- 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
- Texas Health Resources (Arlington, TX)
- **RN/ Registered Nurse - Utilization Management , Clinical Reviews** **Work location:** 100% remote but must live in Texas, preferably in the Dallas-Fort ... an acute hospital setting required and + 1 Year Utilization Management required and + Experience in...necessity criteria preferred **Licenses and Certifications** + RN - Registered Nurse Current license to practice professional… more
- Matrix Providers (Aurora, CO)
- Registered Nurse (RN) - Utilization Management Location: Aurora, CO, United States Healthcare Provider Type : Nursing START YOUR APPLICATION ... and fair, reliable schedules. Matrix Providers is hiring a Registered Nurse (RN) - Utilization Management to join our team of talented professionals who… more
- VNS Health (Manhattan, NY)
- …and updates through on-going training, coaching and educational materials. + For Utilization Management Only: + Issues Determinations, Notices of Action, and ... by state or federal regulations are saved in the Utilization Management System. + Reviews, evaluates and...and Certifications: + Current license to practice as a Registered Professional Nurse or an Occupational Therapist… more
- Crouse Hospital (Syracuse, NY)
- …health education and outreach programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse (RN) to track and ... 8:00am-4:30pm with occasional weekends (typically requires 6 weekends a year). Utilization Management Registered Nurse (RN) Position Responsibilities: +… more
- Trinity Health (Syracuse, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** The RN Utilization Management Nurse Coordinator is responsible for both concurrent and ... outcomes are achieved, and high-quality professional practice is realized. **Position Purpose:** Registered Nurse Coordinator is a dynamic leadership role that… more
- Prime Healthcare (Weslaco, TX)
- …#registerednurse #casemanagement Connect With Us! (https://careers-primehealthcare.icims.com/jobs/188814/ registered - nurse -case-manager utilization - ... Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC\_KnowYourRights\_screen\_reader\_10\_20.pdf Responsibilities Responsible for the quality and resource management of all patients that are admitted to the… more
- Ellis Medicine (Schenectady, NY)
- Basic Function: The Utilization Management Registered Nurse (UM RN) supports daily coordination of care across healthcare continuum with the healthcare ... preoperative, concurrent and retrospective reviews in accordance with the utilization management program. The UM RN ensures...care related field required. Current registration as a Licensed Registered Professional Nurse in New York State.… more
- AdventHealth (Daytona Beach, FL)
- …Daytona Beach, FL 32117 **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse (RN) is to use clinical expertise by ... + Current and valid license to practice as a Registered Nurse + Minimum three years acute...acute care clinical nursing experience + Minimum two years Utilization Management experience + Excellent interpersonal communication… more
- Molina Healthcare (Reno, NV)
- …Time Zone hours** **KNOWLEDGE/SKILLS/ABILITIES** + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management ... them. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN) Program and Associate's or...years of experience in case management , disease management or utilization management in… more
- Cleveland Clinic (Weston, FL)
- Utilization Management Specialist Join Cleveland Clinic Weston Hospital's team of caregivers that remain on the leading edge of technology and education all ... of the most respected healthcare organizations in the world. Utilization Management (UM) Specialists perform UM activities,...of professional nursing. + Current state licensure as a Registered Nurse (RN). + Basic Life Support… more
- Ascension Health (Wamego, KS)
- …and coordinate compliance to federally mandated and third party payer utilization management rules and regulations. **Requirements** Licensure / Certification ... offer._ **Responsibilities** Provide health care services regarding admissions, case management , discharge planning and utilization review. +.../ Registration: + Licensed Registered Nurse credentialed from the Kansas Board… more
- Humana (Lexington, KY)
- …and help us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Nurse 2 who will utilize clinical nursing skills to ... benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work...30 miles of Lexington or Louisville, Kentucky.** + Licensed Registered Nurse (RN) in the state of… more
- Humana (Dublin, OH)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...an impact** **Required Qualifications** + Bachelor's degree + Licensed Registered Nurse (RN) in the state of… 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 ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse (RN) - Active, current and… more
- CVS Health (Albany, NY)
- …weeks of training will be Monday through Friday, 8:00am to 5:00pm EST. As a Utilization Management Nurse Consultant you will utilize clinical experience and ... of residence + 3+ years of experience as a Registered Nurse + 1+ year(s) of Med/Surg...to 7:00pm EST with holiday rotation per business needs. Utilization Management is a 24/7 operation and… more
- CVS Health (Montgomery, AL)
- …operation and work schedules may include weekends, holidays, and evening hours As a Utilization Management Nurse Consultant, you will utilize clinical skills ... **Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current...of clinical experience in acute or post-acute setting + Utilization management is a 24/7 operation. Work… more
- Humana (Columbus, OH)
- …and help us put health first** Humana Healthy Horizons in Ohio is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to support ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CVS Health (Tallahassee, FL)
- …members sign up to work one major and one minor holiday yearly. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, ... health care more personal, convenient and affordable. **Position Summary:** Utilization Management is a 24/7 operation and...**Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current… more
- CVS Health (Trenton, NJ)
- …more personal, convenient and affordable. **Position Summary** This is a fulltime remote Utilization Management Nurse Consultant opportunity. Utilization ... external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working...of residence + 3+ years of experience as a Registered Nurse working in ER, Med/Surg, and/or… more