- Catholic Health Initiatives (Little Rock, AR)
- …Matching 401(k) and 457(b) Retirement Programs Wellness Programs. **Responsibilities** The Utilization Review Nurse coordinates the communication of ... cost effective use of available resources. The care manager utilization review will monitor the changes in...the payer on changes in the patients **Qualifications** Registered Nurse with Bachelors degree or diploma/associates degree A current… more
- Catholic Health Initiatives (Little Rock, AR)
- **Overview** As a Utilization Review nurse with CHI St Vincent Little Rock, you'll work with physicians, other registered nurses, specialized departments, ... statistics. + Monitors and tracts Medicare denials, works with medical records to review third party payor denials. + Works with other disciplines to develop a… more
- Humana (Little Rock, AR)
- …a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and… more
- Wellpath (Pine Bluff, AR)
- …care through adherence to policies and procedures for admission and transfer, utilization review , and referrals. + Assumes responsibility and accountability for ... of care support. **How you make a difference** The Psychiatric Nurse Practitioner(Psych NP)follows established policies and procedures and state guidelines, ensuring… more
- Evolent (Little Rock, AR)
- …be the single point of responsibility for all clinical operations inclusive of nurse , physician, and shared services performance. and core work can be divided into ... for operational performance of physician, nursing, and shared services staff in the utilization management value chain + Owns clinical rationale for utilization … more
- CVS Health (Little Rock, AR)
- …with transferring patients to lower levels of care + 1+ years' experience in Utilization Review + CCM and/or other URAC recognized accreditation preferred + 1+ ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
- Highmark Health (Little Rock, AR)
- …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health care ... services, application of criteria to assure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management, and… more
- United Therapeutics (Little Rock, AR)
- …reimbursement support, patient support programs, field reimbursement managers, patient navigators and nurse educators + Review Needs Assessment Forms related to ... with superior financial performance and our communities with earth-sensitive energy utilization . Our company was founded by an entrepreneur whose daughter was… more
- Catholic Health Initiatives (Little Rock, AR)
- **Overview** As a Case Manager Nurse with CHI St Vincent Infirmary, you'll work with physicians, other registered nurses, specialized departments, and community ... new, innovative ways, you belong with us. **Responsibilities** + Conduct an initial review of each patient's information and initiate contact + Participate in daily… more
- Veterans Affairs, Veterans Health Administration (North Little Rock, AR)
- …coordinated care delivery model. Coordinates with the patient care team to review clinic appointment availability ( utilization ) to ensure that clinic schedules ... of medical clinicians across multiple disciplines (eg medical doctors, nurse practitioners, physician assistants, psychologists, psychiatrists, social workers, clinical… more
- Veterans Affairs, Veterans Health Administration (Little Rock, AR)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... standards. Assist the Medicine Service Chief in the areas of: Resource Utilization ; Accomplishment of local, VISN and national goals; Safety. Provide shared coverage… more