- UNC Health (Chapel Hill, NC)
- …unique communities we serve.RN Utilization Manager position specifically for a Utilization Manager/Clinical Appeals Nurse . This person is based at the ... UNC Health is seeking a Registered Nurse (RN) Care Manager for a nursing job...Manager to manage level of care transitions & appropriate utilization of services. Coordinates with the support … more
- UNC Health (Chapel Hill, NC)
- UNC Health is seeking a Registered Nurse (RN) Care Manager for a nursing job in Chapel Hill, North Carolina.Job Description & RequirementsSpecialty: Care ... visit: />The purpose of this position is to provide ongoing support and expertise through comprehensive assessment, planning, implementation and overall evaluation… more
- Saint Francis Health System (Tulsa, OK)
- Saint Francis Health System is seeking a Registered Nurse (RN) Virtual Care for a nursing job in Tulsa, Oklahoma.Job Description & RequirementsSpecialty: Virtual ... Employees - Please click HERE to login and apply.Full Time7p - 7aVirtual Nurse works from an on-site office location (not a remote position)Will perform admit,… more
- Advocate Aurora Health (Berwyn, IL)
- …stated purpose of helping people live well. To encourage you to be the best nurse you can, Advocate Aurora will provide support , tools and resources for ... demonstrates the ability to thoroughly and decisively document to support reimbursement and regulatory requirements.Care and Service Coordination: Practices as… more
- Advocate Aurora Health (Adell, WI)
- …stated purpose of helping people live well. To encourage you to be the best nurse you can, Advocate Aurora will provide support , tools and resources for ... caseload for optimal functional and financial outcomes; reviews caseload for Low Utilization Payment Adjustments (LUPA), optimal number of visits based on progress,… more
- ERP International (Vandenberg AFB, CA)
- **Overview** ERP International is seeking a full-time **Registered Nurse (RN) Utilization Management** in support of the30th Medical Group at Vandenberg AFB, ... as identified in the TO. * Conduct research in support of improved practice and patient outcomes. **Qualifications** **Minimum...to practice as a RN from any state Life Support Certification:** Possess a current AHA OR ARC BLS… more
- The Arora Group (Bethesda, MD)
- Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/LVN) - Utilization Review in Bethesda, ... Services will be required on Federal holidays. DUTIES OF THE LICENSED PRACTICAL NURSE (LPN/LVN) - UTILIZATION REVIEW: + Initiate, perform and complete assigned… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE ... direction, administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one of the… more
- WellSpan Health (York, PA)
- Utilization Management Nurse (RN) - Case Management - Day (Temporary) Location: WellSpan Health, York, PA Schedule: Full Time Sign-On Bonus Eligible ... General Summary Performs a variety of reviews and applies utilization and case management techniques to determine the most...to determine the most efficient use of resources to support the provision of appropriate, cost effective and quality… more
- CVS Health (Raleigh, NC)
- …deliver solutions to make health care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote and ... what we deliver. Our Heart At Work Behaviors (TM) support this purpose. We want everyone who works at...team supporting the membership of plan sponsor. As a Utilization Management Nurse Consultant, you will utilize… more
- Beth Israel Lahey Health (Needham, MA)
- …in people's lives.** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission status based ... based on medical necessity and documentation is sufficient to support the level of care being billed. Conducts concurrent...billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records to… more
- Beth Israel Lahey Health (Burlington, MA)
- …Center is now offering up to a $3,500 in signing bonuses for our Utilization Review positions. Important Details: * Signing Bonuses are paid out in three payments. ... **Job Description:** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission status… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist LVN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose....net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist LVN II will… more
- Humana (Richmond, VA)
- …community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently… more
- Kepro (Indianapolis, IN)
- …partner for health solutions in the public sector. Acentra is currently looking for a Utilization Management Appeals Nurse - LPN/RN to join our growing team. Job ... Summary: Our Utilization Management Appeals Nurse - LPN/RN will...in fulfilling department responsibilities and collaborates with others to support the department's short- and long-term goals/priorities. + Prepares… more
- 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 Position Type: ... County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose....net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will… more
- McLaren Health Care (Detroit, MI)
- **Department: Utilization Management** **Daily Work Times: 7:00am-3:30pm** **Shift: Days** **Scheduled Bi-Weekly Hours: 40** **Position Summary:** Responsible for ... hospital admissions are based on medical necessity and documentation is sufficient to support the level of care being billed . Conducts concurrent reviews to ensure… more
- Martin's Point Health Care (Portland, ME)
- …Point has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of the Utilization Review ... retrospective requests for services requiring clinical review prior to payment. The Utilization Review Nurse will use appropriate governmental policies as well… more
- State of Connecticut, Department of Administrative Services (Hartford, CT)
- Utilization Review Nurse (40 Hour) Office/On-Site Recruitment # 240604-5612FP-002 Location Hartford, CT Date Opened 6/5/2024 12:00:00 AM Salary $76,565 - ... seeking a highly motivated and compassionate U tilization Review Nurse (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5612FP&R1=&R3=) to join our team! This position is… more
- R1 RCM (Pittsburgh, PA)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Utilization Review Nurse ** , you will help our hospital ... position. **Here's what you will experience working as a Utilization Review Nurse :** + Perform initial admission...stay reviews utilizing InterQual or Milliman to identify and support the appropriate level of care. + Abstract data… more
