- CenterWell (Austin, TX)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... license + Possession of or ability to obtain Compact Nursing License + A minimum of three years clinical...procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous… more
- Dignity Health (Chandler, AZ)
- …and Responsibilities** Under the general direction of the Director of Care Management , performs criteria-based concurrent and retrospective utilization review to ... hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of...healthcare field + At least five (5) years of nursing experience + Certified Case Manager (CCM),… more
- Dignity Health (Gilbert, AZ)
- …and Responsibilities** Under the general direction of the Director of Care Management , performs criteria-based concurrent and retrospective utilization review to ... hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of...healthcare field + At least five (5) years of nursing experience + Certified Case Manager (CCM),… more
- AmeriHealth Caritas (Philadelphia, PA)
- …us at www.amerihealthcaritas.com . **Responsibilities:** Under the supervision of the LTSS Manager /Director for Utilization Management , this position is ... Home Modification Team and staff members within the LTSS Review Utilization Management Department. Responsibilities include providing technical and operational… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- … review functions. Oversees daily operations, which include supervising staff performing utilization management activities. The goal is to achieve clinical, ... *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional...financial, and utilization goals through effective management , communication, and… more
- Guthrie (Corning, NY)
- …in the State of practice. Certification within area of expertise or practice preferred ( Nursing Management , CCRN, CEN, etc.) BSN required within 3 years of hire. ... impact on practice in the planning and delivery of nursing and other services. + Utilizes staffing management...+ Manages daily staffing issues in conjunction with Charge Nurse / Nurse Manager , analyzing… more
- WMCHealth (Valhalla, NY)
- Supervisor Of Nursing - Nurse Manager Transplant Company: Westchester Medical Center City/State: Valhalla, NY Category: Nursing / Nursing Management ... (https://pm.healthcaresource.com/cs/wmc1/#/preApply/31152) Internal Applicant link Job Details: N4 Supervisor of Nursing / Nurse Manager - Transplant Required… more
- Prime Healthcare (Evanston, IL)
- …care in alignment with regulatory standards, hospital goals, and best practices in cardiovascular nursing . The Nurse Manager will lead a team of RNs, ... https://www.eeoc.gov/sites/default/files/2022-10/EEOC\_KnowYourRights\_screen\_reader\_10\_20.pdf #LI-SK3 Connect With Us! (https://careers-primehealthcare.icims.com/jobs/227652/ nursing - manager registered- nurse… more
- Trinity Health (Berwyn, IL)
- …are currently looking for an experienced Authorization Referral Coordinator. Reporting to the Manager of Utilization Management and working under general ... the clinical team per protocol. Refers requests to the nurse reviewer or medical director if criteria or guidelines...and assist with in-network referrals. + Escalate requests to nurse reviewers or medical directors when guidelines are not… more
- Children's Mercy Kansas City (Kansas City, MO)
- …of, and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including patient ... management and accountability Qualifications + Bachelor's Degree in nursing and + 3-5 years experience + Experience in... and + 3-5 years experience + Experience in Utilization Review + Master's Degree in nursing … more