• Utilization Review Case

    Covenant Health (Bangor, ME)
    …supervision of the VP of Accountable Care Operations & Population Health Strategy the Utilization Review Case Manager will work collaboratively with other ... members of the healthcare team. The nurse case manager also acts as an...Manager conducts medical necessity reviews in accordance with the Utilization Management (UM) plan for patients that are housed… more
    Covenant Health (11/27/24)
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  • Utilization Review RN

    LifePoint Health (Danville, VA)
    * Registered Nurse , RN - Utilization Review Case Manager* Job Type:Full Time|Days *$10,000 Sign-on Bonus Eligibility for Full-Time, Bedside RNs* ... valued as an employee, but as a person. As a* registered nurse ( RN )*joining our team,...and harassment in employment." **Job:** **Nursing* **Organization:** ** **Title:** * Utilization Review RN Case more
    LifePoint Health (12/09/24)
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  • Case Manager with Utilization

    Beth Israel Lahey Health (Burlington, MA)
    …you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital and Medical Center in ... Weekend and holiday rotations required **Job Description:** The Inpatient Registered Nurse ( RN ) Case...a timely process. Registered Nurses (RNs) with utilization review experience, case management… more
    Beth Israel Lahey Health (12/10/24)
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  • RN - Utilization Review - HS…

    Baptist Memorial (Jackson, MS)
    Summary The Utilization Review Nurse is...Summary: Position: 19738 - RN - Utilization Review Facility: MBMC - Hospital Department: HS Case ... appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse...against standard criteria per payer guidelines + Prioritizes observation case review + Assists with level of… more
    Baptist Memorial (11/24/24)
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  • Director of Case Management…

    Ascension Health (Kalamazoo, MI)
    …or management experience preferred. **Additional Preferences** There will be a dual focus on case management and utilization review in this position + ... prior to hire date or job transfer date. + Registered Nurse credentialed from the Michigan Board...Case Management experience - Strongly preferred + Utilization Review experience - Strongly preferred **Why… more
    Ascension Health (11/26/24)
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  • Registered Nurse ( RN

    Community Health Network (Indianapolis, IN)
    Registered Nurse ( RN ) Case Manager/ Utilization Review - North Emergency Job Ref 2408203 Category Nursing Job Family Case Manager Department ... Review position available in the Emergency Department. The Registered Nurse Case Manager is...of inpatient and observation services. The RN Case Manager/ Utilization Review RN more
    Community Health Network (12/12/24)
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  • Registered Nurse ( RN )…

    Matrix Providers (Aurora, CO)
    Registered Nurse ( RN ) - Utilization ...12 months consecutive experience in utilization management, utilization review or case management. ... 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
    Matrix Providers (11/26/24)
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  • Utilization Review Nurse

    US Tech Solutions (Columbia, SC)
    …mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review / case management/clinical/or combination; 2 of ... prioritize effectively and have critical thinking skills. Experience in case management or care coordination and telephonic care experience...the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse more
    US Tech Solutions (12/20/24)
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  • Utilization Review Specialist - PRN

    Munson Healthcare (Traverse City, MI)
    …team members, payers and external case managers Why work as a Utilization Review Specialist at Munson Healthcare? + Our dynamic work environment includes ... 5 years of start date. + Current licensure as Registered Nurse in the State of Michigan....+ Minimum of three years clinical experience required. Previous utilization review and/or case management… more
    Munson Healthcare (11/09/24)
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  • Corporate Director of Clinical Utilization

    Prime Healthcare (Ontario, CA)
    …strategic leadership, development, and supervision to utilization review department, provides interprofessional collaboration with facility-based case ... A minimum of seven (7) years' experience in Clinical Utilization Review or Case Management...with a large Health Plan + An active CA Registered Nurse license + Current BCLS (AHA)… more
    Prime Healthcare (11/28/24)
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  • Program Mgr UR/ Case Management - CMC…

