- Humana (Providence, RI)
- …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
- Baylor Scott & White Health (Providence, RI)
- …and members. **Key Success Factors** + Demonstrable knowledge in discharge planning, case management , utilization review and different care levels. + ... type and/or level **Job Summary** As a Manager for Utilization Review , you guide and supervise staff.... management , and budget control. Departments involved are Utilization Management , Case Management , and… more
- Hartford HealthCare (Norwich, CT)
- …Physicians and APP providers, nurses, PT, OT, Imaging, cardiology, neurology, psychiatry, case management and utilization review . The APP will be the ... * Nurse Practitioner / Physician Assistant (APP)- Observation Medicine*...the patients, caregivers and families, as well as case management and utilization review to… more
- Evolent (Providence, RI)
- …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
- Veterans Affairs, Veterans Health Administration (Providence, RI)
- …the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities This RN-Interventional Radiology position is ... Providence location. This position is full-time at 40 hours per week. The Nurse Interventional Radiology (IR) Registered Nurse (RN) is responsible for providing… more
- Evolent (Providence, RI)
- …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
- Brown University (Providence, RI)
- …helps patients reduce medications that cause falls. Both models are led by a remote nurse who will review electronic health records and consult with an external ... findings will provide evidence that directly informs medication prescribing, deprescribing, and management to improve the safe use of medications among nursing home… more