- Baptist Memorial Health (Southaven, MS)
- …BMH - Desoto Hospital Department: DC Case Management Admin BMH Desoto Category: Nurse RN Type: Clinical Work Type: Full Time Work Schedule: Days Location: ... of patients throughout the continuum of care for appropriate utilization of resources, service delivery and compliance with federal...Diploma or Associate Degree in Nursing Experience Preferred : RN with 3 years of clinical experience with Case… more
- Baptist Memorial Health (Memphis, TN)
- Summary Manages resource utilization and communication to achieve the organizational goals. Has direct supervisory accountability for all positions, employees, ... Experience Minimum : 5 years nursing with 1 year of management experience in related field. Leadership experience utilizing problem-solving methodologies. Licensure,… more
- VitalCore Health Strategies (Ogden, UT)
- …REQUIREMENTS Bachelor's degree in healthcare administration/related field. Licensed Registered Nurse . Minimum of two (2) years of management experience in ... has an opening for a Health Services Administrator / Registered Nurse at Weber County Correctional Facility...make a difference in this field! HEALTH SERVICES ADMINISTRATOR ( RN ) BENEFITS PACKAGE: Holiday Pay: New Year's Day, Martin… more
- University Health (San Antonio, TX)
- …of Nurse Examiners of the State of Texas to practice as a registered nurse is required. National certification in related field is desirable. Case Manager ... Graduation from an accredited school of nursing with current RN licensure in the State of Texas, BSN preferred....full time hospital experience preferred. Work experience in case management , utilization review, or hospital quality assurance… more
- University Health (Hondo, TX)
- …of Nurse Examiners of the State of Texas to practice as a registered nurse is required. National certification in related field is preferred. Case Manager ... Three years recent, full-time hospital experience preferred. Work experience in case management , utilization review or hospital quality assurance experience is… more
- The Laurels of Fulton (Perrinton, MI)
- …current with American Association of Nursing Assessment Coordinators (AANAC) requirements. Qualifications Registered Nurse ( RN ) AANC certification a plus. ... coordination for guests. The MDS Coordinator supervises the Care Management Nurse , MDS Nurse . The...PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management… more
- Katmai (Fort Carson, CO)
- …Red Cross. + Three (3) years within the last four (4) years as a registered nurse in utilization management . + One (1) year of experience in UR/UM and ... Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE...full, active, and unrestricted license to practice as a registered nurse . + Must be a graduate… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of ... productivity and gain efficiencies for performance improvement opportunities in the Utilization Management Department. + Assists in updating departmental… more
- UNC Health Care (Morrisville, NC)
- …the unique communities we serve. **Summary** : The **Executive System Director of Utilization Management (UM)** is a strategic and operational leader responsible ... for designing, implementing, and standardizing utilization management functions across a large healthcare system, including a complex academic health system and… more
- Alameda Health System (Oakland, CA)
- Director, Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + ... plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight,… more
- McLaren Health Care (Port Huron, MI)
- …related duties as required and directed. **Qualifications:** Required ⦁ State licensure as a registered nurse ( RN ) ⦁ Bachelor's degree in nursing from ... as Assigned:** 1. Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure that appropriate… more
- McLaren Health Care (Flint, MI)
- …to help people live healthier and more satisfying lives. We are looking for a Utilization Management RN , to join in leading the organization forward. MHP ... service to all our members. **Position** **Summary:** This position is responsible for utilization management functions. This includes but is not limited to… more
- CVS Health (Carson City, NV)
- …1 holiday per year). There is no travel expected with this position. As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... with heart, each and every day. **Position Summary** **This Utilization Management (UM) Nurse Consultant... function. **Required Qualifications** -Must reside in PST zone. - RN with active and unrestricted state licensure in state… more
- Alameda Health System (San Leandro, CA)
- Clinical Nurse III, Acute Inpatient Behavioral Health Utilization Management + San Leandro, CA + John George Psychiatric Hospital + JGP Care Coordination + ... fields in EHR. 17. Maintains current knowledge of clinical practice and Utilization Management by literature review, membership in a professional organization.… more
- CVS Health (Baton Rouge, LA)
- …we do it all with heart, each and every day. **Position Summary** The Utilization Management Manager of Prior Authorization oversees a team of clinical ... professionals to ensure the efficient, compliant, and high-quality delivery of utilization management processes. This leader supports organizational goals by… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** The Clinical Product Consultant for Utilization Management is a member of the Customer Success Organization who will provide clinical ... best practice workflows. We are specifically seeking an experienced Utilization Review Nurse who will serve as...acute care setting + 2+ years of experience in utilization management + Knowledge and understanding of… more
- CVS Health (Columbus, OH)
- …and type on the computer. **Preferred Qualifications** Utilization Management experience preferred **Education** Diploma RN acceptable; Associate degree/BSN ... quality expectations as established by UMNC. **Required Qualifications** + Registered Nurse + 3+ years of experience...in acute or post-acute setting, and 1+ years of Utilization Management / Care Management … more
- CVS Health (Phoenix, AZ)
- …a meaningful difference in the lives of patients? Join Mercy Care as a Utilization Management Clinical Consultant and become part of a mission-driven team that's ... weekends or holidays) Location: 100% Remote (Must have Arizona RN license or compact license that includes Arizona.) Candidate...in ER, ICU, or Critical Care preferred. + Managed Care/ Utilization Management experience. + Experience with Claims… 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 ... achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- Highmark Health (Harrisburg, PA)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... setting **Preferred** + Experience in UM/CM/QA/Managed Care + Medical/Surgical experience + Utilization Management (UM) or (UR) Utilization Review experience… more
