- Crouse Hospital (Syracuse, NY)
- Utilization Management Registered Nurse has well-developed knowledge and is proficient with standard Utilization Review processes. The Utilization ... their appropriate admission status. This individual will support the Utilization Management process by maintaining effective and.../ LICENSURE + Required: + Currently licensed as a Registered Professional Nurse in New York State.… more
- Humana (Louisville, KY)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the state of… more
- SSM Health (MO)
- …years' registered nurse experience and two years' utilization management experience PHYSICAL REQUIREMENTS + Frequent lifting/carrying and pushing/pulling ... operations within assigned region(s) or ministries related to the Utilization Management (UM) Review area under the...Professional Regulation (IDFPR) State of Work Location: Missouri + Registered Nurse (RN) Issued by Compact State… more
- Trinity Health (Springfield, MA)
- …care determinations using screening criteria, and assists the physician, bedside Registered Nurse , ICC and Social Worker with utilization management and ... BSN graduate preferred, Master's preferred + **Licensure** : Current Licensure as a Registered Nurse RN in Massachusetts. + **Certification** : BLS (AHA/ARC).… more
- Stanford Health Care (Palo Alto, CA)
- …adoption assistance! **This is an onsite Stanford Health Care job.** **A Brief Overview** The Utilization Management Registered Nurse (UM RN) will be ... the institution, navigating the complexities of patient care and resource utilization management , and education. Primary responsibilities include: 1.… more
- Actalent (Santa Barbara, CA)
- Non-profit healthcare network is looking for a utilization management registered nurse to join their team on a contract basis! Opportunity to gain ... to work a 3-month contract + Medi-Cal Experience + Utilization Management WHAT'S IN IT FOR YOU:...Health Plan Nurse Coordinator (HPNC) is a Registered Nurse who is assigned to one… more
- AdventHealth (Altamonte Springs, FL)
- …**The role you'll contribute:** The role of the Emergency Department Utilization Management (UM) Registered Nurse (RN) is to use clinical expertise ... for additional review as determined by department standards. The Utilization Management Nurse is accountable.... Current and valid license to practice as a Registered Nurse (ADN or BSN) required. .… more
- ERP International (Corpus Christi, TX)
- **Overview** ERP International is seeking a ** Registered Nurse (RN)** ** Utilization Manager** for a full-time position in support of the **Naval Health ... staff, newcomers, as appropriate. * Participate in all phases of the Utilization Management Program (UMP) and ensure that the UMP meets established … more
- Ascension Health (Manhattan, KS)
- **Details** + **Department:** Utilization Management + **Schedule:** Full Time, 40 hours weekly, Monday - Friday 7:30am - 4pm + **Hospital:** Ascension Via ... and coordinate compliance to federally mandated and third party payer utilization management rules and regulations. **Requirements** Licensure / Certification… more
- Commonwealth Care Alliance (Boston, MA)
- …services, procedures, and facilities under the provisions of CCA's benefits plan. The Nurse Utilization Management (UM) Reviewer is responsible for ... clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA… more
- Emory Healthcare/Emory University (Duluth, GA)
- …+ And more **Description** **FT / PT / Days / Nights** We're seeking a ** Registered Resource Utilization Critical Care Nurse ,** who will be primarily ... direct patient care assignment as needed while the primary nurse is off unit with another patient, and assisting...nurse may assist the emergency department in the management of critical care patients awaiting inpatient bed admission… more
- CVS Health (Tallahassee, FL)
- …may include weekends and holidays and evening rotations. This is a full-time remote Utilization Management Nurse Consultant opportunity. As a Utilization ... health care more personal, convenient and affordable. **Position Summary** Utilization management is a 24/7 operation. Work...of residence + 3+ years of experience as a Registered Nurse + 1+ years of clinical… more
- CVS Health (Atlanta, GA)
- …operation and work schedule may include weekends, holidays and evening hours. As a Utilization Management Nurse Consultant, you will utilize clinical skills ... **Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current...clinical experience in acute or post acute setting + Utilization management is a 24/7 operation. Work… 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 ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse (RN) - Active, current and… more
- CVS Health (Albany, NY)
- …Work schedules may include weekends and holidays and evening rotations. As a Utilization Management Nurse Consultant, you will utilize clinical skills ... **Required Qualifications** + 3+ years of experience as a Registered Nurse + 1+ years of clinical...and unrestricted RN licensure in state of residence + Utilization management is a 24/7 operation. Work… more
- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (Montgomery, AL)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in Illinois, Minnesota or… more
- CVS Health (Jefferson City, MO)
- …members sign up to work one major and one minor holiday yearly. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, ... health care more personal, convenient and affordable. **Position Summary:** Utilization Management is a 24/7 operation and...**Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current… more
- CVS Health (Albany, NY)
- …This is a full-time remote position. **Position Summary** Precertification (Infertility): Utilization Management Nurse Consultant + Utilizes clinical ... management function. **Required Qualifications** + 3+ years of acute experience as a Registered Nurse + Must have active current and unrestricted RN licensure… more
- MetroHealth (Cleveland, OH)
- …Required: Bachelor's degree in Nursing (applies to placements after 1/1/2017). Current Registered Nurse License State of Ohio. Minimum of five years ... level of care at the point of entry. The utilization review nurse will work on defined...management , and PC skills. Current working knowledge of, utilization management , case- management , performance improvement,… more