- Elliot Health System (Manchester, NH)
- …quality, risk management, utilization , infection control and resource utilization etc. Participates in multidisciplinary meetings to review ... a Sign on Bonus up to $5,000! POSITION SUMMARY The Inpatient Behavioral Health Social Worker cares for adult patients with acute and chronic psychiatric disorders;… more
- The Arora Group (Bethesda, MD)
- Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/LVN) - Utilization Review in ... required on Federal holidays. DUTIES OF THE LICENSED PRACTICAL NURSE (LPN/LVN) - UTILIZATION REVIEW :...days per year + 11 paid Federal holidays + Health & Welfare allowance mostly cover the cost of… more
- Beth Israel Lahey Health (Burlington, MA)
- …difference in people's lives.** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission ... of various commercial and government payers. Partners with the health care team to ensure reimbursement of hospital admissions...billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review … 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 ... CA Job Type Full time Job Number Y5126D Department HEALTH SERVICES Opening Date 06/08/2020 + Description + Benefits...and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General… more
- Matrix Providers (Aurora, CO)
- Utilization Review Nurse (RN)...to join our team of talented professionals who provide health care services to our Military Service Members and ... Quality and Management (HCQM) through American Board of Quality Assurance and Utilization Review Physicians (ABQARP) + Certified Informatics Nursing, Ambulatory… more
- Independent Health (Buffalo, NY)
- …perks, benefits and a culture that fosters growth, innovation and collaboration. **Overview** The Utilization Review Nurse (URN) performs clinical review ... clinical experience as an RN in a varied clinical setting required. + Previous utilization review experience preferred. + Previous experience in a managed care… more
- Ascension Health (Baltimore, MD)
- … health care services regarding admissions, case management, discharge planning and utilization review . Responsibilities: + Review admissions and service ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
- CDPHP (Albany, NY)
- …who share these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review ... of acute care experience is required as a Registered Nurse . + Minimum of two (2) years Utilization...to provide excellent customer service. + Demonstrated ability to review health care delivery against established criteria.… 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, or ... Description Take on a high-impact role within a world-class health organization. Help drive the continued delivery of exceptional patient care. Take your career to… more
- Dartmouth Health (Lebanon, NH)
- Overview Utilization Review - RN Per Diem, Fully Remote Works with physicians and multidisciplinary team members to develop a plan of care for assigned patients. ... determine the decision to appeal or accept, assisting in the response to Health Plan, etc. * Develops and implements communication strategies to keep clinicians and… more
- CVS Health (Columbus, OH)
- …in ER, Med/Surg, and/or Critical care setting - Managed Care experience - Utilization review experience - Experience working with electronic medical record ... At CVS Health , we're building a world of health...holidays and evening rotations._ This is a full-time remote Utilization Management Nurse Consultant opportunity. As a… more
- CVS Health (Olympia, WA)
- …cardiology **Preferred Qualifications** -1+ years' experience in either Precertification or Utilization Review -1+ years' experience Managed Care -Strong ... At CVS Health , we're building a world of health...with heart, each and every day. **Position Summary** **This Utilization Management (UM) Nurse Consultant role is… more
- Fallon Health (Worcester, MA)
- …level of utilizing established Care Coordination polices and protocols, Fallon Health benefit criteria, applicable regulatory review criteria and nationally ... to department protocol + Collaborates with attending physicians and health care professionals regarding appropriate utilization of...clinical setting required. + 2 years' experience as a Utilization Management nurse in a managed care… more
- Community Health Systems (Naples, FL)
- …Benefits **Job Summary** Under the direction of the UR Director/Manager the UR Nurse reviews all admissions for medical necessity, correct orders based on medical ... improvement programs + Addresses facility and departmental communication through daily review of all correspondence, including incoming email messages. + Performs… 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 Position Type: ... (Mid.) - $142,166.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by...net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates,… more
- Humana (Columbus, OH)
- …a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to ... of behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work assignments… more
- CVS Health (Columbus, OH)
- …care **Preferred Qualifications** + NICU experience highly preferred + Managed care/ utilization review experience + Ability to multitask, prioritize and ... At CVS Health , we're building a world of health...the telephone, and typing on the computer. The UM Nurse Consultant utilizes clinical skills to coordinate, document and… more
- CVS Health (Albany, NY)
- …could be up to 10% in the event of a clinical audit. As a Utilization Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate ... with heart, each and every day. **Position Summary:** This Utilization Management Nurse Consultant (UMNC) position is...the past 10 years). **Preferred Qualifications:** -2 years of Utilization Review experience -2 years of Managed… more
- Crouse Hospital (Syracuse, NY)
- …while maintaining the quality of care. + Demonstrates proficiency with standard Utilization Review processes. + Responsible for concurrent and continued stay ... Since 1887, Crouse Health has been a leading healthcare provider in...programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse (RN) to track… more
- CVS Health (Tallahassee, FL)
- …with heart, each and every day. **Position Summary** This is a fulltime remote Utilization Review opportunity. Working hours are four 10hr days **including every ... At CVS Health , we're building a world of health...participating in non-traditional, weekend shift rotation **Preferred Qualifications** + Utilization review experience + Experience with LTAC,… more
