- 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, ... Job Description: Position Purpose: Provide clinical services to employees within regulated scope of...employees within regulated scope of practice and disability case management . Experience/Education: MS/NP in nursing degree and current NP… more
- HumanEdge Travel Nursing and Allied Health (Hartford, CT)
- …(RN) license Clinical nursing experience Experience in care or utilization management (2+ years) BLS certification Computer proficiency Organizational skills ... Travel Nursing and Allied Health is seeking a travel nurse RN Utilization Review for a travel...Care management experience is a plus Excellent pay tailored to… more
- Novo Nordisk Inc. (Milwaukee, WI)
- About the Department The Clinical , Medical and Regulatory (CMR) department at Novo Nordisk is one of the most diverse and collaborative groups within the ... commensurate with experience. The Position Builds relationships and demonstrates the clinical outcome and benefits of Novo Nordisk Inc. (NNI) products. Educates… more
- UNC Health (Chapel Hill, NC)
- … experience in a medical facility and/or comparable Utilization Management experience.Knowledge/Skills/and Abilities Requirements:Job DetailsLegal Employer: ... serve.RN Utilization Manager position specifically for a Utilization Manager/ Clinical Appeals Nurse . This...The Utilization Manager works collaboratively with other Clinical Care Management staff to ensure patient… more
- The University of Vermont Health Network (Plattsburgh, NY)
- …summarization supports the Medical Center's performance improvement/quality program, risk management , clinical pathway development and outcome measurement using ... Unit Description: The Utilization Review Team monitors, collects and analyzes data...collects and analyzes data and evaluates variances of resource utilization , complications and overall quality of care based on… more
- Dana-Farber Cancer Institute (Boston, MA)
- …Director of Nursing is responsible for the planning, implementation and evaluation of clinical operations and personnel management of the assigned patient care ... the highest quality patient experience while maximizing provider time and space utilization . The Nurse Director uses extensive theoretical, evidence-based, and… more
- Saint Francis Health System (Tulsa, OK)
- …error, and support decision-making. Working knowledge of general disease state management processes, bio-psychosocial model, and clinical pathways. Ability to ... Saint Francis Health System is seeking a Registered Nurse (RN) Virtual Care for a nursing job...be detail oriented as required in the examination of clinical and numerical data. Ability to demonstrate comfort and… more
- Dana-Farber Cancer Institute (South Boston, MA)
- …Director of Nursing is responsible for the planning, implementation and evaluation of clinical operations and personnel management of the assigned patient care ... the highest quality patient experience while maximizing provider time and space utilization . The Nurse Director uses extensive theoretical, evidence-based, and… 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 ... as indicated and provides physician with status report. Maintains and updates clinical and patient records according to state and federal guidelines.Manages assigned… more
- CVS Health (Phoenix, AZ)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. Gathers clinical information and ... the state of Arizona or Compact RN licensure Preferred Qualifications: + Utilization management experience preferred. + Acute care setting experience preferred… more
- Humana (Montgomery, AL)
- …of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent… more
- Humana (Richmond, VA)
- …of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work... Nurse 2/Home Health Utilization Management : + Review cases using clinical knowledge,… more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... Communities is good for the Soul. Join Us!** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent critical… more
- CVS Health (Austin, TX)
- …more personal, convenient and affordable. Position Summary Precertification: Utilization Management Nurse Consultant + Utilizes clinical experience and ... 8:00pm EST zone (twice per month) Preferred Qualifications + Prior Authorization or Utilization Management experience + Managed care experience + MedCompass &… more
- CVS Health (Raleigh, NC)
- …the membership of plan sponsor. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate ... make health care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant...to coordinate, document and communicate all aspects of the utilization /benefit management program. -Utilizes clinical … more
- CVS Health (Raleigh, NC)
- …travel expected with this position. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and ... make health care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant...to coordinate, document and communicate all aspects of the utilization /benefit management program. - Utilizes clinical… more
- WellSpan Health (York, PA)
- Utilization Management Nurse (RN)...Relevant experience. Required + Experience in utilization management , case management , or clinical ... effective and quality health care. Provides leadership in the integration of utilization management principles throughout the System. Responsible for screening… 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. ... to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions...Job Summary: Our Utilization Management Appeals Nurse -… more
- AmeriHealth Caritas (Newark, DE)
- ** Utilization Management Plan Oversight Manager, Registered Nurse (must reside in DE)** Location: Newark, DE Primary Job Function: Medical Management ... reporting/analytics for UM DE, and serves as SME for clinical components DE Medicaid Utilization Management Program. Works in close collaboration with… 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 ... to support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist LVN II will facilitate, coordinate and… more
