- Dana-Farber Cancer Institute (Brookline, MA)
- …protocol submission to assist with MCA determinations/study design + Bachelor's Degree or RN Credential required + 5 years of Medicare coverage analysis ... fully remote with the ocassional time onsite as needed.** The Sr. Medicare Coverage Analyst (MCA) is responsible for reviewing clinical research protocols, Informed… more
- 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
- HCA Healthcare (Richmond, VA)
- …reviews, and patient audits as needed. **Qualifications that you will need:** + Registered Nurse Degree required. + Minimum 1 year directly related Healthcare ... **Introduction** Do you have the career opportunities as a Revenue Integrity Clinical Charge Review Analyst RN you want with your current employer? We have an… more
- Alameda Health System (Oakland, CA)
- System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Evening + Nursing + ... 2025 **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review RN is responsible for ensuring the...IRR) Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California… more
- Trinity Health (Columbus, OH)
- …accredited school of nursing. + Licensure / Certification: Current license to practice as a Registered Nurse ( RN ) in the State of Ohio. + Experience: Three ... **Employment Type:** Full time **Shift:** Day Shift **Description:** ** RN , Utilization Review Case Manager** **Why Mount Carmel?** With five hospitals… more
- Catholic Health Initiatives (Houston, TX)
- …be required to perform other duties as assigned. **Qualifications** **Required:** -Associate's Degree - Registered Nurse ( RN ) -Two (2) years of experience ... assist in determination of clinical appropriateness for level of care and Medicare /Medicaid and Managed Care related issues 3. Reviews all patient documentation in… more
- Centene Corporation (Sacramento, CA)
- …State Licensure required or + LVN - Licensed Vocational Nurse required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure ... a fresh perspective on workplace flexibility. This position requires RN California Licensure and for candidates to have a...analyzing the basis for the appeal + Ensures timely review , processing, and response to appeal in accordance with… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Case Manager PRN (CM) position is a licensed registered nurse ( RN ) who comprehensively plans for case management of a target ... department and the hospital. **SERVICE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued stay and...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Case Manager (CM) Certified position is a registered nurse ( RN ) responsible for comprehensively planning for case management of a ... includes two years in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + Health Services\ RN - Registered Nurse - Texas State Licensure and/or… 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