- Humana (Jackson, MS)
- **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
- Fresenius Medical Center (Oxford, MS)
- …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
- Veterans Affairs, Veterans Health Administration (Biloxi, MS)
- …possesses intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation ... possesses intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation… more
- 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
- Sharecare (Jackson, MS)
- …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
- 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
- Highmark Health (Jackson, MS)
- …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
- Baptist Memorial (Meridian, MS)
- …Manager Facility: BAMC-Baptist Anderson Regional Medical Center North Department: North - Case Management North Category: Nurse RN Type: Clinical Work Type: ... identified during their hospitalization, illness, and/or life situation. Responsibilities + Utilization Review + Discharge planning + Readmission Reduction… more
- South Central Regional Medical Center (Laurel, MS)
- …and across other departments. JOB REQUIREMENTS Required Licenses [Mississippi, United States] Registered Nurse Must have a current Mississippi license or a ... through the ED - work collaboratively with the inpatient care manager and the utilization review department to support transitions from ED to inpatient - work… more
- 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
- Baptist Memorial (Columbus, MS)
- …the safe movement of patients throughout the continuum of care, ensures optimal utilization of resources, service delivery and compliance with external review ... the patient's health goals and coordinate services with the RN Case Manager for an effective transition plan. Meets...and revising a care plan to ensure good transition management and continuity of care (LOS, discharge delays), cost… more