- 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
- Trinity Health (Albany, NY)
- …NY** is looking for an experienced RN to work as a Registered Professional Utilization Management Nurse (UMRN) full time evenings. M-F 8hr shifts The ... **The selected candidate will** : + Be responsible for the utilization management , both concurrent and retroactive for inpatient and outpatient services in… more
- Dignity Health (Northridge, CA)
- …required. + Current CA Registered Nurse (RN) license + Prior Utilization Management experience in a clinical or insurance setting required. + Previous ... 400 care centers. Visit dignityhealth.org/northridgehospital for more information. The RN Utilization Management Coordinator (UMC) is responsible for assessing… more
- Actalent (San Diego, CA)
- …admission status and patient classification. Skills: case management , acute care, registered nurse , utilization management , Care management ... care coordination for patients under the direction of a Registered Nurse and in compliance with evidence-based...for case management scope of services including: Utilization Management supporting medical necessity and denial… more
- Actalent (San Diego, CA)
- …admission status and patient classification. Skills: case management , acute care, registered nurse , utilization management , Care management ... the scope of services defined by the Registered Nurse RN state licensure requirements. + Utilization Management : Assures the patient is in the… more
- Actalent (San Marcos, CA)
- …practice, internal and external requirements. Skills: case management , acute care, registered nurse , utilization management , Care management ... case management scope of services including: + Utilization Management supporting medical necessity and denial...on-site case management at a hospital + Registered Nurse - RN NEED ACUTE EXPERIENCE… more
- Universal Health Services (Fremont, CA)
- …Come join our team and love what you do! We are currently hiring a per diem Utilization Management Registered Nurse (RN) for Fremont Hospital! The per ... diem Utilization Management RN is responsible for the facilitation of clinically...for continued stay reviews including completion of certifications. The Utilization Management RN will interface with managed… more
- Trinity Health (Hartford, CT)
- …provide that care efficiently to control costs. **What you will do:** + As a ** Utilization Management Registered Nurse RN** you will conduct prospective, ... Connecticut Joint Replacement Institute, and the Smilow Cancer Hospital. **Keywords: Case Management ; Case Manager; Registered Nurse ; RN; BSN; Connecticut**… more
- AmeriHealth Caritas (Newark, DE)
- ** Utilization Management Plan Oversight Manager, Registered Nurse (must reside in DE)** Location: Newark, DE Primary Job Function: Medical Management ... UM DE, and serves as SME for clinical components DE Medicaid Utilization Management Program. Works in close collaboration with all departments to achieve… more
- WellSpan Health (York, PA)
- Utilization Management Nurse (RN) -...administration or management . Preferred Licenses: + Licensed Registered Nurse Upon Hire Required or + ... quality health care. Provides leadership in the integration of utilization management principles throughout the System. Responsible...Registered Nurse Multi State License Upon Hire Required Apply Now… more
- Humana (Richmond, VA)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... 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) compact licensure with no… 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 ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse (RN) - Active, current and… 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 -...applicable to the position assignment. Required Qualifications/Experience: + Active Registered Nurse (RN) or Licensed Practical … more