- CVS Health (Hartford, CT)
- …verbal and written **Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN licensure in state of ... residence + Must possess 1+ years of clinical experience in acute or post acute setting **Preferred Qualifications** + Managed Care experience **Education** + Associates Degree required + BSN preferred **Pay Range** The typical pay range for this role is:… more
- CVS Health (Columbus, OH)
- …management function. **Required Qualifications** * 3+ years of experience as a Registered Nurse * Must hold active and unrestricted RN licensure in state of ... Experience Medicare/Medicaid populations * MCG experience * Managed care experience * UM Certification * MedCompass **Education** * Minimum of an Associate's Degree… more
- US Tech Solutions (RI)
- …+ MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE 1 YEAR OF UTILIZATION ... MANAGEMENT EXP, pref. knowledge of Milliman/MCG. + MUST HAVE 6 months of Prior Authorization. **Education:** + RN with current unrestricted state licensure **About US Tech Solutions:** US Tech Solutions is a global staff augmentation firm providing a wide… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Clinical Quality Nurse Reviewer RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... required to achieve that purpose. Job Summary The Utilization Management Clinical Quality Nurse Reviewer RN II, under the purview the Utilization Management ( UM )… more
- ERP International (Corpus Christi, TX)
- …review, discharge planning, continued stay reviews, and appeal reviews. * Serve as consultant to all disciplines regarding UM issues. Provide nursing expertise ... **Overview** ERP International is seeking a **Registered Nurse (RN)** **Utilization Manager** for a full-time position in support of the **Naval Health Clinic Corpus… more
- Veterans Affairs, Veterans Health Administration (Chicago, IL)
- …and resources are used while maintaining quality of care. Responsibilities The Registered Nurse (RN) - Utilization Management ( UM ) is responsible for reviewing ... reviews, utilization case management, focused studies of utilization patterns and is a consultant to clinical and administrative staff for UM issues. This RN… more
- ERP International (Camp Pendleton, CA)
- **Overview** ERP International, LLC is seeking a **Registered Nurse - Case Manager** for a full-time position supporting **Branch Health Clinic Port Hueneme, CA** in ... and databases for community resources. * Integrate CM and utilization management ( UM ) and integrating nursing case management with social work case management. *… more
- University of Miami (Miami, FL)
- …Alex's Place Sylvester Cancer Center Sign-on Bonus: $25,000 T he Pediatric Chemotherapy Nurse will be a professional registered nurse who administers research ... process' in the Pediatric Hematology/Oncology Clinic. In addition, the Pediatric Chemotherapy Nurse may assist in sedations and procedures in the treatment room in… more
- Kepro (ND)
- …a vital partner for health solutions in the public sector. Acentra is looking for a Nurse (RN) Clinical Reviewer to join our growing team. Job Summary: Our Nurse ... for services. + Determines approval or initiates a referral to the physician consultant and processes physician consultant decisions ensuring reason for the… more
- LA Care Health Plan (Los Angeles, CA)
- …required to achieve that purpose. Job Summary The Supervisor of Utilization Management ( UM ) RN is responsible for executing the day-to-day operations of the UM ... overall performance metrics. The Supervisor ensures all functions of the UM department are operating in accordance with the organization's mission, values… more
- University of Michigan (Ann Arbor, MI)
- …In addition, the ED PA coordinates emergent and urgent care with consultant services, recommends follow-up care, facilitates referrals to various internal and ... posting or would like assistance with Physician Assistant opportunities please contact Nurse and Physician Assistant Recruitment at ### or e-mail [email protected] .… more
- Alameda Health System (Oakland, CA)
- …tracking variances based on critical timelines. + Develops and provides statistical UM information and reports to appropriate committees and in conjunction with the ... and/or techniques. + Review cases regularly with staff; acts as clinical consultant regarding care management issues; guides clinical staff with review of… more
- Alameda Health System (Oakland, CA)
- …of tracking variances based on critical timelines. -Develops and provides statistical UM information and reports to appropriate committees and in conjunction with ... equipment and/or techniques. -Reviews cases regularly with staff; acts as clinical consultant regarding care management issues; guides clinical staff with review of… more