- Health First (Melbourne, FL)
- …vehicle. **Job:** ** Case Management* **Organization:** **Holmes Regional Medical Center* **Title:** * Utilization Review Nurse - Case Management UR ... *POSITION SUMMARY* The Utilization Review (UR) nurse ...Emergency Department Nursing *Knowledge/Skills/Abilities:*Current working knowledge of care transitions, utilization management, case management and managed care… more
- 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
- Providence (Medford, OR)
- …based on population focus. Duties also include complex discharge planning and utilization review . The Nurse Case Manager must be competent to analyze ... the cognitive, physical, emotional/psychosocial, spiritual, and chronological maturation process. The Nurse Case Manager is accountable for meeting clinical and… more
- Beth Israel Lahey Health (Burlington, MA)
- …Shift:** Day (United States of America) Joint role of Case Manager and Utilization Review Nurse Hospital at Home Full Time Days 8:00am-4:30pm weekend ... and holiday rotations required **Job Description:** The Inpatient Registered Nurse (RN) Case Manager for Hospital at...to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case management… more
- State of Connecticut, Department of Administrative Services (Wallingford, CT)
- Utilization Review Nurse Coordinator Hybrid...utilization review including conducting second level review of cases and case referral to a ... has a full-time (1st shift) job opportunity for a Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=)… more
- Beth Israel Lahey Health (Burlington, MA)
- …Medical Center is now offering up to a $3,500 in signing bonuses for our Utilization Review positions. Important Details: * Signing Bonuses are paid out in three ... Description:** **Job Description:** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate… more
- Beth Israel Lahey Health (Needham, MA)
- …difference in people's lives.** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission ... the level of care being billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records to ensure… 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
- Albany Medical Center (Albany, NY)
- …stays, and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and ... Department.* Demonstrates proper use of MCG and documentation requirements through case review and inter-rater reliability studies.* Facilitates removal of… more
- R1 RCM (Pittsburgh, PA)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Utilization Review Nurse ** , you will help our ... review , utilizing client-specific guidelines. Upon identification of a case , you will ensure that appropriate orders and clinical...position. **Here's what you will experience working as a Utilization Review Nurse :** + Perform… more
- Milford Regional Medical Center (Milford, MA)
- …1 year Nurse Case Management experience Minimum of 1 year Utilization Review Nurse Experience including solid working knowledge with InterQual ... services to our community with dignity, compassion, and respect. Statement of Purpose: The Utilization Review Nurse is responsible for utilization … more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …The Role BHPS provides Utilization Management services to its clients. The Utilization Review Appeals Nurse performs daily appeal reviews and clinical ... + Adaptive to a high pace and changing environment. + Proficient in Utilization Review process including benefit interpretation, contract language, medical and… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …+ Adaptive to a high pace and changing environment. + Proficient in Utilization Review process including benefit interpretation, contract language, medical and ... Role BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs daily medical necessity reviews. This position… 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
- Prime Healthcare (Bloomington, IN)
- …current. #LI-AS2 Connect With Us! (https://careers-primehealthcare.icims.com/jobs/165937/ case -manager 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. + Grandfathered prior to April 1, 2015.… more
- Prime Healthcare (Lynwood, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/163839/*rn- case -manager 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
- Intermountain Health (Murray, UT)
- …Medicare, Medicaid, Marketplace Qualified Health Plans and commercial health plans. Utilization review behavior health professional proactively manage inpatient ... years clinical nursing experience. + One year in Managed Care, Utilization Management, or Case Management. + Basic computer skills including word processing and… more
- Actalent (Memphis, TN)
- …the Memphis area in need of a LPN to join their team for a Utilization Review opportunity. Please see below for details and qualifications! Description: + ... facilitation, payor authorizations, service access, discharge and post-discharge activities, and utilization review + Identifies patients that meet criteria for… more
- Albany Medical Center (Albany, NY)
- …stays, and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and ... Department.* Demonstrates proper use of MCG and documentation requirements through case review and inter-rater reliability studies.* Facilitates removal of… 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