• Payment Integrity Nurse Coder RN III

    LA Care Health Plan (Los Angeles, CA)
    …of Microsoft Office suite, including Word, Excel and PowerPoint. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... Payment Integrity Nurse Coder RN III Job Category:...policies within the claim adjudication process through medical record review for Payment Integrity and Utilization Management projects. The… more
    LA Care Health Plan (04/11/25)
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  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    …or squatting. Considerable ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management ... OPTION II: Two (2) years of experience as a registered nurse , of which one year must...**? **In the County of Los Angeles, a Utilization Review Nurse is an RN more
    The County of Los Angeles (05/22/25)
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  • Care Nurse Coordinator- RN

    WellSpan Health (Lebanon, PA)
    …2 years Nursing experience and recent behavioral health experience required **Licenses:** + Licensed Registered Nurse Upon Hire Required or + Registered ... care and treatment progress. + Participates in daily communication with primary nurse , communicating any clinical concerns and assist in developing an action plan… more
    WellSpan Health (05/31/25)
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  • RN Nurse Manager Home Health

    BAYADA Home Health Care (Honolulu, HI)
    …position including client visits as necessary. **Qualifications:** + An active Hawaii Registered Nurse license. + Home Health experience preferred. + Recent ... Health Care** is currently seeking **full-time Clinical Managers (HI RN active license required)** in our Medicare ...field staff + Orientation of field staff + Documentation review , including OASIS and Home Care Home Base (HCHB)… more
    BAYADA Home Health Care (06/01/25)
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  • Clinical Nurse ( RN ) - Transfer…

    Stanford Health Care (Palo Alto, CA)
    …and other government programs as well as private insurance **Licenses and Certifications** + Nursing\ RN - Registered Nurse - State Licensure And/Or Compact ... entire transfer episode, from start to finish. Our Clinical Nurse ( RN ) job classification is represented by...Nursing Achievement (CRONA). CRONA is an independent union for Registered Nurses at Stanford Health Care and Lucile Packard… more
    Stanford Health Care (05/28/25)
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  • RN Staff Nurse

    South Central Regional Medical Center (Laurel, MS)
    REGISTERED NURSE - QUALITY CARE MANAGER Position: Quality Care Manager - RN Department: Quality Management Reports to: Director/Designated Manager Created: ... quality measures, payors and payment models + Knowledgeable of criteria for Medicare , Medicaid, HMO, and private insurance coverage + Responsible for evaluating and… more
    South Central Regional Medical Center (05/21/25)
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  • Utilization Review Nurse (Position…

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse ( RN ) who comprehensively conducts point of entry and ... in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -...experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare , Medicaid,… more
    Houston Methodist (05/15/25)
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  • Case Manager ( RN ) - Full Time…

    Houston Methodist (The Woodlands, TX)
    At Houston Methodist, the Case Manager (CM) position is a registered nurse ( RN ) responsible for comprehensively planning for case management, which includes ... clinical experience + Case management experience preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or… more
    Houston Methodist (05/16/25)
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  • MDS RN - Part time

    SSM Health (Fond Du Lac, WI)
    …Support HealthCare Provider (BLS HCP) - American Heart Association (AHA) + And + Registered Nurse ( RN ) - Missouri Division of Professional Registration + ... documentation of CNA's and nursing staff. Conducts training and review of ADL's and other minimum data set related...Or + Registered Nurse ( RN ) Issued by… more
    SSM Health (05/19/25)
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  • RN Utilization Review Specialist Per…

    HonorHealth (AZ)
    …1 year experience in UR/UM or Case Management Required Licenses and Certifications Registered Nurse ( RN ) State And/Or Compact State Licensure Required ... because it does. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization of health care… more
    HonorHealth (03/12/25)
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