- Humana (Montgomery, AL)
- **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... independent determination of the appropriate courses of action. The Utilization Management Registered Nurse...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Baylor Scott & White Health (Montgomery, AL)
- …and members. **Key Success Factors** + Demonstrable knowledge in discharge planning, case management , utilization review and different care levels. + ... type and/or level **Job Summary** As a Manager for Utilization Review , you guide and supervise staff....work experience + Hold a valid registration as a Registered Nurse As a health care system… more
- Fresenius Medical Center (Mobile, AL)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Highmark Health (Montgomery, AL)
- …and Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent with established… more
- Sharecare (Montgomery, AL)
- …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... and their Primary Care Provider according to the disease management program intervention guidelines. An RN is...orientation and to take the pre and posttests to review competency during orientation. Yearly competency test is required… more
- Highmark Health (Montgomery, AL)
- …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES:** + Implement care management review processes that are consistent with established… more
- CenterWell (Jasper, AL)
- …license, auto insurance and reliable transportation. + Two years as a Registered Nurse with at least one-year of management experience in a home care, ... clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- NHS Management, LLC (Pleasant Grove, AL)
- …successes they experience along the way. We are in search of a qualified Registered Nurse Shift Supervisor: + Assists in maintaining resident care standards by ... of subordinate nurses engaged in quality assurance, infection control, and utilization review activities. + Receives physicians' instructions regarding resident… more
- Guardian Life (Montgomery, AL)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… more
- NHS Management, LLC (Birmingham, AL)
- …of subordinate nurses engaged in quality assurance, infection control, and utilization review activities. + Receives physicians' instructions regarding resident ... medical plan! We are in search of a qualified RN Unit Manager : + Assists in maintaining resident...documentation of treatment and nursing observations. Qualifications: + Current RN license by State required with experience in the… more
- NHS Management, LLC (Mobile, AL)
- …of subordinate nurses engaged in quality assurance, infection control, and utilization review activities. + Receives physicians' instructions regarding resident ... your life! We are in search of a qualified RN Unit Manager + Assists in maintaining resident care...documentation of treatment and nursing observations. Qualifications: + Current RN license by State required with experience in the… more
- Community Health Systems (Birmingham, AL)
- Utilization management is the analysis of...of medical services and procedures in the hospital setting. Utilization review is the assessment for medical ... the UR team. Coordinates insurance specific duties including CURP protocol. LPN or RN degree is required. Three years of previous nursing experience is required.… more