- 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 ... care and cost effectiveness through the integrating and functions of case management, utilization review and discharge planning. The Care Manager must be highly… more
- Glens Falls Hospital (Glens Falls, NY)
- …**Job:** **Nursing - Case Management* **Title:** * Registered Nurse - Utilization Review Nurse - Care Management (Sign-On Bonus for Full-Time ... utilization management, or payer experience preferred. *Licenses, Certifications, Registrations:* * Registered Nurse (RN) in New York State *Skills and… more
- Ascension Health (Minooka, IL)
- …Provide health care services regarding admissions, case management, discharge planning, and utilization review . + Review admissions and service requests ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
- The Arora Group (Bethesda, MD)
- …guidelines. + The Contractor shall frequently collaborate with managers of the UBO, Utilization Review Registered Nurse (RN) and pre-certification ... Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/LVN) - Utilization Review in… more
- State of Connecticut, Department of Administrative Services (Middletown, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-Site Recruitment # 240516-5613FP-001 Location Middletown, CT Date Opened 5/17/2024 12:00:00 AM ... we serve. THE POSITION: We are currently seeking a Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=undefined&R3=undefined)… more
- McLaren Health Care (Detroit, MI)
- …accordance with established SOP procedures. 4. Maintains current knowledge of hospital utilization review processes and participates in the resolution of ... **Department: Utilization Management** **Daily Work Times: 7:00am-3:30pm** **Shift: Days**...projects as needed. _Required:_ + State licensure as a registered nurse (RN) + Bachelor's degree in… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR...CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board ... II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE SUPERVISOR II Salary $113,309.04 -… more
- University of Washington (Seattle, WA)
- …artistic pursuits, and natural beauty. Requirements: Current license to practice as a Registered Nurse in the State of Washington. Minimum of three years ... Req #: 228720 Department: HARBORVIEW - UTILIZATION MANAGEMENT Posting Date: 05/03/2024 Closing Info: Open... Management Specialist RN2 is responsible for the ongoing review of a designated group of patients through the… more
- New York State Civil Service (Albany, NY)
- NY HELP Yes Agency Corrections and Community Supervision, Department of Title Registered Nurse 2 Utilization (NY HELPS) Occupational Category Health Care, ... Possession of a license and current registration as a registered professional nurse in New York State;...clinical nursing experience of which one year was in utilization review and/or discharge planning. Substitution: a… more
- State of Connecticut, Department of Administrative Services (New Haven, CT)
- Utilization Review Nurse (40 Hour) Office/On-site Recruitment # 240514-5612FP-001 Location New Haven, CT Date Opened 5/16/2024 12:00:00 AM Salary $76,565* - ... and Addiction Services ( DMHAS (https://portal.ct.gov/DMHAS/About-DMHAS/Agency/About-DMHAS) ) as a Utilization Review Nurse (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5612FP&R1=&R3=) !… 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 insurance ... we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ . Skills… more
- Geisinger (Danville, PA)
- …re-admissions. + Assesses and recommends policies as they relate to readmissions and utilization review activities. + Reviews inpatient level of care and ... of 5 years-Health Insurance/Managed Care (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania; Basic… more
- Beth Israel Lahey Health (Burlington, MA)
- …Medical 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 ... Description:** **Job Description:** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate… 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 ... requiring clinical review prior to payment. The Utilization Review Nurse will use...License(s) and/or Certification(s): + Unrestricted state license as a Registered Nurse + Certification in managed care… more
- University of Utah Health (Salt Lake City, UT)
- …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** + ... Current license to practice as a Registered Nurse in the State of Utah,...Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of… more
- CDPHP (Albany, NY)
- …who share these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review ... constituents on CDPHP guidelines, policies, and procedures. QUALIFICATIONS + Registered Nurse or Licensed Practical Nurse...acute care experience is required as a Licensed Practical Nurse . + Minimum of two (2) years Utilization… more
- R1 RCM (Pittsburgh, PA)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Utilization Review Nurse ** , you will help our ... position. **Here's what you will experience working as a Utilization Review Nurse :** + Perform...onsite at a hospital setting. **Required Skills:** + Active Registered Nurse license For this US-based position,… more
- Milford Regional Medical Center (Milford, MA)
- …services to our community with dignity, compassion, and respect. Statement of Purpose: The Utilization Review Nurse is responsible for utilization ... Minimum of 1 year Nurse Case Management experience Minimum of 1 year Utilization Review Nurse Experience including solid working knowledge with InterQual… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …discharge between levels of care and facilities Essential Qualifications + Current licensed Registered Nurse (RN) in good standing. Must retain active licensure ... + Adaptive to a high pace and changing environment. + Proficient in Utilization Review process including benefit interpretation, contract language, medical and… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …The Role BHPS provides Utilization Management services to its clients. The Utilization Review Appeals Nurse performs daily appeal reviews and clinical ... Outpatient, DME, and Complex Care Needs. Essential Qualifications + Current licensed Registered Nurse (RN) with state licensure. Must retain active and… more