- Prime Healthcare (Weslaco, TX)
- …#registerednurse #casemanagement Connect With Us! (https://careers-primehealthcare.icims.com/jobs/188814/registered- nurse - case -manager utilization - ... (RN) degree in a related field. At least one year experience in case management , discharge planning or nursing management ;2. CCM or obtained within 6… more
- Community Health Network (Indianapolis, IN)
- …promote continuity of care and cost effectiveness through the integrating and functions of case management , utilization review and management and ... Registered Nurse (RN) Case Manager/ Utilization...Registered Nurse (RN) Case Manager/ Utilization Review - North...North Emergency Job Ref 2408203 Category Nursing Job Family Case Manager Department Case Management … more
- Matrix Providers (Aurora, CO)
- Registered Nurse (RN) - Utilization Management ...and 12 months consecutive experience in utilization management , utilization review or case ... lower provider-to-patient ratios and fair, reliable schedules. Matrix Providers is hiring a Registered Nurse (RN) - Utilization Management to join our team… more
- Veterans Affairs, Veterans Health Administration (Seattle, WA)
- …customer satisfaction throughout the continuum of care. Duties include but not limited to: The Nurse Utilization Management (UM) Registered Nurse (RN) is ... Summary Registered Nurse (RN) Utilization Management ...inpatient direct patient care Bachelor of Science in Nursing Case Management Experience Utilization … more
- Scottish Rite for Children (Dallas, TX)
- …We're committed to giving children back their childhood! Job Posting Title: Director of Case Management and Utilization Management Location: Dallas - ... Details: Monday - Friday 8:00am to 4:30pm Job Description: Duties/Responsibilities: + Utilization Management supporting medical necessity and denial prevention +… 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 manage ... with occasional weekends (typically requires 6 weekends a year). Utilization Management Registered Nurse (RN)...(3) - Five (5) years acute hospital experience. + Case Management or Utilization … more
- VNS Health (Manhattan, NY)
- …for design and development of, processes and procedures for effective member case management , efficient department operations, and excellent customer service. + ... and updates through on-going training, coaching and educational materials. + For Utilization Management Only: + Issues Determinations, Notices of Action, and… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN...an acute hospital setting. At least 2 years of Utilization Management / Case Management experience ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN...Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, post-service and retrospective claims… 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 ... services and/or benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work assignments are varied… more
- LifePoint Health (Danville, VA)
- *Registered Nurse , RN - Utilization Review Case Manager* Job Type:Full Time|Days *$10,000 Sign-on Bonus Eligibility for Full-Time, Bedside RNs* ** Must have ... . Professional development and growth opportunities *Department/Unit Summary* Our Case Management Department primarily serves the adult...offering safe discharge planning is the use of a Utilization RN and Case Manager RN, in… more
- Baptist Memorial (Jackson, MS)
- …19738 - RN- Utilization Review Facility: MBMC - Hospital Department: HS Case Mgmt Administration Corporate Category: Nurse RN Type: Clinical Work Type: ... Summary The Utilization Review Nurse is responsible for...management , medical necessity reviews, verification of authorization, resource utilization , and denial prevention. Responsibilities + Completes and enters… more
- Signature Healthcare (Louisville, KY)
- …the MDS RUG system. Previous experience with MDS and assessment preferred Hospital Case Management /Hospital Utilization Management . Obtaining ... communication with leadership, patients, families, internal care givers, and external Utilization Management Nurses. + Coordinate internal and external health… more
- CVS Health (Columbus, OH)
- …within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Utilizes clinical experience and skills in a… more
- Prime Healthcare (Redding, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/189120/** case -manager srmc- utilization - management ... accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum...nursing experience preferred. At least one year experience in case management , discharge planning or nursing … more
- Prime Healthcare (National City, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/187724/ case -manager-rn utilization - management ... accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum...nursing experience preferred. At least one year experience in case management , discharge planning or nursing … more
- Martin's Point Health Care (Portland, ME)
- …level of care at the appropriate place and time + Mentors new staff into case management role as assigned. + Assumes extra duties as assigned based on ... "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member...preferred. + 3+ (total) years clinical nursing experience + Utilization management experience in a managed care… more
- Covenant Health (Bangor, ME)
- … Case Manager will work collaboratively with other members of the healthcare team. The nurse case manager also acts as an advocate for the patient and assists ... in providing information regarding their insurance coverage. The UR Nurse Case Manager conducts medical necessity reviews in accordance with the Utilization … more
- Glens Falls Hospital (Glens Falls, NY)
- …be foundhere. **Job:** **Nursing - Case Management * **Title:** *RN - Utilization Review Nurse * **Location:** *NY-Glens Falls* **Requisition ID:** *2410V* ... accurate information to payers. The role integrates and coordinates utilization management and denial prevention by focusing...degree RN with relevant experience and obtains certification in case management (CCM or ACM) within 1… more
- State of Connecticut, Department of Administrative Services (Hartford, CT)
- Utilization Review Nurse (40 Hour) Office/On-site Recruitment # 250102-5612FP-001 Location Hartford, CT Date Opened 1/6/2025 12:00:00 AM Salary $78,480 - ... and Addiction Services ( DMHAS (https://portal.ct.gov/DMHAS/About-DMHAS/Agency/About-DMHAS) ) as a Utilization Review Nurse (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5612FP&R1=&R3=) ! Bring your… more
- Independent Health (Buffalo, NY)
- …Collaborative and Accountable. **Essential Accountabilities** Provide High Quality, Professional Utilization Management Services: (Medical necessity review for ... + Prompt, courteous, professional and error free in performing utilization management functions. + Available to answer...disposition of cases - MD reviews, chart reviews, audits, case management referrals, etc. Provide Technical and… more