- CHRISTUS Health (Wake Village, TX)
- …nursing is required. Experience Minimum of two (2) years' experience in Case Management and/or Utilization Management is required. Licenses, Registrations, ... Description Summary: The Registered Nurse Clinical Care Coordinator is responsible for...errors are identified to maximize hospital reimbursement and resource utilization . * Responsible for 24/7 ongoing management … more
- CVS Health (Jefferson City, MO)
- …solutions to make health care more personal, convenient and affordable. **Position Summary:** Utilization Management is a 24/7 operation and work schedules may ... one major and one minor holiday yearly. As a Utilization Management Nurse Consultant, you will utilize...**Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted… more
- R1 RCM (Chicago, IL)
- …you must have experience in a clinical inpatient environment and hospital-based utilization or case management experience. Proficiency in basic computer skills ... sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Utilization Review Author** , you will help our hospital clients by… more
- WellSpan Health (York, PA)
- Registered Nurse - Case Management - Weekend Option Location: WellSpan Health, York, PA Schedule: Part Time Schedule Weekend Option Part Time Every ... + 2 years Recent acute care experience. Required + Utilization management , case management , or..., or clinical nursing specialty. Preferred Licenses: + Licensed Registered Nurse Upon Hire Required or + Registered… more
- Sharp HealthCare (San Diego, CA)
- …the episode of care and supports other members of the System Centralized Utilization Management team to ensure final status reconciliation. This position ensures ... Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse (RN) - CA Board of Registered...Degree in a health related field. + 3 Years Utilization Management or case management … more
- Sharp HealthCare (San Diego, CA)
- …Qualifications** + Bachelor's Degree in Healthcare or a related field + 3 Years Utilization Management or case management within a hospital or payer ... Guidelines (MCG) + Experience and understanding of federal and state regulations governing utilization management + Accredited Case Manager (ACM) - American Case… more
- Sharp HealthCare (San Diego, CA)
- …or case management experience + 3 Years recent case management , utilization review, care coordination experience + California Registered Nurse (RN) - CA ... competency and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge planning, as… more
- Hackensack Meridian Health (Neptune, NJ)
- …to transform healthcare and serve as a leader of positive change. The **Care Management , Care Coordinator, Utilization Management ** is a member of the ... patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of… more
- Humana (Salem, OR)
- …of our caring community and help us put health first** The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, ... communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within specific guidelines and… more
- Hackensack Meridian Health (Holmdel, NJ)
- …transform healthcare and serve as a leader of positive change. The **Care Coordinator, Utilization Management ** is a member of the healthcare team and is ... patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of… more
- CVS Health (Columbus, OH)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + UMNC meets set productivity and ... once M-F training schedule completed and UMNC participating in non-traditional, weekend shift rotation **Preferred Qualifications** + Utilization review… more
- CVS Health (Columbus, OH)
- …solutions to make health care more personal, convenient and affordable. **Position Summary** Utilization Management is a 24/7 operation and work schedules may ... include weekends, holidays, and evening hours As a Utilization Management Nurse Consultant, you will utilize...**Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted… more
- CVS Health (Sacramento, CA)
- …Work schedules may include weekends and holidays and evening rotations._ As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... **Required Qualifications** - 3+ years of experience as a Registered Nurse - Must have active current and unrestricted...clinical experience in acute or post acute setting - Utilization management is a 24/7 operation. Work… more
- CVS Health (Raleigh, NC)
- …more personal, convenient and affordable. **Position Summary** **This is a fully remote Utilization Management opportunity.** Utilization management is a ... operation. Work schedules will include a minimum of 6 weekend rotations per year, as well as holidays and...external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working… more
- CVS Health (Springfield, IL)
- …personal, convenient and affordable. **Position Summary** This is a fulltime remote Utilization Management Nurse Consultant opportunity. Utilization ... of residence + 3+ years of experience as a Registered Nurse ie Med/Surg, ICU, Critical care, Telemetry, LTAC,...applications such as Teams, Outlook, Excel, and Word + Utilization management is a 24/7 operation. Work… more
- St. Luke's University Health Network (Easton, PA)
- …but not limited to: RN and Social Work care managers, assistants, coordinators, utilization management staff, and director. + Facilitates communication among all ... we serve, regardless of a patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager is responsible for coordinating the complex… more
- CVS Health (Columbus, OH)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + Must reside in… more
- Humana (Boise, ID)
- …a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and… more
- UNC Health Care (Chapel Hill, NC)
- …stay, and discharge reviews in accordance with federal regulations & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is ... + 40 hrs/week with flexible schedule options available + Weekend rotation + Holiday rotation + No Nights +...management referrals. Initiates appropriate social work referrals. 3. Utilization Management Process - Performs utilization… more
- CVS Health (Olympia, WA)
- …Must possess 1+ years of clinical experience in acute or post acute setting - Utilization management is a 24/7 operation. Work schedules will include weekend ... and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with… more
