- Northeast Georgia Health System, Inc (Gainesville, GA)
- …team members as needed to ensure services will be covered.Coordinate and communicate with Utilization Review Nurse on a daily, consistent basis to ensure ... Job Category:Nursing - Registered Nurse Work Shift/Schedule:8 Hr Morning...patient needs; Works collaborate with the Physicians, patient/family, nursing, utilization review and other members of the… more
- Protouch Staffing - Permanent (El Paso, TX)
- Protouch Staffing - Permanent is seeking a Registered Nurse ( RN ) Case Management for a nursing job in EL Paso, Texas.Job Description & ... StaffPerks: Benefits: All Standards benefits are covered. Manager of Case Management RN - El Paso, TX...review of patient medical records for purposes of utilization review , compliance with requirements of external… more
- Northeast Georgia Health System, Inc (Oakwood, GA)
- Job Category:Nursing - Registered Nurse Work Shift/Schedule:8 Hr Morning - AfternoonNortheast Georgia Health System is rooted in a foundation of improving the ... to ensure appropriate feedback is received before product decisions are made. Utilization Review of necessity, quality, effectiveness and efficiency of medical… more
- Trusted Resource Associates (TRA) (Palm Springs, CA)
- Trusted Resource Associates (TRA) is seeking a local contract nurse RN Utilization Review for a local contract nursing job in Palm Springs, ... California.Job Description & RequirementsSpecialty: Utilization ReviewDiscipline: RNStart Date: 09/25/2024Duration: 13 weeks40 hours per...Contract security compared to with an outside agency. The RN Case Manager is responsible to facilitating… more
- ICONMA (Kentfield, CA)
- …Active CA RN License Certifications/Requirements: BLS/BCLS Must have strong Utilization Review and InterQual experience required! Minimum Years of ... Requirements: Must have strong Utilization Review and InterQual experience required! Conducting patient initial assessments Acute Care hospital experience EPIC… more
- ICONMA (Kentfield, CA)
- Requirements: Must have strong Utilization Review and InterQual experience required! Conducting patient initial assessments Acute Care hospital experience EPIC ... EMR documentation experience Active CA RN License Shift Information: Day shift (0800-1630), Monday thru Friday Minimum Years of Experience: 2… more
- Pacer Staffing (Atlanta, GA)
- …regulatory requirements, and HIPAA privacy regulations. . Thorough knowledge of Case Management, Utilization Management, HIPAA Privacy and Security regulations. ... Provides Disease Management (DM) services to TRICARE beneficiaries. . The DM nurse will collaboratively assess, plan, implement, coordinate, monitor and evaluate the… more
- Blanchard Valley Health System (Findlay, OH)
- …to the Acute Care Transitions Team, including the disciplines of Social Work, Case Management, Utilization Review , and Emergency Department Care Navigation ... during acute care stay. Duty 9: Maintains position as Utilization Review committee chair. Works in collaboration...service area. REQUIRED QUALIFICATIONS Current Ohio Licensure as a Registered Nurse Nursing experience 5+ years, 2-4… more
- Pacer Staffing (Atlanta, GA)
- …state or territory of the United States, as a Licensed Clinical Social Worker or Registered Nurse US Citizenship Must be able to receive a favorable Interim and ... syndrome, serious disabilities, physical disabilities.) Job Summary: The position provides case management services for TRICARE beneficiaries registered in the… more
- Equiliem (Orange, CA)
- …position such as those listed above may also be qualifying.Preferred Prior authorization/ utilization review experience. Managed care experience. Post degree ABA ... Health experience. The Care Manager is responsible for the oversight and review of Behavioral Health Treatment (BHT) including Applied Behavior Analysis (ABA)… more
- Accounting Now (Carson City, NV)
- …(ABA) services only, and there is licensed staff supervisionPrevious experience in case management/ utilization management with a broad range of experience with ... and outpatient professional treatment health benefits through telephonic or written review Will use appropriate screening criteria knowledge and clinical judgment to… more
- Staffing Now (Carson City, NV)
- …(ABA) services only, and there is licensed staff supervision. Previous experience in case management/ utilization management with a broad range of experience with ... and outpatient professional treatment health benefits through telephonic or written review . Will use appropriate screening criteria knowledge and clinical judgment… more
- Trinity Health (Mason City, IA)
- …its goals **Hours:** Monday-Friday 0630-1430; no weekends or holidays **About The Job** The Utilization Review Case Manager responsibilities include case ... **What We Are Looking For** Education [formal]: + Licensed registered nurse in the state of Iowa....of Iowa. + Bachelor's Degree required. BSN preferred + Utilization management focused certifications that are recognized in the… more
- Cedars-Sinai (Los Angeles, CA)
- …named us one of America's Best Hospitals! **What You Will Do in This Role:** The Utilization Review Case Manager validates the patient's placement to be at ... Manager follows the UR process as defined in the Utilization Review Plan in accordance with the...from an accredited nursing program required. Bachelors Degree in Nurse preferred. California RN License required. **Experience:**… more
- Baptist Memorial (Memphis, TN)
- …referral program Job Summary: Position: 19738 - RN - Utilization Review Facility: BMHCC Corporate Office Department: HS Case Mgmt Administration Corporate ... Summary The Utilization Review Nurse is...against standard criteria per payer guidelines + Prioritizes observation case review + Assists with level of… more
- Fairview Health Services (St. Paul, MN)
- …role (grandfather status) + Current RN licensure in MN + 3-5 years utilization review or case management experience in hospital, clinic, insurance ... meets regulatory requirements. Participates in interdisciplinary communication related to utilization review issues. Educates on status. Provides all… more
- Prime Healthcare (Ontario, CA)
- …strategic leadership, development, and supervision to utilization review department, provides interprofessional collaboration with facility-based case ... A minimum of seven (7) years' experience in Clinical Utilization Review or Case Management...with a large Health Plan + An active CA Registered Nurse license + Current BCLS (AHA)… more
- Actalent (Rancho Cordova, CA)
- …indicated, timely verbal and written documentation, and completion of the file Skills: Utilization review , Case management, Acute care, Prior authorization, ... Concurrent review , Discharge planning, Epic Additional Skills & Qualifications: CA RN License Five or more year's clinical experience required. Three to five… more
- ChenMed (St. Petersburg, FL)
- …continuity of care and cost effectiveness through the integrating and functions of case management, utilization review and discharge planning. The incumbent ... related field preferred + Valid, active licensure as professional nurse ( RN , LPN or other nursing discipline)...nursing discipline) required + A minimum of 7 years' utilization review / case management experience, including… more
- Mohawk Valley Health System (Utica, NY)
- Registered Nurse - Case Management - Full Time - Days Department: CASE MANAGEMENT Job Summary Reports to and is under direct supervision of Case ... regulatory compliance. Education/Experience Requirements Required: + Minimum of two (2) years utilization review / case management experience or social work… more
