- Stanford Health Care (Palo Alto, CA)
- …to create an effective plan to address them. **Licenses and Certifications** + Nursing / RN - Registered Nurse - State Licensure and/or Compact State ... + Knowledge of principles and best practices of case management, utilization review , social work, care coordination and discharge planning. + Knowledge of… more
- UCLA Health (Los Angeles, CA)
- …+ experience in an HMO environment + Thorough knowledge of health care industry, utilization review , utilization management, and concurrent review ... all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management, you'll provide direct management to a team of UM coordinators and… more
- Providence (Mission Hills, CA)
- **Description** Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost effective ... them. **Required qualifications:** + Nursing school graduate. + California Registered Nurse License upon hire + 3...License upon hire + 3 years of experience in utilization management and/or case management. + 3 years of… more
- Sharp HealthCare (San Diego, CA)
- …recent case management, utilization review , care coordination experience + California Registered Nurse ( RN ) - CA Board of Registered Nursing ... Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA...the department head as indicated. + Utilization review and utilization managementThe SRS RN… more
- Matrix Providers (Aurora, CO)
- Registered Nurse ( RN ) - Utilization Management Location: Aurora, CO, United States Healthcare Provider Type : Nursing START YOUR APPLICATION ... schedules. Matrix Providers is hiring a Registered Nurse ( RN ) - Utilization Management...Management (HCQM) through American Board of Quality Assurance and Utilization Review Physicians (ABQARP) + Certified Informatics… more
- Stanford Health Care (Palo Alto, CA)
- …a remote Stanford Health Care job.** **A Brief Overview** The Utilization Management Registered Nurse (UM RN ) will be responsible for ensuring the ... ensure the necessity and appropriateness of care provided. 3. Utilization Review : Conduct thorough utilization ...systems and other healthcare software. **Licenses and Certifications** + Nursing/ RN - Registered Nurse -… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR...CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board ... II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,161.60 -… more
- CareFirst (Baltimore, MD)
- …is required in addition to the required work experience. **Licenses/Certifications:** + Health Services\ RN - Registered Nurse - State Licensure and/or ... detail can be shared during the interview process. Plans, organizes, and manages utilization review programs. Directs the utilization of referral services.… more
- CareFirst (Baltimore, MD)
- …experience is required in addition to the required work experience. **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or Compact ... **Resp & Qualifications** **PURPOSE:** Utilizing key principles of utilization management, the Utilization Review...Upon Hire Required or + LPN - Licensed Practical Nurse - State Licensure Upon Hire Required + CNS-Clinical… more
- Trinity Health (Springfield, MA)
- …program. BSN graduate preferred, Master's preferred + **Licensure** : Current Licensure as a Registered Nurse RN in Massachusetts. + **Certification** : BLS ... Shift **Description:** Requires BSN At **Mercy Medical Center** the ** Utilization Review /Appeals & Denials** ** RN **...criteria, and assists the physician, bedside Registered Nurse , ICC and Social Worker with utilization … more
- Molina Healthcare (WI)
- …Experience** _Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... acute care/medical experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. Must… more
- LifePoint Health (Las Cruces, NM)
- …federal, state or local law./ **Job:** **Nursing* **Organization:** **Memorial Medical Center* **Title:** * Registered Nurse ( RN ) Case Manager - UM - PRN ... resources in the development of care, discharge planning and Utilization Review . * Utilization Management...is desirable. * Current New Mexico licensure as a Registered Nurse . * Certification as CCM or… more
- Molina Healthcare (Milwaukee, WI)
- **JOB DESCRIPTION** **_For this position we are seeking a ( RN ) Registered Nurse with previous experience in Hospital Acute Care, Concurrent Review / ... care/medical experience. **Required License, Certification, Association** Active, unrestricted Wisconsin Registered Nursing ( RN ) license in good standing. Must… more
- Molina Healthcare (UT)
- …SKILLS:** _For this position we are seeking a ( RN ) Registered Nurse , with previous experience in Prior Authorizations, Utilization Review / ... for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of… more
- Molina Healthcare (IA)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... ICU, Medical, or ER unit. _with previous experience in hospital acute care, Inpatient Review , Prior Authorizations, Utilization Review / Utilization … more
- Sharp HealthCare (San Diego, CA)
- …Case Manager (CCM) - Commission for Case Manager Certification; Bachelor's Degree in Nursing; California Registered Nurse ( RN ) - CA Board of Registered ... or equivalent experience in the healthcare setting. + California Registered Nurse ( RN ) - CA...the department head as indicated. + Utilization review and utilization managementThe RN … more
- Emory Healthcare/Emory University (Atlanta, GA)
- …development, and leadership programs + And more **Description** We're seeking a ** Registered Nurse , Clinical Utilization Preceptor** responsible for ... training, mentoring, and coaching for the Utilization Review Department. The UR RN Preceptor must be an expert in the utilization review functions… more
- AdventHealth (Altamonte Springs, FL)
- …2 years utilizing InterQual and/or MCG . Minimum of three (3) years' experience as Registered Nurse ( RN ) in an acute clinical setting . Clinical experience ... in non-nursing field, must have at least an Associate's Degree in Nursing) . Utilization Review / Utilization Management experience of at least 2 years… more
- Molina Healthcare (ID)
- …**JOB QUALIFICATIONS** **Required Education** Any of the following: Completion of an accredited Registered Nurse ( RN ), Licensed Vocational Nurse (LVN) ... medical clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ), Licensed Vocational Nurse … more
- University of Michigan (Ann Arbor, MI)
- …position is unique in that it combines clinical/quality considerations with regulatory/financial/ utilization review demands. The position creates a balance ... RN CASE MANAGER: University Hospital (Care Management) Apply...+ Participate in venues to reduce barriers to discharge ** Utilization Review and Utilization Management**… more