- VitalCore Health Strategies (Hopkinton, MA)
- …Animal/Pet Insurance Employee Assistance Program and Discount Center 401K EEO Keywords: Utilization Management , RN , Nurse , Administrative, #INDMA ... in Correctional Healthcare, has a Full-Time opening for a Utilization Management RN at the...of an accredited School of Nursing Licensure as a Registered Nurse in the state of employment… more
- Hartford HealthCare (Willimantic, CT)
- …**Windham Hospital* **Title:** * Registered Nurse Case Manager ( RN ) - Utilization Management * **Location:** *Connecticut-Willimantic-Windham Community ... the direction of the Manager of Continuing Care and Utilization Management and in collaboration with physicians,... experience preferred. *LICENSURE/CERTIFICATION* * Current license as a registered nurse in the State of Connecticut.… more
- Humana (Providence, RI)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- CVS Health (Woonsocket, RI)
- …active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include weekends, ... all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and...**Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care… more
- Baystate Health (Springfield, MA)
- …- $62.85 **Per Diem Hospital Case Manager / Utilization Management ** The ** RN Hospital Case Manager** is a registered nurse responsible for the ... MD's about safe plan for transitions + Leads the team to ensure appropriate utilization of patient resources and directs care to other settings when appropriate +… more
- Cognizant (Providence, RI)
- …have to be considered** + Educational background - Registered Nurse ( RN ) + 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
- CenterWell (Providence, RI)
- … RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous… more
- Hartford HealthCare (Manchester, CT)
- … Management * **Organization:** **Manchester Memorial Hospital* **Title:** *Clinical Resource Management Nurse ( RN ) - Case Coordination* **Location:** ... timely and accurate information to payers. The role integrates and coordinates utilization management and denial prevention by focusing on identifying and… more
- Trinity Health (Springfield, MA)
- …affiliated nursing program. BSN graduate preferred. + **Licensure** : Current Licensure as a Registered Nurse RN in Massachusetts. + **Certification** : BLS ... **Shift:** Day Shift **Description:** At **Mercy Medical Center** our ** RN Inpatient Care Coordinators** are responsible for coordinating patient...(AHA/ARC). Certification in Case Management (ACM, CCM) required within one year of employment… more
- Baystate Health (Springfield, MA)
- …to this role. **Education:** Bachelors Degree in Nursing (Required) **Certifications:** Registered Nurse - State of MassachusettsState of MassachusettsState of ... - Midpoint - Maximum $46.22 - $53.13 - $62.85 ** RN , Patient Placement Bed Manager** **Part Time - 24...outlined in the evidence based practice guidelines + Uses Utilization Analysis / Management principles, insures that patient's… more
- Hartford HealthCare (Manchester, CT)
- …is your moment. **Job:** ** Management * **Organization:** **Manchester Memorial Hospital* **Title:** * Nurse Manager ( RN , Registered Nurse , Clinical) - ... part of Connecticut's most comprehensive healthcare network as a Nurse Manager. The Greater Manchester Region has approximately 2,500...people in 19 towns. POSITION SUMMARY: Responsible for the management of more than one defined area of organized… more
- Fallon Health (Worcester, MA)
- … Nurse in a clinical setting required. * 2 years' experience as a Utilization Management /Prior Authorization nurse in a managed care payer preferred. * ... degree in nursing required **License/Certifications:** Active and unrestricted licensure as a Registered Nurse in Massachusetts. **Experience:** * A minimum of… more
- Baystate Health (Springfield, MA)
- …(BMC), a Magnet Hospital for Nursing Excellence is looking for a medical inpatient Registered Nurse to join our team in Springfield, MA. At Baystate Health, ... Support - American Heart AssociationAmerican Heart AssociationAmerican Heart Association, Registered Nurse - State of MassachusettsState of MassachusettsState… more
- Baystate Health (Springfield, MA)
- …a Magnet Hospital for Nursing Excellence is looking for a medical telemetry inpatient Registered Nurse to join our team in Springfield, MA. At Baystate Health, ... Support - American Heart AssociationAmerican Heart AssociationAmerican Heart Association, Registered Nurse - State of MassachusettsState of MassachusettsState… more
- Fresenius Medical Center (Providence, RI)
- …and post procedure, under the direction of the Facility Manager and/or Charge Registered Nurse , utilizing standard nursing techniques to assist the physician in ... acting on adverse events and action thresholds in collaboration with facility management . + Maintains integrity of medical records and other FVC administrative and… more
- Evolent (Providence, RI)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... Be Doing:** + Practices and maintains the principles of utilization management and appeals management ...and Preferred:** + 1-3 years' experience and as an RN - **Required** + Minimum of 5 years in… more
- Highmark Health (Providence, RI)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... data to assure appropriate level of payment and resource utilization . It is also used to identify issues which...experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- Utilization Review Nurse Coordinator (40 Hour)...+ + + + Introduction Are you an experienced Registered Nurse looking to make a difference ... to learn more about joining our team as a Utilization Review Nurse Coordinator! The State of...GENERAL EXPERIENCE Five (5) years of experience as a Registered Nurse . MINIMUM QUALIFICATIONS - SPECIAL EXPERIENCE… more
- Charter Care Health Partners (North Providence, RI)
- …Graduate of a School of Nursing (BSN preferred) with current license to practice as a Registered Nurse in the State of Rhode Island or in the nurse 's ... specific patient population. Performs functions related to Patient Advocacy; Utilization Review; Resource Management ; Continuum of Care...residency if that state is a member of the Nurse Licensure Compact. Five (5) years of clinical experience… more
- Charter Care Health Partners (North Providence, RI)
- …Graduate of a School of Nursing (BSN preferred) with current license to practice as a Registered Nurse in the State of Rhode Island or in the nurse 's ... specific patient population. Performs functions related to Patient Advocacy; Utilization Review; Resource Management ; Continuum of Care...residency if that state is a member of the Nurse Licensure Compact. Five (5) years of clinical experience… more
