- Alameda Health System (Oakland, CA)
- …each individual in the classification. Lead and manage a team of utilization review professionals providing guidance, training, and performance evaluations. ... reviews and determine program improvements. Develop and implement utilization review policies and procedures in accordance...: UM / CM certifications Highland General Hospital SYS Utilization Management Full Time Day Nursing FTE:… more
- University Health (San Antonio, TX)
- …Staff nurse II or above). Work experience in case management, utilization review or hospital quality is preferred. LICENSURE/ CERTIFICATIONS Current ... POSITION SUMMARY/RESPONSIBILITIES The full job description covers all associated skills, previous...any qualifications that applicants are expected to have. The nurse case manager coordinates, in collaboration with the patient… more
- University of New Mexico - Hospitals (Albuquerque, NM)
- …patient responses to interventions in collaboration with quality assurance and utilization review , maintaining interdependent follow-up as necessary * VARIANCE ... limited to experience, education, and other business and organizational considerations. Department: Utilization Management - UH Read on to fully understand what this… more
- Christus Health (San Antonio, TX)
- …Medicare GMLOS by managing per Milliman/Interqual Care Guidelines. Resource/ Utilization Management/appropriateness: Assess assigned patient population for medical ... Proactively refers cases to physician adviser for P2P, medical necessity review , and denail avoidance. Demonstrates and maintains current knowledge of regulatory… more
- Swedish Health Services (Renton, WA)
- …any applications. Care Manager RN - Emergency Department @ Swedish First Hill Full time Night Shift Fantastic benefits and compensation package offered by Providence ... focus on what really matters - our patients. The nurse case manager coordinates the care and service of...to the organization, to improve patient care through effective utilization and monitoring of healthcare resources and assumes a… more
- University of New Mexico - Hospitals (Corrales, NM)
- …patient responses to interventions in collaboration with quality assurance and utilization review , maintaining interdependent follow-up as necessary * TREATMENT ... for this role, read on for all the relevant information. FTE: 1.00 Full Time Shift: Days Position Summary: Coordinate all systems/services required for an organized,… more
- University Health (San Antonio, TX)
- …full time hospital experience preferred. Work experience in case management, utilization review , or hospital quality assurance experience is preferred. ... you will need for this opportunity Simply read the full description below to get a complete picture of...clinicians in the Ambulatory setting by gathering information, coordinating utilization efforts, and reviewing HCC quality indicators, and RAF… more
- University Health (Hondo, TX)
- … full -time hospital experience preferred. Work experience in case management, utilization review or hospital quality assurance experience is preferred. Must ... POSITION SUMMARY/RESPONSIBILITIES Make sure to read the full description below, and please apply immediately if...hire date. LICENSURE/CERTIFICATION Current license from the Board of Nurse Examiners of the State of Texas to practice… more
- UnitedHealthcare (Kaunakakai, HI)
- …experience * Experience with or exposure to discharge planning * Experience with utilization review , concurrent review and/or risk management * Experience ... arranging community resources * Experience as a Public Health Nurse * Field-based work experience * Background in managing...range from $28.27 to $50.48 per hour based on full -time employment. We comply with all minimum wage laws… more
- State of Connecticut, Department of Administrative Services (Middletown, CT)
- Utilization Review Nurse Coordinator (40... Licensure Compact for more details. Position Highlights: + Full -time, 40 hours per week + First (1st) shift + ... Campus Hospital (https://portal.ct.gov/dcf/solnit-center/south) - is accepting applications for a Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=)… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW ... $167,136.48 Annually Location Los Angeles County, CA Job Type Full time Job Number Y5125L Department HEALTH SERVICES Opening...information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW ... $177,314.88 Annually Location Los Angeles County, CA Job Type Full time Job Number Y5126D Department HEALTH SERVICES Opening...and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of ... this position is able to cover a multitude of utilization review functions through point of entry,...**LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure -… more
- State of Connecticut, Department of Administrative Services (New Haven, CT)
- Utilization Review Nurse (40...full range of duties involving the assessment and review of health care delivery systems or medical cost ... and Addiction Services ( DMHAS (http://portal.ct.gov/DMHAS) ) as a Utilization Review Nurse (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5612FP&R1=&R3=) !… more
- Emory Healthcare/Emory University (Decatur, GA)
- …development _,_ and leadership programs + And more **Description** We're seeking a **Clinical Utilization Review Nurse Preceptor (Registered Nurse / ... . This individual will be responsible for training, mentoring, and coaching for the Utilization Review Department and must be an expert in the utilization… more
- University of Utah Health (Salt Lake City, UT)
- …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** + ... Current license to practice as a Registered Nurse in the State of Utah, or obtain one...Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of… more
- UNC Health Care (Kinston, NC)
- …to support the clinical documentation specialists and Patient Financial Services. Supports the Utilization Review Nurse team when necessary by applying ... a Registered Nurse required. + 2 years utilization review , care management, or compliance experience...Lenoir Health Care Organization Unit: Care Management Work Type: Full Time Standard Hours Per Week: 40.00 Salary Range:… more
- CVS Health (Lansing, MI)
- …of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review , you'll play a vital role in ... phone, computer, etc. and clinical documentation systems. + 1+ Year of Utilization Review Management and/or Medical Management experience. + Commitment to… more
- Centene Corporation (New York, NY)
- …clinical license; and a NYS Driver's License or Identification card.** **Position Purpose:** The Utilization Review Nurse I provides first level clinical ... requiring authorization. Utilizes decision-making and critical-thinking skills in the review and determination of coverage for medically necessary health care… more
- CVS Health (Austin, TX)
- …care experience is in behavioral health) **Preferred Qualifications** + 1+ years' experience Utilization Review experience + 1+ years' experience Managed Care + ... Social Worker (LCSW) preferred. + Requisition Job Description **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and… more