    UTMB Health (Friendswood, TX)
    …a safe and efficient work environment. + Monitors the work performance of the Utilization Review Case Management staff and provides guidance as necessary. ... nursing. + Provides assistance with clinical issues for non-nursing Utilization Review Case Management staff....Professional Nursing + Current Texas Nursing Licensure as a Registered Nurse ( RN ). + Minimum… more
    UTMB Health (12/20/24)
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  • Registered Nurse Case Manager…

    Henry Ford Health System (Detroit, MI)
    …community partners to support patient needs beyond the hospital setting. Qualifications: + Registered Nurse ( RN ) with active licensure + Minimum [number] ... with computers, electronic health records (EHR), database systems, and utilization review / case management documentation systems....work in a fast-paced environment. Licenses and Certifications: + Registered Nurse ( RN ) with a… more
    Henry Ford Health System (10/03/24)
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  • Case Management Specialist

    University of Utah Health (Salt Lake City, UT)
    …LOS, high dollar and frequent utilizers. + Collaborate with unit case manager, utilization review nurse and other organization staff on establishing an ... specific condition. + Participates in organization Utilization Review Committee, weekly Medicare IPPS Case Reviews...**Licenses Required** + Current license to practice as a Registered Nurse in the State of Utah,… more
    University of Utah Health (12/24/24)
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  • Registered Nurse ( RN

    LifePoint Health (Warrenton, VA)
    …federal, state or local law./ **Job:** **Nursing Management* **Organization:** ** **Title:** * Registered Nurse ( RN ) Case Manager* **Location:** ... Sign On Bonus for experienced candidates (new hires)* The RN Case Manager monitors and manages patient...*Required*- Three years of nursing experience. *Preferred*- Experience in utilization review , case management, discharge… more
    LifePoint Health (12/26/24)
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  • Registered Nurse - Case

    Mohawk Valley Health System (Utica, NY)
    Registered Nurse - Case Management - Full Time - Days Department: CASE MANAGEMENT Job Summary Reports to and is under direct supervision of Case ... regulatory compliance. Education/Experience Requirements Required: + Minimum of two (2) years utilization review / case management experience or social work… more
    Mohawk Valley Health System (11/28/24)
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  • Director, Case Management

    LifePoint Health (Bullhead City, AZ)
    …continuity of care and cost effectiveness through the integrating and functions of case management, utilization review and management of discharge planning. ... five (5) years management experience, five (5) years of utilization review / case management...with MedHost EMR and with MorCare Required Licenses[United States] Registered Nurse Current RN Licensure… more
    LifePoint Health (11/05/24)
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  • Case Manager (Inpatient Units)

    Ellis Medicine (Schenectady, NY)
    …for appropriate Level of Care and status on all patients through collaboration with Utilization Review RN + Contacts the attending physician for additional ... SECTION I BASIC FUNCTION: The RN Case Manager has responsibility for...Case Manager include, but are not limited to, utilization review , case management, care… more
    Ellis Medicine (12/13/24)
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  • Registered Nurse ( RN )…

    Avera (Sioux Falls, SD)
    …transfers from Avera facilities as Swing Bed transfers. + Supports compliance with Utilization Review Process. Case Manager will have ongoing conversation ... with Utilization Review staff on patients status and ongoing coverage +...the employer. **Required Education, License/Certification, or Work Experience:** + Registered Nurse ( RN ) - Board… more
    Avera (12/23/24)
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  • RN Case Manager - Hospital (36…

    Marshfield Clinic (Marshfield, WI)
    …**Minimum Required:** One year of healthcare experience. **Preferred/Optional:** Discharge Planning, Utilization Review or Case Management experience in ... the most exciting missions in the world!** **Job Title:** RN Case Manager - Hospital (36 Hours/Week)...to the position._ **Minimum Required:** Current State of Wisconsin Registered Nurse license or Nurse more
    Marshfield Clinic (12/21/24)
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  • Oncology Prior Authorization Case Manager,…

    University of Miami (Miami, FL)
    …Department of UMHC SCCC Business Operations has an exciting opportunity for a full time Utilization Review Case Manager to work to work remote. The incumbent ... retrospective chart reviews for clinical utilization and authorization. The Utilization Review Case Manager coordinates with the healthcare team for… more
    University of Miami (12/06/24)
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