- 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
- 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
- Dana-Farber Cancer Institute (Boston, MA)
- …of which must be in Nursing.Licensed as a Registered Nurse in the Commonwealth of Massachusetts.Hematology-Oncology experience required. Management experience ... the highest quality patient experience while maximizing provider time and space utilization . The Nurse Director uses extensive theoretical, evidence-based, and… more
- Dana-Farber Cancer Institute (South Boston, MA)
- …degree required, one of which must be in Nursing. Licensed as a Registered Nurse in the Commonwealth of Massachusetts. Hematology-Oncology experience required. ... the highest quality patient experience while maximizing provider time and space utilization . The Nurse Director uses extensive theoretical, evidence-based, and… more
- Wilson Medical Center (Wilson, NC)
- …external delivery of healthcare services. The Case Manager integrates the roles of Utilization Management , Case Management , and Discharge Planning. The Case ... with internal and external resources for optimal discharge planning Required Licenses Registered Nurse - Current/active North Carolina or compact RN license… more
- Advocate Aurora Health (Adell, WI)
- …with status report on a regular basis.Communicates problems to physicians and management and clearly states plans, actions and goals so changes are reflected ... caseload for optimal functional and financial outcomes; reviews caseload for Low Utilization Payment Adjustments (LUPA), optimal number of visits based on progress,… more
- UT Health Tyler (Tyler, TX)
- …regulations related to case management services. Qualifications Job Requirements: Registered Nurse - Diploma, Associates Degree or BSN Licensure current ... Manager of Case Management has overall responsibility for hospital utilization management , transition management and operational management of the… 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
- Glens Falls Hospital (Glens Falls, NY)
- …30 hours per week, can be foundhere. **Job:** **Nursing - Case Management * **Title:** * Registered Nurse - Utilization Review Nurse - Care ... timely and accurate information to payers. The role integrates and coordinates utilization management and denial prevention by focusing on identifying and… 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
- 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
- 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 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
- Ascension Health (Minooka, IL)
- …and coordinate compliance to federally mandated and third party payer utilization management rules and regulations. **Requirements** Licensure / Certification ... specifics._ **Responsibilities** Provide health care services regarding admissions, case management , discharge planning, and utilization review. +.../ Registration: + Registered Nurse credentialed from the Illinois Board… more
