• RN - Utilization Review

    Health Advocates Network (Medford, OR)
    Review experience. * Pay Rate: $2,608 weekly * Specialty: Discharge Planning and Utilization Review Registered Nurse ( RN ) * Shift: Day * 13 Week ... of Nursing * 2 years of experience as a Discharge Planning and Utilization Review Registered Nurse ( RN ) * American Heart Association BLS * An active,… more
    Health Advocates Network (02/08/25)
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  • Utilization Management Behavioral Health…

    Humana (Salem, OR)
    …an impact** **Required Qualifications** **Must meet one of the following:** + Active unrestricted registered nurse license in the state of Virginia or obtain a ... problem-solving skills, facilitation skills **Preferred Qualifications** + Experience with utilization review process + Experience with behavioral change,… more
    Humana (03/15/25)
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  • Care Manager RN

    Providence (Medford, OR)
    …**Full Time/ Day Shift** The RN Case Manager is an expert professional registered nurse who is responsible for developing and managing patient care outcomes ... population focus. Duties also include complex discharge planning and utilization review . Providence caregivers are not simply...must empower them. **Required Qualifications:** + Upon hire: Oregon Registered Nurse License. + 3 years Acute… more
    Providence (03/04/25)
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  • Pre-Authorization Registered Nurse

    Humana (Salem, OR)
    …guidelines/procedures. **Use your skills to make an impact** **Required Qualifications** + Active Licensed Registered Nurse ( RN ) in the state of Virginia or ... of our caring community and help us put health first** The Pre-Authorization Nurse 2 reviews prior authorization requests for appropriate care and setting, following… more
    Humana (03/15/25)
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  • Registered Nurse

    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 ... primary care procedures as necessary in times of staffing constraints. -Performs RN led patient visits for health maintenance, patient education, and treatment of… more
    Insight Global (02/07/25)
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  • Care Manager RN

    Providence (Portland, OR)
    …hire. + Bachelor's degree in Nursing or higher within 3 years of hire. + Oregon Registered Nurse License upon hire + 2 years Acute care hospital or community ... systems. + 1 year Home health, mental health, substance use, hospice, utilization review , discharge planning or care management experience **Preferred… more
    Providence (03/05/25)
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  • Clinical Letter Writer (Part-time) - RN

    Evolent (Salem, OR)
    …+ Performs other duties as assigned. **Qualifications: Required and Preferred:** + Licensed registered nurse or LVN/LPN (current and unrestricted) + Minimum of ... direct clinical patient care + **Minimum one year of experience with Utilization Review (UM) in a managed care environment** + Cardiology and Oncology Healthcare… more
    Evolent (03/11/25)
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  • Care Manager RN (Delaware) Remote

    Highmark Health (Salem, OR)
    …+ Experience in UM/CM/QA/Managed Care **LICENSES or CERTIFICATIONS** **Required** + United States Registered Nurse ( RN ) license + Delaware RN ... Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health… more
    Highmark Health (02/20/25)
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  • Manager, Utilization Management Behavioral…

    Humana (Salem, OR)
    …**Required Qualifications:** **Must meet** **one** **of the following:** + Active unrestricted registered nurse license in the state of Virginia or reside ... case manager required. **Additional Information:** **Workstyle:** Remote work at Home **Location for Registered Nurse :** must reside in the state of Virginia or… more
    Humana (03/12/25)
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  • Nurse (Community Care Coordinator)

    Veterans Affairs, Veterans Health Administration (Roseburg, OR)
    …while keeping families here for generations. The Community Care (CC) Coordinator Registered Nurse ( RN ) executes position responsibilities that demonstrate ... intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
    Veterans Affairs, Veterans Health Administration (03/13/25)
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  • RN Clinical Consultant

    Guardian Life (Salem, OR)
    **Position Summary** The RN Clinical Consultant serves as a clinical resource for the investigation and assessment of medical information regarding disability by ... medical reviews and analysis of long-term disability claims. The RN Clinical Consultant identifies restrictions, limitations and duration impacting functional… more
    Guardian Life (03/15/25)
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  • RN Medicare Compliance

    Sedgwick (Salem, OR)
    …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer RN Medicare Compliance **We are growing and looking for nurses who have their ... clinical data; to complete complex submissions revisions/updates in preparation for Medicare review and act as an internal resource regarding Centers for Medicare &… more
    Sedgwick (02/14/25)
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  • Medical Director/Physician

    Lincoln County (Newport, OR)
    …graduation from an accredited nurse practitioner school, possession of a license as registered nurse in the State of Oregon, and certification as a nurse ... nurse practitioner: possession of a license as registered nurse in the State of Oregon...Collaborate with the CHC Managers in the distribution and utilization of personnel in the health care team to… more
    Lincoln County (02/07/25)
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