- University Health (San Antonio, TX)
- …recent, full time hospital experience preferred. Work experience in case management, utilization review , or hospital quality assurance experience is preferred. ... clinicians in the Ambulatory setting by gathering information, coordinating utilization efforts, and reviewing HCC quality indicators, and RAF...of the State of Texas to practice as a registered nurse is required. National certification in… more
- University of New Mexico - Hospitals (Albuquerque, NM)
- …patient responses to interventions in collaboration with quality assurance and utilization review , maintaining interdependent follow-up as necessary* VARIANCE - ... * Subject to an annual contract and performance appraisal * Tuberculosis testing is completed upon hire and additionally as requiredDepartment: Registered Nurse more
- University Health (Pleasanton, CA)
- …recent, full-time hospital experience preferred. Work experience in case management, utilization review or hospital quality assurance experience is preferred. ... Graduation from an accredited school of nursing with current RN licensure in the State of Texas, BSN preferred....of the State of Texas to practice as a registered nurse is required. National certification in… more
- Community Health Systems (Naples, FL)
- Join us as a ** Registered Nurse ( RN ) - Utilization Review position** at Physicians Regional Collier Unit: Utilization Review Shift: Mon-Fri ... and Part-Time roles **Job Summary** The Utilization Review Nurse - RN reviews...patient-centered service and continuous improvement. **Licenses and Certifications** + RN - Registered Nurse -… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse ( RN ) who comprehensively conducts ... this position is able to cover a multitude of utilization review functions through point of entry,...and/or case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
- The County of Los Angeles (Los Angeles, CA)
- …Considerable ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience ... OPTION II: Two (2) years of experience as a registered nurse , of which one year must...the County of Los Angeles, a Utilization Review Nurse is an RN ...Los Angeles, a Utilization Review Nurse is an RN that has Case… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- Utilization Review Nurse Coordinator (40...+ + + + Introduction Are you an experienced Registered Nurse looking to make a difference in ... to learn more about joining our team as a Utilization Review Nurse Coordinator! The...GENERAL EXPERIENCE Five (5) years of experience as a Registered Nurse . MINIMUM QUALIFICATIONS - SPECIAL EXPERIENCE… 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 $118,457.04 -… more
- New York State Civil Service (Syracuse, NY)
- NY HELP Yes Agency Mental Health, Office of Title Utilization Review Coordinator, (NY HELPS), Hutchings Psychiatric Center, P26038 Occupational Category Health ... Code 13210 Duties Description Hutchings Psychiatric Center is recruiting for a Utilization Review Coordinator to analyze and evaluate quality, effectiveness, and… more
- Catholic Health (Kenmore, NY)
- …Days with Weekend and Holiday Rotation Hours: 8 am- 4 pm Summary: The Registered Nurse ( RN ), Utilization Review , as an active member of the Middle ... in the hospital setting. Utilizing foundational nursing clinical skills Utilization Review nurse collaborates with...facilitate movement of the patient through the continuum. The Utilization Review RN identifies and… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for evaluating ... nursing*( RN ) experience or * 2 years of recent* utilization review , utilization management*nursing experience.../*License/Certifications:*/ * Possession of a valid license as a Registered Nurse issued by the State of… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a* Utilization Review Manager* to join ourTransitional Care Team.This is a full-time role and will be required to work ... this position: *Manages the design, development, implementation, and monitoring of utilization review functions. Oversees daily operations, which include… more
- Huron Consulting Group (Chicago, IL)
- …Management is responsible for planning, organizing, developing, and directing implementation of the Utilization Review Plan and the overall operation of the ... + Staff Acquisition and Support: Leads and manages the utilization review staff and function for the...Criteria and Milliman Care Guidelines (MCG) preferred. + Current RN license from Maryland Board of Nursing. + CCM… more
- Community Health Systems (Franklin, TN)
- …Knowledge of HIPAA regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or ... **Job Summary** The Remote PRN Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital… more
- St. Peters Health (Helena, MT)
- The Utilization Management RN reports directly to Utilization Review RN Coordinator. The UR RN supports the UR RN Coordinator and other UR ... team members in providing all identified utilization review functions for the organization to...the patient/family, physicians, and the interdisciplinary team, the UR RN ensures the care delivery systems at SPH are… more
- Martin's Point Health Care (Portland, ME)
- …preferred + 3+ years of medical management experience in a managed care setting including utilization review + RN experience in a clinical setting + ... The Supervisor is responsible for day-to-day operations of the utilization review clinical team, in the areas...Required License(s) and/or Certification(s): + Current Licensure as an RN in Maine and other appropriate jurisdictions as necessary… more
- Tenet Healthcare (Detroit, MI)
- RN Utilization Review -...dedicated healthcare team where compassion meets innovation! As a Registered Nurse with us, you'll have the ... level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as...Conditions of Participation and Tenet policies Operates within the RN scope of practice as defined by state licensing… more
- University of Utah Health (Salt Lake City, UT)
- …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** + ... Current license to practice as a Registered Nurse in the State of Utah,...Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of… more
- UTMB Health (Webster, TX)
- Utilization Review Case Mgr - CMC...**_REQUIRED EDUCATION/EXPERIENCE_** **:** + Current Texas licensure as a Registered Nurse ( RN ).with a minimum ... observation in Community Hospitals and UTMB-TDCJ Hospital. + Performs utilization review procedures by prospectively, concurrently, and...transfers and admissions from the prison facility. + Conducts nurse to nurse conference calls for all… more
- George C. Grape Community Hospital (Hamburg, IA)
- Quality/ Utilization Review Nurse Position Summary: The Quality/ Utilization Review Nurse is responsible for evaluating the medical necessity, ... infection control, and payers to resolve care coordination issues. Qualifications: * Education: Registered Nurse ( RN ) license required; BSN preferred. *… more
