- Humana (Salem, OR)
- …and help us put health first** Humana Healthy Horizons in Ohio is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to support ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Insight Global (Oregon City, OR)
- …-Triages minor to emergent situations. -Respond to medical emergencies. -Performs nurse visits and administers medications and immunizations as ordered by an ... health through advocacy, counseling, teaching, problem solving, and selection and utilization of resources. -Instructs individuals, families, and other groups on… more
- Evolent (Salem, OR)
- …for operational performance of physician, nursing, and shared services staff in the utilization management value chain + Owns clinical rationale for ... point of responsibility for all clinical operations inclusive of nurse , physician, and shared services performance. and core work...utilization management decisions made by all clinical staff + Ensures… more
- CenterWell (Lake Oswego, OR)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...and reliable transportation. + Two years as a Registered Nurse with at least one-year of management … more
- Evolent (Salem, OR)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and client policies and ... behind it. **What You'll Be Doing:** The Evolent Appeals Nurse team offers candidates the opportunity to make a...and regulations. * Practices and maintains the principles of utilization management and appeals management … more
- Intermountain Health (Salem, OR)
- …of 2 years' experience in acute clinical nursing setting + Knowledge of utilization management and case management principles preferred KNOWLEDGE, SKILLS, ... **Job Description:** The Pre-Access Prior Authorization RN provides timely review of authorization requests and/or review of denials to ensure medical necessity,… more
- Veterans Affairs, Veterans Health Administration (Portland, OR)
- …documents, standard operating procedures, protocols, guidelines and related materials; nurse management such as tracking, development, completion, submission ... accomplishes special projects and programs. Administers programs concerning position management and human-resources utilization . Backup to Administrative… more