- Novo Nordisk Inc. (Atlanta, GA)
- …relationships include key opinion leaders (KOL's), academic institutions, physicians, nurse practitioners, advocacy group leaders, pharmacists, blood bank staff, ... policies, legal, regulatory, and compliance requirements Ensures effective administrative management of regional business as well as operational budgets Maintains… more
- VNS Health (Manhattan, NY)
- VNS Health is seeking a Registered Nurse (RN) Utilization Review for a nursing job in Manhattan, New York.Job Description & RequirementsSpecialty: ... interdepartmental quality improvement activities such as development and engagement, clinical review , clinical risk management , and patient satisfaction. Serves… more
- GHR Healthcare (Atlanta, GA)
- …making critical decisions that impact patient care? Join us as a Care Management Coordinator and play a key role in evaluating and authorizing essential healthcare ... Pay Rate: 37.50 -40.00 Hourly (paid weekly) What You'll Do: Clinical Analysis: Review medical records to determine the necessity of patient services based on… more
- Trusted Resource Associates (TRA) (Palm Springs, CA)
- Trusted Resource Associates (TRA) is seeking a local contract nurse RN Utilization Review for a local contract nursing job in Palm Springs, California.Job ... Description & RequirementsSpecialty: Utilization ReviewDiscipline: RNStart Date: 09/25/2024Duration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type:… more
- Northeast Georgia Health System, Inc (Oakwood, GA)
- …to ensure appropriate feedback is received before product decisions are made. Utilization Review of necessity, quality, effectiveness and efficiency of medical ... Job Category:Nursing - Registered Nurse Work Shift/Schedule:8 Hr Morning - AfternoonNortheast Georgia Health System is rooted in a foundation of improving the health… more
- Northeast Georgia Health System, Inc (Braselton, GA)
- Job Category:Nursing - Registered Nurse Work Shift/Schedule:8 Hr Morning - AfternoonNortheast Georgia Health System is rooted in a foundation of improving the health ... Center of Excellence in Minimally Invasive Surgery and Robotic Job SummaryThe Nurse Manager (NM) functions as the first-line administrative nursing leader, with… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …team members as needed to ensure services will be covered.Coordinate and communicate with Utilization Review Nurse on a daily, consistent basis to ensure ... Job Category:Nursing - Registered Nurse Work Shift/Schedule:8 Hr Morning - AfternoonNortheast Georgia...patient needs; Works collaborate with the Physicians, patient/family, nursing, utilization review and other members of the… more
- Protouch Staffing - Permanent (El Paso, TX)
- …and retrospective review of patient medical records for purposes of utilization review , compliance with requirements of external review agencies ... Protouch Staffing - Permanent is seeking a Registered Nurse (RN) Case Management for a nursing job in EL Paso, Texas.Job Description & RequirementsSpecialty:… more
- Russell Tobin & Associates (Remote, OR)
- …4 Month Contract You will be responsible for providing non-clinical support to the utilization management team in maintaining and managing the utilization ... manner consistent with policies and procedures as described in the Utilization Management plan. Responsibilities: Consistently exhibits behavior and… more
- Blanchard Valley Health System (Findlay, OH)
- …the Acute Care Transitions Team, including the disciplines of Social Work, Case Management , Utilization Review , and Emergency Department Care Navigation to ... during acute care stay. Duty 9: Maintains position as Utilization Review committee chair. Works in collaboration...staff, equipment, and services. Duty 12: Maintains computerized record management systems to store and process data to produce… more
- VNS Health (Manhattan, NY)
- …understanding of the community's needs.Oversees the implementation and monitoring of utilization review and quality management procedures, while ... efficient manner.Engages in and contributes to the interdisciplinary team's utilization management activities and recommended interventions for… more
- Pacer Staffing (Atlanta, GA)
- … Utilization Review Certification or Certified Professional Utilization Management Certification Experience in UM policy writing, development, ... Job Description: Summary: This individual contributor position reports to the Directors of Utilization Management (UM) and Referral Management (RM) and… more
- Pacer Staffing (Atlanta, GA)
- …description Job Summary This individual contributor position reports to the Directors of Utilization Management (UM) and Referral Management (RM) and ... Nurse , with current unrestricted license in appropriate state . 4+ years Utilization Management experience . Proficient at in-depth analysis of clinical… more
- Pacer Staffing (Atlanta, GA)
- …regulatory requirements, and HIPAA privacy regulations. . Thorough knowledge of Case Management , Utilization Management , HIPAA Privacy and Security ... Job Summary . Provides Disease Management (DM) services to TRICARE beneficiaries. . The... (DM) services to TRICARE beneficiaries. . The DM nurse will collaboratively assess, plan, implement, coordinate, monitor and… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …administration identify areas of further savings.Assist Clinical Coordinator with FTE utilization and management .Serves as primary liaison between referral ... therapy skills Essential Tasks and ResponsibilitiesWorks with the Clinical Coordinator and Nurse Manager to develop patient schedules for inpatient, DPH and IOP… more
- Pacer Staffing (Atlanta, GA)
- …direction and build group engagement. Technical Skills: Thorough knowledge of Case Management , Utilization Management , TRICARE policies and procedures, HIPAA ... serious disabilities, physical disabilities.) Job Summary: The position provides case management services for TRICARE beneficiaries registered in the Extended Care… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …of our communities. About the Role:Job SummaryResponsible for the systematic review of patient throughput including evaluating and implementing strategies and ... meet established metrics, improve handoffs, reduce daily crisis regarding bed management , improve overall flow and drive the throughput policies and procedures.… more
- Humana (Montgomery, AL)
- …documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are ... a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the… more
- UCLA Health (Los Angeles, CA)
- …leader with: + Current CA LVN licensure required + Two or more years of utilization review / utilization management experience in an HMO, MSO, IPA, ... and guidelines in the issuance of adverse organization determinations. You will review for appropriate care and setting while working closely with denial… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs daily medical necessity reviews. This ... + Adaptive to a high pace and changing environment. + Proficient in Utilization Review process including benefit interpretation, contract language, medical and… more
