- PIH Health (Downey, CA)
- The Registered Nurse ( RN ) Charge Nurse , BSN provides direct patient care and charge nurses duties. The primary nursing responsibilities include ... practice, effective communication, leadership skills, collaboration, and evidence-based practice/research utilization . Charge nurse duties include, assessment of… more
- PIH Health (Downey, CA)
- The RN Case Manager manages a continuum of care from pre-admission through post-discharge for assigned patients. Assure that patients and families proceed ... the course of hospitalization. Focus of the position is the appropriate utilization of hospital services, maximizing reimbursement from all third party payors, and… more
- PIH Health (Whittier, CA)
- …practice, effective communication, leadership skills, collaboration, and evidence-based practice/research utilization . Charge nurse duties include, assessment of ... in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation's top… more
- PIH Health (Bell, CA)
- …of out-of-network patients from PHWH to the patient's contracted facilities. The RN Access Case Manager performs utilization review with a high ... RN Access Case Manager works to ensure appropriate utilization of hospital resources in all settings and levels...and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one… more
- PIH Health (Pasadena, CA)
- The Clinical Education Specialist for Perioperative Services is a registered nurse with expertise in nursing education who influences the professional growth, ... practice, effective communication, leadership skills, collaboration, and evidence-based practice utilization . PIH Health is a nonprofit, regional healthcare network… more
- Matrix Providers (Aurora, CO)
- Registered Nurse ( RN ) - Utilization Management Location: Aurora, CO, United States Healthcare Provider Type : Nursing START YOUR APPLICATION ... schedules. Matrix Providers is hiring a Registered Nurse ( RN ) - Utilization Management to join our team of talented professionals who provide… more
- Centene Corporation (Tallahassee, FL)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... to ensure appropriate care for members and supervises day-to-day activities of BH utilization management team. + Monitors behavioral health (BH) utilization … more
- Centene Corporation (Oklahoma City, OK)
- …Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact ... **Must reside in the State of Oklahoma!** **Now Hiring: Remote Supervisor, Utilization Management ** **Centene is looking for a dynamic leader to join our team… more
- Fairview Health Services (St. Paul, MN)
- …utilization review experience. Working knowledge of utilization management and quality improvement. License/Certification/Registration Current Registered ... **Overview** M Health Fairview has an immediate opening for a Utilization Management Supervisor. This is a 1.0 FTE (80 hours per two week pay period),… more
- Crouse Hospital (Syracuse, NY)
- …and outreach programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse ( RN ) to track and manage data ... occasional weekends (typically requires 6 weekends a year). Utilization Management Registered Nurse ( RN ) Position Responsibilities: + Works… more
- CVS Health (Austin, TX)
- … Nurse Consultant participating in non-traditional, weekend shift rotation. As a Utilization Management Nurse Consultant, you will utilize clinical skills ... needs require + 3+ years of experience as a Registered Nurse + 1+ years of clinical...shifts of 10hrs each in time zone of residence; Utilization Management is a 24/7 operation and… more
- Independent Health (Buffalo, NY)
- …managed care operations required; multi-dimension project management experience preferred. + Registered Nurse ( RN ) with active, unrestricted NYS license ... perks, benefits and commitment to diversity and inclusion. **Overview** The Program Manager- Utilization Management (UM) will be accountable for the management… more
- Ascension Health (Nashville, TN)
- **Details** + **Department:** Utilization Management + **Schedule:** Monday - Friday. 40 hours week. + **Hospital:** Ascension Saint Thomas + **Location:** ... TN market. We're looking for an experienced Director of Utilization Management to join our team! In...all clients. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Tennessee Board… more
- Hackensack Meridian Health (North Bergen, NJ)
- …transform healthcare and serve as a leader of positive change. The **Care Coordinator, Utilization Management ** is a member of the healthcare team and is ... Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to... **Licenses and Certifications Required:** + NJ State Professional Registered Nurse License. + AHA Basic Health… more
- Wellpath (Fort Lauderdale, FL)
- …for training, education, and point of care support. **How you make a difference** The Utilization Management Registered Nurse works under the guidance of ... specific deadline posted in the job description. Quick Apply (https://careers-wellpath.icims.com/jobs/172920/ utilization - management - registered - nurse /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336175207) **Need help… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... net required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …medical necessity criteria and BCBSMA policies and procedures + Focus on efficient utilization management with emphasis on discharge planning + Understand and ... to obtain and/or share information relating to benefits and the BCBSMA utilization management process + Collaborate with members/families, providers, medical… more
- Aspen Medical (Aurora, CO)
- JOB AD: Registered Nurse - Utilization Management Introduction : Aspen Medical has an exciting opportunity for Registered Nurses to partner with us in ... Management through the American Nurses Credentialing Center or Utilization Management Accreditation through National Committee for...full, active, and unrestricted license to practice as a Registered Nurse as required in the TO… more
- Trinity Health (Philadelphia, PA)
- …**Description:** Nazareth Hospital, a member of Trinity Health Mid-Atlantic, is seeking experienced Utilization Management RN to join the Case Management ... Under the general supervision of the Manager of Utilization Management , the Utilization RN assists physicians and the interdisciplinary team in… more
- CVS Health (Carson City, NV)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... demonstrated ability to make thorough, independent decisions using clinical judgement. + A Registered Nurse that must hold an unrestricted license in their state… more
