- Munson Healthcare (Traverse City, MI)
- …families, interdisciplinary team members, payers and external case managers Why work as a Utilization Review Specialist at Munson Healthcare? + Our dynamic ... 5 years of start date. + Current licensure as Registered Nurse in the State of Michigan....+ Minimum of three years clinical experience required. Previous utilization review and/or case management in a… more
- Medical Center Hospital (Odessa, TX)
- Position Summary: The Utilization Review Specialist /Outcomes Specialist conducts concurrent and retrospective review functions in support of the ... hospital Utilization Review Program and makes appropriate referrals to designated Physician...Advisors. Education: Holds a current Texas license as a Registered Nurse . Training and Experience: Three years… 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
- Corewell Health (Grand Rapids, MI)
- … management ,discharge planning designing patient centered care plan or related work Required. + Registered Nurse ( RN ) - State of Michigan Upon Hire required ... Must have a MICHIGAN RN License About Priority Health We are the...continued stay. Educates medical staff/other health care professionals regarding utilization management and quality requirements. Makes recommendations and provides… more
- BayCare Health System (Clearwater, FL)
- …a foundation of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior responsibilities include:** + ... + **On Call:** No **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred...Nursing or Business **Experience:** + Required 2 years in Utilization Review or + Required 2 years… more
- Community Health Systems (Franklin, TN)
- …necessity, both for admission to the hospital as well as continued stay. The Utilization Review Clinical Specialist supports and coordinates the various ... hospital stays with portals, faxes and phone calls. The Utilization Review Clinical Specialist will...in computer and web-based applications. **Licenses and Certifications** + RN - Registered Nurse -… more
- LifePoint Health (Henderson, NC)
- Registered Nurse ( RN ) Case Manager Up to $20,000 Commitment Bonus Job Type: Full Time|weekend 10-hour shifts Schedule Requirement: Friday-Monday Your ... as an employee but as a person. As a registered nurse ( RN ) joining our...skills. Requires a working knowledge of community resources and Utilization /Quality Review standards and activities conducted by… more
- AdventHealth (Orlando, FL)
- …experiences you'll need to succeed:** **EDUCATION AND EXPERIENCE REQUIRED:** + Associates Degree Nursing or RN Diploma degree + Registered Nurse ( RN ) + ... Annual number of emergency cases: 89,018 **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses,… more
- MyFlorida (Gainesville, FL)
- REGISTERED NURSE SPECIALIST -F/C OPS - 60957257 Date: Dec 30, 2024 The State Personnel System is an E-Verify employer. For more information click on our ... . Requisition No: 843860 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST -F/C OPS - 60957257 Pay… more
- AdventHealth (Orlando, FL)
- …+ Associate of Science degree in Nursing (ASN) + Current valid license as a Registered Nurse in the state of Florida + Two (2) years of medical/hospital ... St, Orlando, FL 32803 **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
- Sanford Health (Sioux Falls, SD)
- …experience. Minimum of three years nursing experience is required. Currently holds an unencumbered registered nurse ( RN ) license with the State Board of ... and execute authorizations. Essential functions must occur simultaneously; therefore, the specialist must be able to appropriately handle and prioritize various… more
- McLaren Health Care (Bay City, MI)
- …Bi-Weekly: 0** **Position Summary:** U nder the direction of the Manager, provides utilization review and evaluation of Emergency admissions and direct admits to ... + Licensed by the State of Michigan as a Registered Nurse . + Three years experience as...Degree in Nursing. + Two years experience in hospital utilization review . + Minimum of one-year experience… more
- Louisiana Department of State Civil Service (Lafayette, LA)
- Registered Nurse Supervisor A Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4788940) Apply Registered Nurse Supervisor A Salary ... at ###. Minimum Qualifications MINIMUM QUALIFICATIONS: Possession of a current Louisiana Registered Nurse license or a temporary permit or multi-state license… more
- Louisiana Department of State Civil Service (Colfax, LA)
- …particularly during the absences of the RN supervisor A as indicated. This Registered Nurse 4 is accountable for promoting a positive image and working ... Registered Nurse 4 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4790761) Apply...Unit. Monitors public health practice for quality and appropriate utilization of services. Serves as the Lead Nurse… more
- St. Luke's University Health Network (Allentown, PA)
- …near vision, visual monotony. EDUCATION: Graduate of an accredited professional nursing program. Registered nurse with current license to practice in the state ... ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials for...experimental, coding or other issues that may require record review . Provides billing with information needed to obtain payment… more
- Louisiana Department of State Civil Service (Vidalia, LA)
- Registered Nurse 3 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4790819) Apply Registered Nurse 3 Salary $4,784.00 - $8,608.00 ... to be considered for this vacancy. Position Description: This Registered Nurse 3 is assigned to the...as they emerge. Administrative supervision is received from the RN Supervisor A. 50% This Register Nurse … 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 ... entry date. + Current License to practice as a Registered Professional Nurse in New York State...certifications as needed. + Prior experience in Case Management, Utilization Review , and Appeals/Denials, highly preferred. *Additional… more
- MyFlorida (Port Charlotte, FL)
- …that all verbal orders, including telephone orders from attending physicians are received by a registered nurse . If no RN is available, receive all telephone ... SENIOR REGISTERED NURSE SUPV - 50009026 Date:...current status and providing supervision and guidance to the RN , LPN, CNA, and other Allied Health Care Professionals.… more
- Katmai (Usaf Academy, CO)
- …from the Commission on Collegiate Nursing Education accredited college or university. + Registered Nurse shall possess a current, active, full and unrestricted ... Registered Nurses ( RN ) licensed in Colorado or be...contract at no expense to the Government. + The registered nurse must have a minimum of two-years… 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 facilitates,...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more