• Post-Acute Utilization Management

    Humana (Jackson, MS)
    …independent determination of the appropriate courses of action. The Post-Acute Utilization Management Nurse 2: + Review Post-Acute Preauth cases using ... caring community and help us put health first** The Utilization Management Nurse utilizes clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) compact license… more
    Humana (01/25/25)
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  • Care Manager RN - Weekends (Remote)

    Highmark Health (Jackson, MS)
    …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
    Highmark Health (01/07/25)
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  • RN - Utilization Review - HS…

    Baptist Memorial (Jackson, MS)
    Summary The Utilization Review Nurse is...+ Employee referral program Job Summary: Position: 19738 - RN - Utilization Review Facility: MBMC - ... appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse...Hospital Department: HS Case Mgmt Administration Corporate Category: Nurse RN Type: Clinical Work Type: Full… more
    Baptist Memorial (01/16/25)
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  • Utilization Management Nurse

    Humana (Jackson, MS)
    **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 ) compact licensure… more
    Humana (01/25/25)
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  • RN -Case Manager - Case Management

    Baptist Memorial (Jackson, MS)
    …11344 - RN -Case Manager Facility: MBMC - Hospital Department: JS Case Management Administration MBMC Category: Nurse RN Type: Clinical Work Type: ... and/or life situation. Performs other duties as assigned. Responsibilities + Utilization Review + Discharge planning + Readmission Reduction Participation… more
    Baptist Memorial (01/15/25)
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  • RN Clinical Consultant, Claims Shared…

    Guardian Life (Jackson, MS)
    …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
    Guardian Life (12/20/24)
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