- Humana (Salt Lake City, UT)
- **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
- Baylor Scott & White Health (Salt Lake City, UT)
- …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....work experience + Hold a valid registration as a Registered Nurse As a health care system… more
- Molina Healthcare (West Valley City, UT)
- …Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG ... guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). **WORK SCHEDULE: Mon - Fri / Sun… more
- Fresenius Medical Center (Salt Lake City, UT)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- HCA Healthcare (Salt Lake City, UT)
- …you passionate about delivering patient-centered care?** Submit your application for Operating Room Registered Nurse position and spend more time at the bedside ... clinical excellence behind the scenes in data science, case management or transfer centers. Unlock your potential at Mt....career! We are interviewing candidates for our Operating Room Registered Nurse opening. **Apply today and a… more
- Sharecare (Salt Lake City, UT)
- …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
- Highmark Health (Salt Lake City, UT)
- …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
- Highmark Health (Salt Lake City, UT)
- …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
- University of Utah Health (Salt Lake City, UT)
- …education in healthcare or a related field. + One year of experience in a utilization review or case management environment. + Basic Life Support Health ... coordination of care activities under the direction of a registered nurse and/or social worker. The incumbent...discharge plans prepared and delegated by social work or nurse case management by coordinating with home… more
- Intermountain Health (Murray, UT)
- …- Case management Certification. - and - Experience in Case management , Utilization review , and/or discharge planning. **Physical Requirements:** Ongoing ... needs in area(s) of responsibility. Completes documentation as required. + Performs utilization review activities to provide patient appropriate, timely, and… more
- Intermountain Health (Salt Lake City, UT)
- …be verified. + Case management Certification. + Experience in Case management , Utilization review , and/or discharge planning. **Physical Requirements:** ... needs in area(s) of responsibility. Completes documentation as required. + Performs utilization review activities to provide patient appropriate, timely, and… more
- Molina Healthcare (West Valley City, UT)
- …and production levels are maintained + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case ... Management (CM), Member Assessment Team (MAT), Health Management (HM), and/or Disease Management (DM) and...them.. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ) Program and… more
- University of Utah Health (Salt Lake City, UT)
- …+ Negotiates with third party payers relative to benefit levels, eligibility, utilization review , and reimbursement. + Identifies actual and potential delays ... **Overview** **Come join our growing Case Management Team! Utilize your clinical & critical thinking...the following** + Current license to practice as a Registered Nurse in the State of Utah,… more
- Molina Healthcare (West Valley City, UT)
- …Medical, or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina ... acute care/medical experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. Must… more
- Molina Healthcare (West Valley City, UT)
- … Registered Nursing ( RN ) license in good standing. + Utilization Management Certification (CPHM) Certified Professional in Health Care Quality (CPHQ), ... and results across Molina Health Plans & Segments. **KNOWLEDGE/SKILLS/ABILITIES** + Review existing case management standards and processes and establishes… more
- Guardian Life (Salt Lake City, UT)
- …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
- Molina Healthcare (West Valley City, UT)
- … Registered Nursing ( RN ) license in good standing. + Utilization Management Certification (CPHM) Certified Professional in Health Care Quality (CPHQ), ... _Candidates must possess a current RN license, as well as a Bachelor's Degree_...Integrated DSNP Medicare and Medicaid model that ensures case management and utilization management work… more
- University of Utah Health (Salt Lake City, UT)
- …from either an IT/Systems Analyst role, or from a Clinical science role (ie RN , PA level clinical roles).** **Hybrid position, so need to be local or willing ... as a resource to end users and team members with regard to application utilization in context with workflow. + Performs the execution and update of test scripts,… more