- 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 ... the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
- CVS Health (Phoenix, AZ)
- …that promote high-quality healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. ... may vary based on business needs. Location: 100% Remote ( US only) **About Us ** American Health Holding,...a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM… more
- Katmai (Fort Carson, CO)
- …American Red Cross. + Three (3) years within the last four (4) years as a registered nurse in utilization management . + One (1) year of experience in UR/UM ... Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE...active, and unrestricted license to practice as a registered nurse . + Must be a graduate from a college… more
- Sanford Health (Rapid City, SD)
- …is one of the largest and fastest-growing not-for-profit health systems in the United States . We're proud to offer many development and advancement opportunities ... providing direct supervision of all departmental staff. Maintains a standardization of utilization management process to ensure all policies and procedures are… more
- US Tech Solutions (Hopewell, NJ)
- …case/care management principles. - Prefers working knowledge of principles of utilization management . - Prefers basic knowledge of health care contracts and ... Player - Time Management - Written/Oral Communication & Organizational Skills **About US Tech Solutions:** US Tech Solutions is a global staff augmentation… more
- Katmai (Usaf Academy, CO)
- …(BSN) is required. + Minimum of two (2) years of prior experience in Utilization Management . + Must possess a current, active, full, and unrestricted Registered ... using a nurse compact state license or have a license from any United States jurisdiction (with no limitations, stipulations or pending adverse actions). +… more
- US Tech Solutions (Columbia, SC)
- …School of Nursing. + Required License/Certificate: Active, unrestricted RN licensure from the United States and in the state of hire, OR, active compact ... multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC) **About US Tech Solutions:** US Tech Solutions is a global staff… more
- Humana (Jackson, MS)
- …a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Penn State Health (Hershey, PA)
- …(MAILTO://###@pennstatehealth.psu.edu) **SUMMARY OF POSITION:** Under the direction of a Utilization Management Nurse or Specialist, the ... prohibit or outlaw discrimination._ **Union:** Non Bargained **Position** UM Coordinator - Utilization Management **Location** US :PA: Hershey | Clerical and… more
- Cedars-Sinai (Los Angeles, CA)
- … us one of America's Best Hospitals. Summary of Essential Duties: + The Utilization Management (UM) Registered Nurse - Medicare Short Stay & Concurrent ... recognized as one of the top ten in the United States ? Do you have a passion...Review Case Manager - 8 Hour Days **Department** : Utilization Management **Business Entity** : Cedars-Sinai Medical… more
- CVS Health (Columbus, OH)
- … solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team **Position ... 8:00am-5:00pm EST (Shift times vary based on business needs) Location: 100% Remote ( US only) **About Us ** American Health Holding, Inc. (AHH), a division… more
- Veterans Affairs, Veterans Health Administration (El Paso, TX)
- …a State, Territory or Commonwealth (ie, Puerto Rico) of the United States , or the District of Columbia. Graduate Nurse Technician (GNT) Exception: Candidates ... knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care… more
- UCLA Health (Los Angeles, CA)
- Description At UCLA Health, the Utilization Management (UM) Review Nurse plays a vital role in ensuring the delivery of high-quality, evidence-based care. ... and CMS criteria required + A minimum of three years of experience in utilization management , preferred + Team leading or management experience, preferred… 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. * ... temporary contract position for a Prior Authorization RN.** **About us :** Fallon Health is a company that cares. We...Twitter and LinkedIn. **Brief summary of purpose:** The PA Nurse uses a multidisciplinary approach to review service requests… more
- The County of Los Angeles (Los Angeles, CA)
- …ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience whose primary charge ... to all rights afforded by the Constitution of the United States . The Department of Human Resources...County of Los Angeles, a Utilization Review Nurse is an RN that has Case Management… more
- Huron Consulting Group (Chicago, IL)
- …the expert you are now and create your future. The Manager of Utilization Management is responsible for planning, organizing, developing, and directing ... Review Plan and the overall operation of the Utilization Management Department in accordance with federal,...be implemented in the future._ **Position Level** Manager **Country** United States of America At Huron, we're… more
- Albany Medical Center (Albany, NY)
- Department/Unit: Care Management /Social Work Work Shift: Day ( United States of America) Salary Range: $71,612.39 - $110,999.20 Responsible for Utilization ... Delay Management for assigned patients. * Completes Utilization Management and Quality Screening for assigned...Triad Team and health care team. Minimum Qualifications:* Registered nurse with a New York State current license.* Bachelor's… more
- George C. Grape Community Hospital (Hamburg, IA)
- …* Education & Collaboration: o Educate clinical staff on documentation requirements, utilization management processes, and infection control standards. o Serve ... Quality/ Utilization Review Nurse Position Summary: The...nursing experience (acute care preferred). o Prior experience in utilization review, case management , quality improvement, and… more
- US Tech Solutions (Chicago, IL)
- …HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE 1 YEAR OF UTILIZATION ... in state of residence + Must have prior authorization utilization experience + Experience with Medcompass **Skills:** + MUST... Review? + Do you have an Active Registered Nurse License? **About US Tech Solutions:** … more
- US Tech Solutions (May, OK)
- …HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review. . MUST HAVE 1 YEAR OF UTILIZATION ... . 1+ years of inpatient hospital experience . Registered Nurse in state of residence . Must have prior...in state of residence . Must have prior authorization utilization experience . Able to work in multiple IT… more