case Manager Job Type: Full Time | Days Up to $20,000 Commitment Bonus Your experience matters At Maria Parham Hospital, we are driven ... as an employee but as a person. As a registered nurse ( RN ) joining our...skills. Requires a working knowledge of community resources and Utilization /Quality Review standards and activities conducted by… more
- AdventHealth (Orlando, FL)
- …+ Associate of Science degree in Nursing (ASN) + Current valid license as a Registered Nurse in the state of Florida + Two (2) years of medical/hospital ... St, Orlando, FL 32803 **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social...(as permitted by the patient) as well as a review of the current and past inpatient and outpatient… more
- MyFlorida (Macclenny, FL)
- REGISTERED NURSE SPECIALIST OPS - 60955422 Date: Nov 22, 2024 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... Requisition No: 772103 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST OPS -...Nurse Practice Committee. Knowledge, skills and abilities, including utilization of equipment, required for the position: Ability to… more
- Veterans Affairs, Veterans Health Administration (Hines, IL)
- Summary The Accreditation and Quality Specialist (AQS) Consultant Nurse demonstrates leadership in providing continuous readiness for accreditation and ... Jr., VA Medical Center. Responsibilities The Accreditation and Quality Specialist (AQS) Consultant Nurse serves as a...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- MyFlorida (Orlando, FL)
- …that all verbal orders, including telephone orders from attending physicians, are reviewed by a registered nurse . + If no RN is available, receive all ... resident's status, and providing supervision and guidance to the Registered ( RN ), Licensed Practical Nurse ...that the residents are receiving total nursing care. + Review shift assignments and ensure that the assignments reflect… 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 - 50950037 Date:...resident's status, and providing supervision and guidance to the RN , LPN, CNA, and other Allied Health Care Professionals.… more
- MyFlorida (Port Charlotte, 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 - 50009026 Date:...current status and providing supervision and guidance to the RN , LPN, CNA, and other Allied Health Care Professionals.… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates,...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- HCA Healthcare (El Paso, TX)
- …set us apart from any other healthcare provider. We are seeking a(an) Registered Nurse ** **Clinical Informatics Coordinator** **to join our healthcare family.** ... **Required:** + **Associate's Degree** + **Bachelor's Degree preferred, or in progress** + ** Registered Nurse license in Texas. If Compact License, Texas license… more
- LifePoint Health (Danville, VA)
- * Registered Nurse , RN - Utilization Review Case Manager* Job Type:Full Time|Days *$10,000 Sign-on Bonus Eligibility for Full-Time, Bedside RNs* ** ... valued as an employee, but as a person. As a* registered nurse ( RN )*joining our team,...and harassment in employment." **Job:** **Nursing* **Organization:** ** **Title:** * RN - Utilization Review Case… more
- Katmai (Fort Carson, CO)
- … Specialist , for this position for initial hire. + The registered nurse must possess sufficient initiative, interpersonal relationship skills and ... The Registered Nurses report and are accountable to the Nurse Manager. **ESSENTIAL DUTIES & RESPONSIBILITIES** + Collect, interpret, record, and communicate… more
- Trinity Health (Livonia, MI)
- …Type:** Full time **Shift:** **Description:** Trinity Health at Home is seeking an experienced RN remote Clinical Quality Review Specialist with ICD10 HCS-D ... hire **Trinity Health at Home is seeking an experienced RN Clinical Quality Review Specialist ...strategic aims and top clinical outcomes. **Minimum Qualifications** + ** Registered Nurse with current license from the… more
- Dayton Children's Hospital (Dayton, OH)
- …timeHours:40Job Details:Under the supervision of the Manager of Utilization Management, the Utilization Review RN conducts medical record review for ... medical guidelines and communicates information to payers in accordance with contractual obligations. The Utilization Review RN serves as a resource to the… more
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