- Prime Healthcare (Lynwood, CA)
- …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum 5… more
- Henry Ford Health System (Warren, MI)
- …screening criteria and critical thinking to maximize reimbursement. EDUCATION/EXPERIENCE REQUIRED: + Registered Nurse required. + Minimum 3-5 years of clinical ... Management experience in lieu of bachelor's degree. CERTIFICATIONS/LICENSURES REQUIRED: + Registered Nurse with a valid, unrestricted State of Michigan… more
- George C. Grape Community Hospital (Hamburg, IA)
- …infection control, and payers to resolve care coordination issues. Qualifications: * Education: Registered Nurse ( RN ) license required; BSN preferred. * ... Quality/Utilization Review Nurse Position Summary: The Quality/Utilization...prevention protocols and regulatory compliance. Key Responsibilities: * Utilization Review : o Conduct concurrent and retrospective reviews… more
- Ventura County (Ventura, CA)
- …CNA_MOA_2023-2028.pdf (ventura.org) (https://vcportal.ventura.org/CEO/HR/MOA/docs/CNA\_MOA\_2023-2028.pdf) PAYROLL TITLE: Senior Registered Nurse - Ambulatory ... Care DISTINGUISHING CHARACTERISTICS: The Senior Registered Nurse -Ambulatory Care series is distinguished from other nursing classifications in that they are… more
- Sacramento County (Sacramento, CA)
- …of Supervising Public Health Nurse : + Must possess and maintain a current Registered Nurse License and Public Health Nurse Certificate issued by the ... improperly rejected may request the Employment Services Division to review its decision to reject the application. If the...to this class must possess and maintain a current Registered Nurse license and Public Health … more
- Sharp HealthCare (La Mesa, CA)
- …**Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered ... care nursing experience or case management experience. + California Registered Nurse ( RN ) - CA...information to the department head as indicated. + Utilization review and utilization managementThe RN CM will:Conduct… more
- HCA Healthcare (Riverside, CA)
- …policies and procedures, and established standards of care. The Trauma Performance Improvement RN Coordinator is a registered nurse with in-depth knowledge ... adequate documentation as required by regulatory agencies. + Complete concurrent review of cases to identify quality,...equivalent work experience preferred. + Current license as a Registered Nurse in the state of California… more
- LA Care Health Plan (Los Angeles, CA)
- …requirements for health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management...to, placement (with level of care) criteria (MCG, InterQual), concurrent review , and discharge planning. Preferred: Consistent… more
- Providence (Beaverton, OR)
- …in the collaboration and management of patient care + Current unencumbered Registered Nurse License in state of residency **Preferred qualifications for ... + Bachelor's Degree in Nursing or Health Education + Upon Hire: Current unencumbered Registered Nurse License in Oregon + Within six months of hire date:… more
- University of Utah Health (Salt Lake City, UT)
- … or Case Management experience. **Licenses Required** + Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 days ... review . + Communication to third-party payers for initial and concurrent clinical review . + Reviews patient chart to ensure patient continues to meet medical… more