- Lincoln Financial Group (Columbus, OH)
- …proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position...in a career at Lincoln, we encourage you to review our current openings and apply on our website.… 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 ... as an employee, but as a person. As a*registered nurse (RN)*joining our team, you're embracing a vital mission...in employment." **Job:** **Nursing* **Organization:** ** **Title:** *RN - Utilization Review Case Manager* **Location:**… more
- VHC Health (Arlington, VA)
- Case Manager/ Utilization Review Registered Nurse Job Description Purpose & Scope: The Case Manager is responsible for the collaborative process of ... and available resources to promote quality cost-effective outcomes. Additionally, the Case Manager ensures that identified and referred patients have a coordinated… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- Utilization Review Nurse Coordinator...utilization review including conducting second level review of cases and case referral to ... Region - is accepting applications for one (1) full-time Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=)… more
- Trinity Health (Silver Spring, MD)
- …management/supervision/leadership experience in an acute healthcare setting required, preferably with case management, utilization review or closely related ... **Shift:** **Description:** The Interim Manager of Care Management & Utilization Review , under the supervision and in...applicable):** + State of Maryland license as a Registered Nurse + RN with BSN or RN with >… more
- Baptist Memorial (Jackson, MS)
- Summary The Utilization Review Nurse is responsible for evaluating the medical necessity and appropriateness of healthcare services and treatment as ... prescribed by utilization review standards. The UR ...program Job Summary: Position: 19738 - RN- Utilization Review Facility: MBMC - Hospital Department: HS Case… more
- R1 RCM (Pittsburgh, PA)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. **Title: Utilization Review Nurse ** **Location: Hospital Client ... vary and some flexibility may be offered** As our ** Utilization Review Nurse ** , you...review , utilizing client-specific guidelines. Upon identification of a case , you will ensure that appropriate orders and clinical… more
- Providence (Kodiak, AK)
- …procedures and standards. The Case Manager/RN Navigator partners with the Utilization Review nurse , patients, physicians, and interdisciplinary team to ... needs for discharge planning, admission to swing bed and case management including utilization review ...Associate's Degree in Nursing + Upon hire: Alaska Registered Nurse License + 3 years Clinical nursing experience +… more
- Emory Healthcare/Emory University (Decatur, GA)
- …and leadership programs + And more **Description** We're seeking a **Clinical Utilization Review Nurse Preceptor** responsible for training, mentoring, ... and coaching for the Utilization Review Department. This individual: + Must...designation, notification and authorization, compliance and regulatory standards, and case management systems. + Be responsible for new hire… more
- Martin's Point Health Care (Portland, ME)
- …Point has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of a team responsible for ... retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use...appropriate place and time + Mentors new staff into case management role as assigned. + Assumes extra duties… more
- Trinity Health (Mason City, IA)
- …its goals **Hours:** Monday-Friday 0630-1430; no weekends or holidays **About The Job** The Utilization Review Case Manager responsibilities include case ... We Are Looking For** Education [formal]: + Licensed registered nurse in the state of Iowa. + Bachelor's Degree...of Iowa. + Bachelor's Degree required. BSN preferred + Utilization management focused certifications that are recognized in the… more
- Trinity Health (Fresno, CA)
- …Reporting to the Manager Social Services*, Social Services, this position coordinates utilization review service for defined patient populations across the acute ... care continuum. This includes discharge planning, utilization management, care coordination collaboration, and support...the facility's resources. 1. Current licensure as a Registered Nurse (RN) in the state of California is required.… more
- Ascension Health (Manhattan, KS)
- …health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests within ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
- MetroHealth (Cleveland, OH)
- …patient care by ensuring the appropriate level of care at the point of entry. The utilization review nurse will work on defined patient populations and is ... in Nursing (applies to placements after 1/1/2017). Current Registered Nurse License State of Ohio. Minimum of five years...time management skills. Preferred: Two years of experience with case management, utilization review . Physical… more
- Travelers Insurance Company (Buffalo, NY)
- …**What Is the Opportunity?** This position is responsible for conducting in-house utilization review with emphasis on determining medical necessity for ... do and where you do it. **Job Category** Claim, Nurse - Medical Case Manager **Compensation Overview**...to the compensable injury and for adhering to multi-jurisdictional Utilization Review criteria. **What Will You Do?**… more
- Pipeline Health System, LLC (Toast, NC)
- Job Title: Utilization Review Registered Nurse - Behavioral Health Unit/FT/Days Job Summary: This Utilization Review (UR) Registered Nurse (RN) ... care to our patients. This position is responsible for utilization review , assessment of discharge planning needs...in acute care setting. + Minimum one-year experience as case manager in acute care setting preferred. + Critical… more
- UNC Health Care (Rocky Mount, NC)
- …Carolina license without sanctions)** Preferred Certifications & Licensures + Utilization Review or other applicable certification **Professional Experience ... - acute care (acute hospital setting) + 0-2 healthcare/medical - - utilization review (or other healthcare-related experience) Preferred Experience: +… more
- Prime Healthcare (Lynwood, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/175183/ case -manager%2c-rn utilization - review ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum… more
- Catholic Health Initiatives (Little Rock, AR)
- **Overview** As a Utilization Nurse Nurse with CHI St Vincent Infirmary, you'll work with insurance, government and nursing personnel to determine ... and tracts Medicare denials, works with medical records to review third party payor denials. + Works with other...care nursing experience required + BSN Required + Previous case management, utilization management, or discharge planning… more
- Stanford Health Care (Palo Alto, CA)
- …transitions of care guidelines and utilization management principles. + Experience in case management, utilization review , or related healthcare roles. + ... onsite Stanford Health Care job.** **A Brief Overview** The Utilization Management Registered Nurse (UM RN) will...ensure the necessity and appropriateness of care provided. 3. Utilization Review : Conduct thorough utilization … more