- Dana-Farber Cancer Institute (Boston, MA)
- …the highest quality patient experience while maximizing provider time and space utilization . The Nurse Director uses extensive theoretical, evidence-based, and ... and direction, and promotes professional growth for self and staff. The Nurse Director acknowledges the inherent value of nursing collegiality to the advancement… more
- CHRISTUS Health (Alamogordo, NM)
- …monitoring, and reporting individual cases and/or trends to the infection control nurse . Performs utilization management functions as required by payer source. ... Director when there are actual or potential sources of under- or over- utilization . Collaborates with providers, nurses, patients, families, and other care providers… 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
- CHRISTUS Health (San Antonio, TX)
- …practice and operations for assigned areas; 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
- CHRISTUS Health (San Antonio, TX)
- …and business operations for CSR Emergency Room (Bitters/Banders). The nurse manager affects departmental outcomes through interpretation, implementation, and ... promote excellence in patient care and enhance patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically… more
- UT Health Tyler (Tyler, TX)
- …The Manager of Case Management has overall responsibility for hospital utilization management, transition management and operational management of the Case ... Management Department to promote effective utilization of hospital resources, timely and accurate revenue cycle processes, denial prevention, safe and timely patient… 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 ... and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center,...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… 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 ... dedicated team supporting the membership of plan sponsor. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document… 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 ... state. There is no travel expected with this position. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and… 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: ... safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist LVN II will facilitate, coordinate and approve medically… more
- Humana (Richmond, VA)
- …a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and… more
- Humana (Montgomery, AL)
- …a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and… 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 ... requests for services requiring clinical review prior to payment. The Utilization Review Nurse will use appropriate governmental policies as well as specified… 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: ... safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will facilitate, coordinate, and approve medically… more
- Humana (Columbus, OH)
- …a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and… more
- Milford Regional Medical Center (Milford, MA)
- …to our community with dignity, compassion, and respect. Statement of Purpose: The Utilization Review Nurse is responsible for utilization management at ... of 1 year Nurse Case Management experience Minimum of 1 year Utilization Review Nurse Experience including solid working knowledge with InterQual criteria more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …Role BHPS provides Utilization Management services to its clients. The Utilization Management Nurse - Prior Authorization performs medical necessity reviews ... any time with or without notice. Primary Responsibilities * Perform prospective utilization reviews and first level determinations for members using evidenced based… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …Role BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs daily medical necessity reviews. This position ... any time with or without notice. Primary Responsibilities + Performs concurrent utilization reviews (Acute, SNF, LTACH, ARF) and first level determination approvals… more
- R1 RCM (Pittsburgh, PA)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Utilization Review Nurse ** , you will help our hospital ... this position. **Here's what you will experience working as a Utilization Review Nurse :** + Perform initial admission and continued stay reviews utilizing… more
- CVS Health (Austin, TX)
- …health care more personal, convenient and affordable. Position Summary Precertification: Utilization Management Nurse Consultant + Utilizes clinical experience ... to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal...Qualifications + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN… more
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