- Cambia Health Solutions, Inc (Renton, WA)
- …creating a person-focused health care experience.Are you an RN who has experience with utilization and care management ? Do you enjoy conducting needs analysis to ... Clinical Learning and Development Specialist or Senior DOEWork from home within Oregon,...degree in Behavioral Health preferred for behavioral health care management ); or Registered nurse (RN) license (must… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …the health of our communities. About the Role:Job SummaryThe clinical informatics specialist (CIS) functions as a consultant, educator, and evaluator to maintain and ... Current Georgia License to practice in a clinical profession (ie Registered Nurse , Pharmacist, Therapist, etc.) if individual has a clinical background. Educational… more
- Comhar Inc. (Philadelphia, PA)
- …in areas such as conflict resolution, problem-solving and anger- management .Educate individuals on evidenced based practices.Demonstrated cultural sensitivity and ... with school, camp and community organizations in developing partnershipsPromote individuals' utilization of community resources and peer supports outside of the… 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 ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will facilitate, coordinate, and… more
- Veterans Affairs, Veterans Health Administration (Vancouver, WA)
- …with a small-town charm, this is the place to call home. The VISN 20 Utilization Management Nurse Specialist collaborates with interdisciplinary team ... Utilization Management (UM) Programs in VISN 20. The VISN 20 Utilization Management Nurse Specialist works closely and collaboratively with the… more
- Robert Half Office Team (Monterey Park, CA)
- Description The Utilization Management Nurse Specialist LVN promotes the quality and cost effectiveness of medical care by applying clinical acumen and ... review depending on case findings. Functions & Job Responsibilities * The Utilization Management Nurse Specialist LVN will facilitate, coordinate, and… more
- Robert Half Office Team (Los Angeles, CA)
- …* Facilitate, coordinate and approve medical referrals that meet specific criteria as a Utilization Management Nurse Specialist RN * Ensure timely ... Description We are seeking a UM Review Nurse to ensure the quality and cost-efficiency of...Function as a department guide for medical service requests/referral management and procedures * Handle incoming calls from providers,… more
- BayCare Health System (Cotton Plant, AR)
- …responsibility and clinical excellence. **BayCare Health System** is currently seeking a ** Utilization Review Specialist Senior** to join our outstanding and ... compassionate team. **The Utilization Review Specialist Senior responsibilities include:** +...Nursing RN. **Certifications and Licensures:** + Required RN (Registered Nurse ) + Preferred ACM (Case Management ) +… more
- Sanford Health (Bemidji, MN)
- …Conduct level of care medical necessity reviews within patient's medical records. Performs utilization management (UM) activities in accordance with UM plan to ... utilization and potentially, prior authorization. Assists the department in monitoring the utilization of resources, risk management and quality of care for… more
- University of Utah (Salt Lake City, UT)
- Details **Open Date** 05/16/2024 **Requisition Number** PRN38568B **Job Title** PS Clinical Nurse Specialist **Working Title** Clinical Nurse Specialist ... individual patients and/or groups of patients based on specialty area. The Clinical Nurse Specialist makes decisions independently and in collaboration with the… more
- Trinity Health (Ann Arbor, MI)
- …Type:** Full time **Shift:** Day Shift **Description:** Exceptional opportunity for a **Clinical Nurse Specialist ** to support our vision and serve with us as ... a compassionate and transforming healing presence in our community. The Clinical Nurse Specialist (CNS) functions as an advanced practice registered nurse … more
- MyFlorida (Gainesville, FL)
- REGISTERED NURSE SPECIALIST -F/C - 60005472 Date: May 15, 2024 Location: GAINESVILLE, FL, US, 32641 The State Personnel System is an E-Verify employer. For more ... Requisition No: 797758 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST -F/C - 60005472 Position Number: 60005472 Salary:… more
- Hackensack Meridian Health (Hackensack, NJ)
- …to transform healthcare and serve as a leader of positive change. The **Appeal Nurse Specialist ** will be responsible for the timely review and submission of ... Management ). **Responsibilities** A day in the life of a **Appeal Nurse Specialist ** at **Hackensack Meridian** **_Health_** includes: + Reviews all… more
- MyFlorida (Gainesville, FL)
- REGISTERED NURSE SPECIALIST -F/C OPS - 60957239 Date: Apr 24, 2024 Location: GAINESVILLE, FL, US, 32641 The State Personnel System is an E-Verify employer. For ... No: 815370 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST -F/C OPS - 60957239 Position Number:...knowledgeable of and utilize the principles of Total Quality Management . The employee in this position spends a minimum… more
- United Therapeutics (CA)
- …and pulmonary diseases, and other orphan diseases. **How you'll contribute** The Regional Nurse Specialist (RNS) is an educational resource deployed to help ... with superior financial performance and our communities with earth-sensitive energy utilization . Our company was founded by an entrepreneur whose daughter was… more
- MyFlorida (Macclenny, FL)
- REGISTERED NURSE SPECIALIST OPS - 60955422 Date: May 3, 2024 Location: MACCLENNY, FL, US, 32063 The State Personnel System is an E-Verify employer. For more ... . Requisition No: 772103 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST OPS - 60955422 Position Number: 60955422 Salary: $45.00… more
- Bon Secours Mercy Health (Richmond, VA)
- …Masters degree from an accredited school of Nursing. + Currently registered as a Clinical Nurse Specialist , licensed as a Nurse Practitioner or eligible to ... excellence. Job Description **Primary Function/General Purpose of Position** The Advanced Practice Nurse (APN) at St. Mary's Hospital is a professional nurse … more
- AdventHealth (Orlando, FL)
- …125,000 outpatients each year **The role you'll contribute:** **The Care Transitions Registered Nurse ensures that a care plan is carried out in partnership with the ... various other teams, including but not limited to Care Management nurses and social workers, nursing, home care liaisons,...high risk for readmission or for high emergency room utilization . Follows up with patients at location of post… more
- Alameda Health System (San Leandro, CA)
- Care Management Clinical Appeals Specialist + San Leandro, CA + Finance + Patient Financial Svcs - Facil + Full Time - Day + Business Professional & IT + Req ... Resource Management issues, other issues including concerns involving under/over utilization , avoidable days and quality issues. 13. Responsible for all incoming… more
- LA Care Health Plan (Los Angeles, CA)
- …the coordination of member care with internal LA Care departments such as Care Management (CM), Utilization Management (UM), Managed Long Term Services and ... Enhanced Care Management Clinical Specialist II Job Category:... Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance Salary Range Disclaimer:… more
