- The University of Vermont Health Network (Plattsburgh, NY)
- Unit Description: The Utilization Review Team monitors, collects and analyzes data and evaluates variances of resource utilization , complications and overall ... and promotes the efficient and effective use of patient services. The Utilization Review Team's role in data collection, analysis and summarization supports the… 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 ... reviews in accordance with federal regulations & the Hospitals? Utilization Management Plan. In addition, the ...of employment date.Licensure/Certification Requirements:* Licensed to practice as a Registered Nurse in the state of North… 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 ... years of employment date.Licensure/Certification Requirements:* Licensed to practice as a Registered Nurse in the state of North Carolina.Professional Experience… more
- CHRISTUS Health (San Antonio, TX)
- …for assigned areas; at CHRISTUS St. Patrick Hospital. The nurse manager affects departmental outcomes through interpretation, implementation, and evaluation ... excellence in patient care, patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically… more
- Aequor (New York, NY)
- …an occupational nursing professional Minimum experience of 1-3 years in case management , utilization review and/or quality assurance Experience in episodic care, ... services to employees within regulated scope of practice and disability case management . Experience/Education: MS/NP in nursing degree and current NP license in New… more
- The University of Vermont Health Network (Elizabethtown, NY)
- …Required:* Minimum 2-year college degree in nursing field. BSN preferred.* Must be a Registered Nurse (RN), licensed in good standing in NYS. Must obtain BSN ... rules, and regulations, clinical practice guidelines, and quality issues related to utilization management with application for appeals and denials management… more
- Sentara Health (Hampton, VA)
- …involvement and creates unlimited opportunities for development and growth. Keywords: RN, registered nurse , case management , care plan, clerical, inpatient, ... those in-hospital patients identified in need of comprehensive case management . Promotes effective utilization and monitoring of...(BLS) - Certification - American Heart Association (AHA) RQI, Registered Nurse (RN) Single State - Nursing… more
- Sentara Health (Virginia Beach, VA)
- …to be the healthcare choice of the communities that we serve! Keywords: RN, Registered Nurse , Case Management , Care Management , Monster, Talroo-Nursing, ... Compact License ASN, BSN, or MSN 3 years case management experience Benefits: Sentara offers an attractive array of...- RN-Master's Level Degree, N-DN - RN-Doctorate Level Degree Registered Nurse (RN) Single State - Nursing… more
- University of New Mexico - Hospitals (Algodones, NM)
- …Medical necessity and manage the insurance authorization throughout the stay . Department: Utilization Management - UH FTE: 0.05 Casual Pool (as needed) Shift: ... This is a Utilization Review position. We review all admissions and...negligible. Working conditions: Essential: * Minor Hazard - physical risks, dirt, dust, fumes, noise Department: Registered Nurse… more
- Pathways Vermont (Burlington, VT)
- …Supervise three Shift Supervisors, a Services Team Lead, and an Advanced Practice Registered Nurse (APRN). Meet weekly for individual supervision, to review role ... residents receive excellent services, including: Individualized Service Plans Monitoring utilization of services, including duration, medication, incidents, external connections,… more
- University of New Mexico - Hospitals (Albuquerque, NM)
- …and all other sedentary criteria are met. Working conditions: Essential: * Minor Hazard - physical risks, dirt, dust, fumes, noise Department: Registered Nurse ... * COORDINATE - Coordinates and facilitate communication between Health Information Management , Utilization Review/Case management , Quality Management… more
- University of New Mexico - Hospitals (Algodones, NM)
- …Essential: * Sig Hazard: Chemicals, Bio Hazardous Materials req PPE * Subject to an annual contract and performance appraisal Department: Registered Nurse ... to base pay. Sign-on Bonus and Relocation Reimbursement available!Department: Care Management Services FTE: 1.00 Full Time Shift: Days Position Summary: Responsible… 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 ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… 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 ... Assigned:** 1. Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure...projects as needed. _Required:_ + State licensure as a registered nurse (RN) + Bachelor's degree in… more
- University of Washington (Seattle, WA)
- Req #: 228720 Department: HARBORVIEW - UTILIZATION MANAGEMENT Posting Date: 05/03/2024 Closing Info: Open Until Filled Salary: $7375 - $13,396 per month Shift: ... benefits for this position, click here (https://hr.uw.edu/benefits/wp-content/uploads/sites/3/2018/02/benefits-summary-classified-staff-greater-than-half-time-20220908\_a11y.pdf) . RN2, Utilization Management Specialist. This is a hybrid… more
- University of Virginia (Charlottesville, VA)
- Under general direction: The Utilization Management RN serves as a leader resource in the Utilization Management process. They collaborate with ... UM RN conducts initial concurrent and retrospective medical necessity reviews. All Utilization Management activities are performed in accordance with the mission… more
- Insight Global (New York, NY)
- Job Description Insight Global is looking for a Pre-Access Utilization Management Registered Nurse to sit remotely with one of their large health ... and send to me with QB - 4-5 years of Remote Utilization Management experience at Payors, inpatient or outpatient - Proficiency using a MacBook… more
- Geisinger (Danville, PA)
- …of 5 years-Health Insurance/Managed Care (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania; Basic ... with decision making and documentation processes. + Works with staff and management team to support recommendations for high risk members to improve transitions… more
- Cleveland Clinic (Stuart, FL)
- …+ Requires three years equivalent full-time clinical experience as a Registered Nurse . + Prior Utilization Management experience is preferred. + ... but also a home away from home. As a Utilization Management (UM) RN Reviewer, you will...an accredited school of nursing with licensure as a Registered Nurse (RN) in the State. +… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** Utilization Management Nurse -Front End Review utilizes clinical nursing skills to ... 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 Florida with no… more
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