- US Tech Solutions (RI)
- …MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1 YEAR OF ... **Job Description:** + Responsible for the review and evaluation of clinical information and documentation....UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG. + MUST HAVE… more
- Highmark Health (Providence, RI)
- …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
- Veterans Affairs, Veterans Health Administration (Providence, RI)
- …full-time at 40 hours per week. The Nurse Interventional Radiology (IR) Registered Nurse ( RN ) is responsible for providing competent, evidence-based care ... VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities This RN...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Guardian Life (Providence, RI)
- …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
- Prime Healthcare (Woonsocket, RI)
- …is unable to meet the patient's care needs. The ICM is responsible for the utilization review process as it relates to triage and admission to the Behavioral ... for the quality of emergency triage and appropriate resource management for all patients who present for emergent psychiatric...EXPERIENCE, TRAINING 1. Maintains an active license as a Registered Nurse , LCSW, or LICSW in Rhode… more