- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR...This can be done at any time. 5.Equal Employment Opportunity/ Non -Discrimination Policy: a. It is the policy of the ... II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,161.60 -… more
- State of Connecticut, Department of Administrative Services (Hartford, CT)
- Utilization Review Nurse (40 Hour) Office/On-site Recruitment # 250102-5612FP-001 Location Hartford, CT Date Opened 1/6/2025 12:00:00 AM Salary $78,480 - ... and Addiction Services ( DMHAS (https://portal.ct.gov/DMHAS/About-DMHAS/Agency/About-DMHAS) ) as a Utilization Review Nurse (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5612FP&R1=&R3=) !… more
- Ascension Health (Wamego, KS)
- …Provide health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
- CVS Health (Phoenix, AZ)
- …and some rotational on-call holiday coverage (URAC and Client Requirements). Utilization Management is a 24/7 operation.** 100% attendance is required during ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
- Catholic Health Initiatives (Little Rock, AR)
- **Overview** As a Utilization Review nurse with CHI St Vincent Little Rock, you'll work with physicians, other registered nurses, specialized departments, ... **CHI St Vincent Infirmary** is a 600 bed faith-based, non -profit, acute care facility providing quality health care to...and tracts Medicare denials, works with medical records to review third party payor denials. + Works with other… more
- Prime Healthcare (Aurora, IL)
- …licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/189384/ utilization - review - nurse ... an acute care, post-acute, or payer setting within the last 5 years. 2. Utilization review and denial management experience required. 3. Current state RN… more
- CVS Health (Columbus, OH)
- …**Required Qualifications:** -3+ Years of clinical experience -1+ Year of Utilization Review Management and/or Medical Management experience. -Must have ... the US. **Schedule is Monday - Friday 8am-5pm est.** No travel required. Non -exempt. Hourly. Pay: Bi-weekly. No shift premium. Occasional Overtime may be required.… more
- Veterans Affairs, Veterans Health Administration (Seattle, WA)
- …satisfaction throughout the continuum of care. Duties include but not limited to: The Nurse Utilization Management (UM) Registered Nurse (RN) is responsible ... Summary Registered Nurse (RN) Utilization Management (UM) delivers...care Bachelor of Science in Nursing Case Management Experience Utilization Management/ Review experience Physical Requirements: Heavy lifting… more
- CVS Health (Columbus, OH)
- …AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Utilizes clinical experience and skills in a collaborative… more
- New York State Civil Service (Malone, NY)
- …of post-licensure clinical nursing experience of which one year was in utilization review and/or discharge planning.Substitution: a bachelor's degree in nursing ... NY HELP Yes Agency Corrections and Community Supervision, Department of Title Registered Nurse 3 - Utilization Per Diem - NY HELPS Occupational Category Health… more
- Katmai (Usaf Academy, CO)
- …for inpatient/outpatient precertification. **ESSENTIAL DUTIES &** **RESPONSIBILITIES** + Review precertification requests for medical necessity, referring to the ... Medical Director those that require additional expertise. + Review clinical information for concurrent reviews. + As part of the UMRN program, conduct ongoing… more
- Beth Israel Lahey Health (Boston, MA)
- …lives.** Position Summary: In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission ... **Work Shift:** Day (United States of America) **FLSA Status:** Non -Exempt **When you join the growing BILH team, you're...billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review … more
- Munson Healthcare (Traverse City, MI)
- …interdisciplinary team members, payers and external case managers Why work as a Utilization Review Specialist at Munson Healthcare? + Our dynamic work ... law regarding the use of Hospital Initiated Notice of Non -Coverage (HINN) and Ambulatory Benefit Notice (ABN). + Monitors...+ Minimum of three years clinical experience required. Previous utilization review and/or case management in a… more
- Ascension Health (Baltimore, MD)
- …salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes ... implement quality review programs and key performance indicators for all utilization review activities. + Interact with medical, nursing, and executive… more
- Ascension Health (Panama City, FL)
- **Details** + **Department: Utilization Review ** + **Schedule:FT day shift** + **Hospital:Ascension Sacred Heart Panama City** + **Location: Panama City, ... Provide health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests… more
- Stanford Health Care (Palo Alto, CA)
- …and Abilities** + Knowledge of principles and best practices of case management, utilization review , social work, care coordination and discharge planning. + ... Here, your leadership, coaching, and mentoring would further develop our robust, Utilization Management team. Are you driven by health care innovation, partnerships,… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Utilization Review Admission Specialist (OR Scheduler), Operating Room Surgical Scheduling, Mount Sinai West - Full Time, Days** The ... Utilization Review Specialist coordinates scheduling of all...and operating room procedures. Seeks the assistance of the Nurse Manager in identifying cases, which require pre admission… more
- VNS Health (Manhattan, NY)
- …CEU credits, and advancement opportunities What You Will Do + Reviews specific utilization issues or requests with Clinical Review team, focusing on problem ... Manages and evaluates staff in delivery and coordination of utilization management review services in compliance with...and current registration to practice as a registered professional nurse in New York State Required + Valid driver's… more
- Methodist Health System (Celina, TX)
- …license to practice professional nursing in Texas * License from respective agency for non - nurse professional * 2 years or more of health care experience; ... minimum 1 year acute hospital experience * Acute hospital case management experience preferred Your Job Responsibilities: * Communicate clearly and openly * Build relationships to promote a collaborative environment * Be accountable for your performance *… more
- Ascension Health (Nashville, TN)
- …initiatives. + Develop systems and processes for prospective, concurrent and retrospective utilization review for allself-funded and fully insured clients to ... **Details** + **Department:** Utilization Management + **Schedule:** Monday - Friday. 40...clients. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Tennessee Board of Nursing obtained… more