- University Health (Pleasanton, TX)
- …(as a Staff nurse II or above). Work experience in case management , utilization review or hospital quality is preferred. LICENSURE/ CERTIFICATIONS Current ... licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. An approved case management certification (ACM, CCM or ANCC)… more
- University Health (Hondo, TX)
- …minimum three years of clinical nursing experience is required. Data entry, referral management , utilization management experience is required. Case ... with OB patients preferred. Experience working with EPIC EMR desirable. LICENSURE/CERTIFICATION Current licensure in the State of Texas as an RN or LVN is required. more
- University Health (Boerne, TX)
- …of Nurse Examiners of the State of Texas to practice as a registered nurse is required. National certification in related field is desirable. Case Manager ... Graduation from an accredited school of nursing with current RN licensure in the State of Texas, BSN preferred....full time hospital experience preferred. Work experience in case management , utilization review, or hospital quality assurance… more
- University Health (Pleasanton, TX)
- …of Nurse Examiners of the State of Texas to practice as a registered nurse is required. National certification in related field is preferred. Case Manager ... Three years recent, full-time hospital experience preferred. Work experience in case management , utilization review or hospital quality assurance experience is… more
- Sunrise Senior Living (Charlottesville, VA)
- …of approved college / school of nursing * Maintains a current state license as a Registered Nurse per state regulations * A minimum of two (2) years' experience ... highest quality standards for well being. * Ensures proper utilization of the Resident Care Plan by all team...in a nurse management position within a skilled nursing… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests ... coverage while working remotely. Primary Responsibilities * Performs clinical utilization reviews using evidenced based guidelines, policies and nationally...* Current Licensed Practical Nurse (LPN) or Registered Nurse ( RN ) with state… more
- CVS Health (Raleigh, NC)
- …holidays and evening hours._ **Must reside in CST or EST zone.** As a Utilization Management Nurse Consultant you will utilizes clinical experience and ... **Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current...Requirement to reside in EST or CST zone. + Utilization Management is a 24/7 operation and… more
- CVS Health (Raleigh, NC)
- …all with heart, each and every day. **Position Summary** Medicare Precertification Utilization Management Nurse Consultant position: _Utilization ... /benefit management function. **Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN … more
- Actalent (Minnetonka, MN)
- Utilization Management Nurse Job...+ Proficiency in prior authorization processes. + Active, unrestricted RN license in the state of MN or WI. ... Description As a Utilization Management Nurse for Post Acute care, you will be responsible...necessity of post-acute stays. Essential Skills + Expertise in utilization management and utilization review.… more
- CVS Health (Columbus, OH)
- …a difference in the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review, ... initiate a Medical Director referral as needed. + Assists management with training new nurse reviewers/business partners...etc. and clinical documentation systems. + 1+ Year of Utilization Review Management and/or Medical Management… more
- CVS Health (Lansing, MI)
- … solutions that promote high-quality healthcare for members. **Position Summary** Join our Utilization Management team as a Nurse Consultant, where you'll ... a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM...are not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence… more
- Katmai (Fort Carson, CO)
- …Red Cross. + Three (3) years within the last four (4) years as a registered nurse in utilization management . + One (1) year of experience in UR/UM and ... Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE...full, active, and unrestricted license to practice as a registered nurse . + Must be a graduate… more
- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in… more
- CVS Health (Columbus, OH)
- …and type on the computer. **Preferred Qualifications** Utilization Management experience preferred **Education** Diploma RN acceptable; Associate degree/BSN ... quality expectations as established by UMNC. **Required Qualifications** + Registered Nurse + 3+ years of experience...in acute or post-acute setting, and 1+ years of Utilization Management / Care Management … more
- CVS Health (Harrisburg, PA)
- …training sessions, or other events as directed. **`** **Required Qualifications** + Registered Nurse + Education: Diploma RN acceptable;Associate degree/BSN ... preferred, 3+ years of experience as a Registered Nurse , 1+ years of clinical experience...in acute or post-acute setting, and 1+ years of Utilization Management / Care Management … more
- CVS Health (Hartford, CT)
- …members. This position does require a weekend schedule. **Required Qualifications** + Registered Nurse + Education: Diploma RN acceptable;Associate ... Licenses as business needs require. **Preferred Qualifications** Utilization Management experience preferred **Education** Education: Diploma RN acceptable;… more
- CVS Health (Trenton, NJ)
- …active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include weekends, ... all with heart, each and every day. Position Summary Utilization Management is a 24/7 operation and...**Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care… more
- CVS Health (Carson City, NV)
- …active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include weekends, ... day. **Must Reside in PST Time Zone** **Position Summary** Utilization Management is a 24/7 operation and...Time Zone + 2+ years of experience as a Registered Nurse in adult acute care/critical care… more
- CVS Health (Austin, TX)
- …sessions, or other events as directed. **`** **Required Qualifications** + Registered Nurse + Education:Diploma RNacceptable;Associate degree/BSN preferred, 3+ ... years of experience as a Registered Nurse , 1+ years of clinical experience...experience in acute or post-acute setting,and 1+ years of Utilization Management / CareManagementExperience + Must have… more
- US Tech Solutions (Hopewell, NJ)
- …**Additional licensing, certifications, registrations:** 1. Requires an active New Jersey Registered Nurse License. **Knowledge:** - Prefers proficiency in the ... case/care management principles. - Prefers working knowledge of principles of utilization management . - Prefers basic knowledge of health care contracts and… more
