- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …participates in all WC State Reporting and audits. Essential Qualifications + Currently licensed Registered Nurse ( RN ), Nurse Practitioner (NP), or ... monitoring, oversees all Clinical Services (CS) functions (prior authorization, concurrent review , appeals, case management, disease management, population… more
- Iowa State University (Ames, IA)
- …+ Master's degree in Nursing, Public Health, Global Health, or a related field. + Registered Nurse ( RN ) license in good standing. + Demonstrated experience ... Nursing Global Health course in spring 2026 for the RN -to-BSN curriculum. The Lecturer will be responsible, in collaboration...is expected that the Lecturer will participate in course review and revision based on feedback and evaluation metrics,… more
- AdventHealth (Orlando, FL)
- …Department experience. + BSN and 3 years of Clinical Documentation Specialist experience + RN - Registered Nurse - State Licensure and/or Compact State ... stewardship in the management of resources entrusted to them. + Reviews concurrent medical record for compliance including completeness and accuracy for severity of… more
- AdventHealth (Daytona Beach, FL)
- …: + Diploma Nursing Required + Bachelor's Required + 6 Related Experience Required + Registered Nurse ( RN ) Current, valid State of Florida or multi state ... for accurate public reporting of clinical outcomes. Utilizes clinical expertise to review patient care episodes across the continuum and make appropriate inferences… more
- AdventHealth (Kissimmee, FL)
- …+ 2 emergency or critical care experience + 5 experience + 5 in acute care setting + Registered Nurse ( RN ) + Basic Life Support - CPR Cert (BLS) + Advanced ... of care systems and assures compliance with quality measures through concurrent and retrospective review , identification of deficiencies, and implementing… more
- MVP Health Care (Schenectady, NY)
- …Master's prepared and licensed mental health clinician (LMSW, LCSW, LMHC, etc.) or Licensed Registered Nurse ( RN ) required + New York State license required ... . The Behavioral Health (BH) Professional is responsible for conducting utilization review for mental health and substance use treatment decisions. This individual… more
- Elevance Health (Ashburn, VA)
- …on relatively complex case types that require the training and skill of a registered nurse . Acts as a resource for more junior Clinicians. **Primary duties ... and/or utilization review experience. + Current active, valid and unrestricted RN license and/or certification to practice as a health professional within the… more
- HCA Healthcare (Englewood, CO)
- …Licensure/Certification/Registration: o Current licensure in the State of Colorado as a Registered Nurse , or current active multistate nursing licensure, or LCSW ... with the efficacious and cost effective utilization of resources. Through concurrent clinical case management, patients will be assessed to determine appropriateness… more
- Elevance Health (Las Vegas, NV)
- …relatively complex case types that do not require the training or skill of a registered nurse . Acts as a resource for more junior Clinicians. Primary duties may ... and/or utilization review experience. + Current active, valid and unrestricted RN license and/or certification to practice as a health professional within the… more
- Queen's Health System (Honolulu, HI)
- … concurrent medical records reviews and query process. * Responsible for the concurrent review of provider documentation to ensure the appropriate capture of ... A. EDUCATION/CERTIFICATION AND LICENSURE: * Current Hawaii State License as a Registered Nurse . * Bachelor's degree in Nursing. * Current certification as a… more