- Williamson Health (Murfreesboro, TN)
- …Education / Training: Must be currently licensed by the State of Tennessee as a Registered Nurse . Emergency Room and or Critical Care preferred Case ... and a drug-free workplace. POSITION SUMMARY To perform the activities of Case Management and Utilization Management to facilitate the collaborative management… more
- Valley Health System Consolidated Services (Las Vegas, NV)
- …experience in varied clinical settings. Two years experience in Utilization Review , Utilization Management or Case Management preferred. Applicant must ... collection/management computer programs. License/Certification: Has a current license to practice as a Registered Nurse in the State of Nevada. Other: Must be… more
- Valley Health System Consolidated Services (Las Vegas, NV)
- …experience in varied clinical settings. Two years experience in Utilization Review , Utilization Management or Case Management preferred. Applicant must ... collection/management computer programs. License/Certification: Has a current license to practice as a Registered Nurse in the State of Nevada. Other: Must be… more
- ChristianaCare (Newark, DE)
- RN Case Manager - Weekender - Day Shift Saturday & Sunday (Plus one rotating Friday shift). Newark, DE ChristianaCare - Wilmington Hospital is currently ... recruiting an RN Case Manager - Weekender with experience...Worker - Resolves psycho-social barriers and supports discharge needs. Utilization Management - Reviews patient status for appropriateness and… more
- Bluestone Child & Adolescent Psychiatric Hospital (University Heights, OH)
- …as a psychiatric nurse . 1-2 years-experience in behavioral health utilization review preferred. AGENCY SUMMARY: Bluestone is seeking dynamic healthcare ... timely response to emails and other communications relating to utilization review . Prepare and submit appeals utilizing...tracking as needed. Perform all duties of the Psychiatric Nurse ( RN /LPN) role as needed or when… more
- MVP Health Care (Tarrytown, NY)
- …in New York Qualifications you'll bring: Current New York State Licensure as a Registered Nurse required. Certification in Case Management required within 24 ... Your key responsibilities: Utilize the essentials of an integrated utilization management and case management model that...through the coordination of quality cost effective care. The Case Manager will also monitor and review … more
- MVP Health Care (Tarrytown, NY)
- …Master's prepared and licensed mental health clinician (LMSW, LCSW, LMHC, etc.) or Licensed Registered Nurse ( RN ) required New York State license required ... The Behavioral Health (BH) Professional is responsible for conducting utilization review for mental health and substance...adolescents, with at least 2 years being ASD related Utilization or Case Management experience in a… more
- Tenet Healthcare (Detroit, MI)
- RN Utilization Review - Case ...dedicated healthcare team where compassion meets innovation! As a Registered Nurse with us, you'll have the ... level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as...required. One (1) year hospital acute or behavioral health case management experience preferred. Active and valid RN… more
- UTMB Health (Webster, TX)
- Utilization Review Case Mgr -...**_REQUIRED EDUCATION/EXPERIENCE_** **:** + Current Texas licensure as a Registered Nurse ( RN ).with a minimum of ... observation in Community Hospitals and UTMB-TDCJ Hospital. + Performs utilization review procedures by prospectively, concurrently, and...transfers and admissions from the prison facility. + Conducts nurse to nurse conference calls for all… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse ( RN ) who comprehensively conducts ... hospital clinical nursing experience, which includes three years in utilization review and/or case management...case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
- Community Health Systems (Franklin, TN)
- …discharge planning, and payer requirements. + Documents all utilization review activities in the hospital's case management software, including clinical ... submitting reconsiderations or coordinating peer-to-peer reviews. + Communicates effectively with utilization review coordinators, case managers, and… more
- University of Utah Health (Salt Lake City, UT)
- …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** ... case that surpasses expected LOS, expected cost, or over/under- utilization of resources. + Performs verbal/fax clinical review...+ Current license to practice as a Registered Nurse in the State of Utah,… more
- George C. Grape Community Hospital (Hamburg, IA)
- Quality/ Utilization Review Nurse Position Summary: The Quality/ Utilization Review Nurse is responsible for evaluating the medical necessity, ... payers to resolve care coordination issues. Qualifications: * Education: Registered Nurse ( RN ) license required;...nursing experience (acute care preferred). o Prior experience in utilization review , case management, quality… more
- BriteLife Recovery (Englewood, NJ)
- …assigned What we need from you? + Minimum of 2-3 years of experience in utilization review , case management, or insurance coordination in a behavioral health ... What you will be doing? The Utilization Review (UR) Specialist is a...EHR and UR logs. + Collaborate with clinicians, therapists, case managers, and medical staff to gather accurate and… more
- Trinity Health (Columbus, OH)
- …direction of the Director, Utilization Management. + Coordinates with the utilization review , case management, discharge planning staff within network ... Licensure / Certification: Current license to practice as a Registered Nurse in their home state or...nursing experience with at least 2 years' experience in utilization review or case management.… more
- Henry Ford Health System (Detroit, MI)
- …community partners to support patient needs beyond the hospital setting. Qualifications: + Registered Nurse ( RN ) with active licensure + Minimum [number] ... with computers, electronic health records (EHR), database systems, and utilization review / case management documentation systems....work in a fast-paced environment. Licenses and Certifications: + Registered Nurse ( RN ) with a… more
- Eastern Connecticut Health Network (Manchester, CT)
- POSITION SUMMARY: The Utilization Review Case Manager (UR...or a related field. + Current licensure as an RN . EXPERIENCE: + 2 - 3 years' experience in ... in the acute-care setting. + Minimum of 1 year Utilization Review experience preferred via industry clinical...to payers for authorization of services provided and completes case review for claim reimbursement. + Reviews… more
- Ellis Medicine (Schenectady, NY)
- …for appropriate Level of Care and status on all patients through collaboration with Utilization Review RN + Contacts the attending physician for additional ... The RN Case Manager has responsibility for ...Case Manager include, but are not limited to, utilization review , case management, care transition,… more
- University of Miami (Miami, FL)
- …Department of UMHC SCCC Business Operations has an exciting opportunity for a full time Utilization Review Case Manager to work to work remote. The incumbent ... retrospective chart reviews for clinical utilization and authorization. The Utilization Review Case Manager coordinates with the healthcare team for… more
- Marshfield Clinic (Marshfield, WI)
- …Required:** Three years' experience in a medical facility. **Preferred/Optional:** Discharge Planning, Utilization Review or Case Management experience in a ... the most exciting missions in the world!** **Job Title:** RN Case Manager - Hospital - No...to the position._ **Minimum Required:** Current State of Wisconsin Registered Nurse license or Nurse … more
