- Sanford Health (Sioux Falls, SD)
- …experience. Minimum of three years nursing experience is required. Currently holds an unencumbered registered nurse ( RN ) license with the State Board of ... utilization and potentially, prior authorization. Assists the department in monitoring the utilization of resources, risk management and quality of care for… more
- Ascension (Baltimore, MD)
- …experience, location, qualifications and comparison with associates in similar roles Registered Nurse , Certified Case Manager (CCM, ACM, URAC) preferred ... training, directing, development and evaluation of staffRequirements Licensure / Certification / Registration: Registered Nurse obtained prior to hire date or job… more
- Ascension (Towson, MD)
- …performance and salary range at the time of the offer.Responsibilities Manage assigned Registered Nurse ( RN ) case managers, related activities and workflow ... for complexcase management issues.Requirements Licensure / Certification / Registration: Registered Nurse credentialed from the Maryland Board of Nursing… more
- Penn State Health (Hershey, PA)
- …status, and family medical or genetic information._ **Union:** SEIU Healthcare Pennsylvania **Position** Utilization Management Specialist - DAY SHIFT - ... maintaining compliance with the CMS Conditions of Participation for Utilization Management . **MINIMUM QUALIFICATIONS:** + Bachelors Degree...setting required. + Currently licensed to practice as a Registered Nurse by state of employment or… 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...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- Vanderbilt University Medical Center (Nashville, TN)
- …through preeminent programs in patient care, education, and research. **Organization:** Utilization Management 20 **Job Summary:** JOB SUMMARY Facilitates ... instead of emphasizing negative elements. **Position Qualifications:** **Responsibilities:** **Certifications:** LIC- Registered Nurse - Licensure-Others **Work Experience:** Relevant… more
- AdventHealth (Altamonte Springs, FL)
- …telephonically, also support telephonically. **The role you'll contribute:** The Care Transitions Registered Nurse ensures that a care plan is carried out ... various other teams, including but not limited to Care Management nurses and social workers, nursing, home care liaisons,...State of Florida or multi state license as a Registered Nurse + Basic Life Support (BLS)… more
- AdventHealth (Orlando, FL)
- …inpatients and 125,000 outpatients each year **The role you'll contribute:** **The Care Transitions Registered Nurse ensures that a care plan is carried out in ... various other teams, including but not limited to Care Management nurses and social workers, nursing, home care liaisons,...State of Florida or multi state license as a Registered Nurse + Basic Life Support (BLS)… more
- Geisinger (Pittston, PA)
- …within 3 years of hire - American Nurses Credentialing Center (ANCC); Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania; Basic Life Support ... and ongoing maintenance of New Manager Training Program, Ambulatory Nurse Leader program, and developing, implementing, and maintaining ongoing professional… more
- LifePoint Health (Henderson, NC)
- …or local law. **Job:** **Case Management /Social Services* **Organization:** ** **Title:** * Registered Nurse ( RN ) Case Manager Full Time* **Location:** ... Registered Nurse ( RN ) Case Manager Up to...in the lives of those we serve. Connect with our RN recruiting specialist . Do you need more time to… more
- AdventHealth (Orlando, FL)
- …experiences you'll need to succeed:** **EDUCATION AND EXPERIENCE REQUIRED:** + Associates Degree Nursing or RN Diploma degree + Registered Nurse ( RN ) + ... documents avoidable days, and facilitates progression of care. Collaborates with Utilization Management staff for collaboration on patient status changes… more
- MyFlorida (Gainesville, FL)
- REGISTERED NURSE SPECIALIST -F/C -...Evaluation and Treatment Center is looking for a skilled RN to join our team, providing comprehensive care and ... Requisition No: 843066 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST -F/C - 60032928...Ability to analyze complex reports and determine the service utilization habits of clients and to evaluate the appropriateness… more
- MyFlorida (Chattahoochee, FL)
- REGISTERED NURSE SPECIALIST -...dynamics. This position with APD will serve staff and management across the Agency. Your work will impact the ... . Requisition No: 837602 Agency: Agency for Persons with Disabilities Working Title: REGISTERED NURSE SPECIALIST - F/C - 67056731 APD/ DDDP… more
- University of Washington (Seattle, WA)
- …joining UW Medicine** **Harborview Medical Center** has an outstanding opportunity for a ** Registered Nurse ( RN )** to join our **Outpatient Specialized ... STEP team consists of 6 team members: a program director/family education specialist , therapist, psychiatrist, registered nurse , supportive employment and… more
- Veterans Affairs, Veterans Health Administration (Leeds, MA)
- Summary This Registered Nurse (Quality Management Accreditation Specialist ) position is located in the Quality and Patient Safety Services at the Leeds, ... , and evaluation of the facilities programs in risk management , clinical analysis, patient safety, utilization with...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- MyFlorida (Gainesville, FL)
- REGISTERED NURSE SPECIALIST -F/C OPS - 60957257 Date: Jan 28, 2025 The State Personnel System is an E-Verify employer. For more information click on our ... . Requisition No: 843860 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST -F/C OPS - 60957257 Pay… more
- AdventHealth (Orlando, FL)
- …+ Associate of Science degree in Nursing (ASN) + Current valid license as a Registered Nurse in the state of Florida + Two (2) years of medical/hospital ... satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily...+ Health-related Master's degree or MSN + Prior Care Management / Utilization Management experience + ACM/CCM… more
- St. Luke's University Health Network (Allentown, PA)
- …serve, regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials for medical ... near vision, visual monotony. EDUCATION: Graduate of an accredited professional nursing program. Registered nurse with current license to practice in the state… more
- Trinity Health (Farmington Hills, MI)
- …professional behavior. **MINIMUM QUALIFICATIONS** Must possess a demonstrated knowledge of denial management functions. Registered Nurse and a graduate of ... and reviews findings with all levels of Payment Resolution Specialist for further review. Serve as a resource to...and managed care. Knowledge of and experience in case management and utilization management . Knowledge… more
- Beth Israel Lahey Health (Milton, MA)
- …other related duties as required and directed. Qualifications: Required . Licensure as a Registered Nurse ( RN ), Massachusetts . Three years of recent ... and Responsibilities: 1. Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure that appropriate… more
