- BayCare Health System (Cotton Plant, AR)
- …responsibility and clinical excellence. **BayCare Health System** is currently seeking a ** Utilization Review Specialist Senior** to join our outstanding ... and compassionate team. **The Utilization Review Specialist Senior responsibilities...Nursing RN . **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred… more
- BayCare Health System (Winter Haven, FL)
- …a foundation of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior responsibilities include:** + ... Critical Care or Emergency Service Equal Opportunity Employer Veterans/Disabled **Position** Utilization Review Specialist Senior **Location** Winter… more
- Providence (WA)
- …the best people, we must empower them._** **Providence Health Plan is calling an Associate Utilization Review Specialist who will:** + Be responsible for all ... configuration, etc.) + Critically assess and prepare all cases for RN /MD review of coverage (medical necessity, eligibility, network status, regulatory) + Uses… more
- WestCare Foundation (Henderson, NV)
- Utilization Review Specialist Job...required Education: + Associates or Bachelors level LPN or RN and/or Bachelors or Masters level CADC/LADC with 2 ... years utilization review experience, preferred experience working with individuals with psychiatric or substance use disorder Experience and Competencies: +… more
- HonorHealth (Scottsdale, AZ)
- …of communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors ... 1 year experience in UR/UM or Case Management Required Licenses and Certifications Registered Nurse ( RN ) State And/Or Compact State Licensure Required more
- BayCare Health System (Cotton Plant, AR)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Denials Specialist - Utilization Review responsibilities include:** + Timely reviews ... year Medicaid/Medicare experience. Equal Opportunity Employer Veterans/Disabled **Position** Denials Specialist - Utilization Review **Location**… more
- Desert Parkway Behavioral Healthcare Hospital (Las Vegas, NV)
- The UR Specialist reviews and monitors patients' utilization of health care services with the goal of maintaining high quality, cost-effective care. The duties ... include providing the medical and utilization expertise necessary to evaluate the appropriateness and efficiency of medical services and procedures. + Performs… more
- University of Washington (Seattle, WA)
- …partial/variable involvement with Harborview's Emergency Department. The Utilization Management Specialist RN2 is responsible for the ongoing review of a ... artistic pursuits, and natural beauty. Requirements: Current license to practice as a Registered Nurse in the State of Washington. Minimum of three years… more
- Bon Secours Mercy Health (Richmond, VA)
- …patient care) ACLS Advanced Cardiac Life Support (preferred) Medical-Surgical Nursing Certification RN -BC ( Registered Nurse - Board Certified) (preferred) ... * Weekly check-in with Nursing Professional Development Coordinator or Clinical Nurse Specialist * Ongoing educational opportunities, including quarterly… more
- New York State Civil Service (Albany, NY)
- NY HELP Yes Agency Corrections and Community Supervision, Department of Title Registered Nurse 2 - Utilization (NY HELPS) Occupational Category Health Care, ... Possession of a license and current registration as a registered professional nurse in New York State;...clinical nursing experience of which one year was in utilization review and/or discharge planning. Substitution: a… more
- AdventHealth (Hinsdale, IL)
- …skills **.** Teamwork principles **EDUCATION AND EXPERIENCE REQUIRED:** . Associates Degree Nursing or RN Diploma degree . Registered Nurse ( RN ) . ... **LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** **.** State of Illinois registered nurse license **LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:**… more
- AdventHealth (Altamonte Springs, FL)
- …Degree Nursing + Current valid State of Florida or multistate license as a Registered Nurse + 2 years of medical/ hospital nursing experience **Preferred ... Drive, Altamonte Springs, 32701 **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social...(as permitted by the patient) as well as a review of the current and past inpatient and outpatient… more
- MyFlorida (Macclenny, FL)
- REGISTERED NURSE SPECIALIST OPS - 60955422 Date: Jun 1, 2024 Location: MACCLENNY, FL, US, 32063 The State Personnel System is an E-Verify employer. For more ... Requisition No: 772103 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST OPS -...Nurse Practice Committee. Knowledge, skills and abilities, including utilization of equipment, required for the position: Ability to… more
- Veterans Affairs, Veterans Health Administration (Hines, IL)
- Summary The Accreditation and Quality (A&Q) Nurse Specialist demonstrates leadership in providing continuous readiness for accreditation and regulatory agency ... package: VA Nurse Total Rewards The A&Q Nurse Specialist reports directly Chief of Quality....level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- The Arora Group (Bethesda, MD)
- Registered Nurse Case Manager Nurse Currently recruiting a Registered Nurse ( RN ) Case Manager to work the Directorate of Healthcare Operations ... be provided one month in advance. DUTIES OF THE REGISTERED NURSE CASE MANAGER ( RN ):...Health Nurse (COHN) or Certified Occupational Health Nurse - Specialist (COHN-S). + National Board for Certification… more
- Cleveland Clinic (Weston, FL)
- …as assigned. **Education:** *Graduate of an accredited school of nursing with licensure as a Registered Nurse ( RN ) in the State of Florida. *Bachelor of ... and remains a top hospital in Florida. As a Utilization Management (UM) Specialist , you will work...valid license in the State of Florida as a Registered Nurse ( RN ). *Basic Life… more
- Northwell Health (Melville, NY)
- …level of care decisions and billing status and ensures compliance with the Utilization Review standard and regulations. Performs concurrent and retrospective ... job entry date. Current License to practice as a Registered Professional Nurse in New York State...Skills + Prior experience in Case Management, Denials/Appeals and/or Utilization Review .*Additional Salary DetailThe salary range and/or… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... that purpose. Job Summary The Utilization Management Nurse Specialist RN II will...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- MyFlorida (Orlando, FL)
- …that all verbal orders, including telephone orders from attending physicians, are reviewed by a registered nurse . + If no RN is available, receive all ... resident's status, and providing supervision and guidance to the Registered ( RN ), Licensed Practical Nurse ...that the residents are receiving total nursing care. + Review shift assignments and ensure that the assignments reflect… more
- MyFlorida (Orlando, FL)
- …that all verbal orders, including telephone orders from attending physicians, are reviewed by a registered nurse . + If no RN is available, receive all ... current status and providing supervision and guidance to the Registered ( RN ), Licensed Practical Nurse ...that the residents are receiving total nursing care. + Review shift assignments and ensure that the assignments reflect… more