- 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 ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** Utilizing key principles of utilization management , the Utilization Review Specialist will perform prospective, ... Practical Nurse - State Licensure Upon Hire Required + CNS-Clinical Nurse Specialist Preferred **Experience:** 5 years Clinical nursing experience. 2 years… more
- Cleveland Clinic (Vero Beach, FL)
- …Manager. May design and initiate special projects as supervised by the Team Manager. Utilization Management Specialist Join our team at Cleveland Clinic ... stay or visit. Some of the responsibilities of a Utilization Management Specialist include medical...professional nursing. + Current state licensure as a Registered Nurse (RN). + Basic Life Support (BLS) certification through… more
- BayCare Health System (Clearwater, FL)
- …responsibility and clinical excellence. **BayCare Health System** is currently seeking a ** Utilization Review Specialist Senior** to join our outstanding and ... compassionate team. **The Utilization Review Specialist Senior responsibilities include:** +...Nursing RN. **Certifications and Licensures:** + Required RN (Registered Nurse ) + Preferred ACM (Case Management ) +… more
- Munson Healthcare (Traverse City, MI)
- …of resources. + Assists in developing and revising policies to support utilization management activities, including criteria and guidelines for appropriate use ... colleagues and hospital associates at information meetings. + May represent Utilization Management on various committees, professional organizations, physician… more
- Katmai (Usaf Academy, CO)
- …(BSN) is required. + Minimum of two (2) years of prior experience in Utilization Management . + Must possess a current, active, full, and unrestricted Registered ... licensed in Colorado, be able to practice using a nurse compact state license or have a license from...checks. **DESIRED QUALIFICATIONS &** **SKILLS** + Certification by a Utilization Management -specific program such as Certified Professional… more
- Dayton Children's Hospital (Dayton, OH)
- … Review TeamSchedule:Full timeHours:40Job Details:Under the supervision of the Manager of Utilization Management , the Utilization Review RN conducts medical ... and communicates information to payers in accordance with contractual obligations. The Utilization Review RN serves as a resource to the physicians, collaborates… more
- Trinity Health (Ann Arbor, MI)
- …clinical, age specific, developmental, cultural and spiritual needs. Facilitates utilization management documentation and appropriate communication with external ... current knowledge of rules, regulations, policies, and procedures related to utilization management work processes and criteria. + Communicates information,… more
- Veterans Affairs, Veterans Health Administration (Hines, IL)
- …and Quality Specialist (AQS) Consultant Nurse serves as a Specialist within the Accreditation & Quality Management Programs. Serves as the point ... Summary The Accreditation and Quality Specialist (AQS) Consultant Nurse demonstrates leadership...with the Patient Safety, HRO, Innovation, Systems Redesign, Risk Management , Infection Control and Utilization Management… more
- MyFlorida (Marianna, FL)
- REGISTERED NURSE SPECIALIST - 67039438 - Sunland - Day Shift Date: Nov 12, 2024 The State Personnel System is an E-Verify employer. For more information click on ... Agency: Agency for Persons with Disabilities Working Title: REGISTERED NURSE SPECIALIST - 67039438 - Sunland -...dynamics. This position with APD will serve staff and management across the Agency. Your work will impact the… more
- MyFlorida (Gainesville, FL)
- REGISTERED NURSE SPECIALIST -F/C - 60005472 Date: Nov 5, 2024 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... Requisition No: 797758 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST -F/C - 60005472 Position Number: 60005472 Salary:… more
- LA Care Health Plan (Los Angeles, CA)
- …Grievance (A&G) program for LA Care Health Plan members under the direct supervision and management of the A&G Nurse Specialist , RN and/or Medical Director. ... Customer Solution Center Appeals and Grievances Nurse Specialist LVN II Job Category:...documentation in the A&G system of record. Work with Utilization Management and PNO to facilitate completion… more
- MyFlorida (Macclenny, FL)
- REGISTERED NURSE SPECIALIST OPS - 60955422 Date: Nov 22, 2024 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... . Requisition No: 772103 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST OPS - 60955422 Position Number: 60955422 Salary: $45.00… more
- Northwell Health (Bay Shore, NY)
- …and transfer of patients to the facility. Job Responsibility + Promotes optimum utilization of hospital beds; conducts rounds and meets with staff regarding bed ... is complete, and ensures hand-off of communication to accepting nurse . + Ensures beds are assigned based on level...of technical experience and 0-2 years of leadership / management experience, required. *Additional Salary Detail The salary range… more
- ManpowerGroup (Rancho Cucamonga, CA)
- … Department. + Communicate with providers in consultation with the Utilization Management Nurse , regarding authorizations, modifications, denials, ... **Job Title: Utilization Management Outpatient** **Duration: 6 months**...three (3) years of experience as a data entry specialist or coordinator + High school diploma or GED… more
- MyFlorida (Chattahoochee, FL)
- REGISTERED NURSE SPECIALIST -F/C OPS - 60953529 Date: Nov 4, 2024 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... No: 817418 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST -F/C OPS - 60953529 Pay Plan:...knowledgeable of and utilize the principles of Total Quality Management . The employee in this position spends a minimum… more
- Cambridge Health Alliance (Cambridge, MA)
- Nurse Practitioner - Clinical Specialist II (APRN), Psychiatry Apply (https://careers.chaproviders.org/clinical- specialist -2-psychiatry) Refer a Friend Back ... is required authorizing practice in an expanded role as a Psychiatric Nurse Clinical Specialist and authorization including prescriptive authority. _In keeping… more
- Health First (Rockledge, FL)
- …necessary to establish appropriateness. * Demonstrates knowledge of accreditation and regulatory Utilization Management and Case * Management standards and ... analytical and problem solving skills. * Ability to think critically in an Utilization Management and Case Management setting, define and identify… more
- Lucile Packard Children's Hospital Stanford (Palo Alto, CA)
- …work experience License/Certification: CA Registered Nurse (RN), CNS - Clinical Nurse Specialist certified by the California Board of Registered Nursing. ... summarizes the general nature, level and purpose of the job. Clinical Nurse Specialists are Master's Degree prepared advanced practice Registered Nurses in roles… more
- Bon Secours Mercy Health (Richmond, VA)
- …Masters degree from an accredited school of Nursing. + Currently registered as a Clinical Nurse Specialist , licensed as a Nurse Practitioner or eligible to ... excellence. Job Description **Primary Function/General Purpose of Position** The Advanced Practice Nurse (APN) at St. Mary's Hospital is a professional nurse … more