- Cedars Sinai (Los Angeles, CA)
- …experience required 3 years of previous experience in case management, discharge planning, utilization review , and HMO in the acute inpatient or outpatient ... their needs, coordinating care, communicating with health plans (including concurrent review , which assists the hospitalist/ specialist and case manager to… more
- Generis Tek, Inc. (Mauston, WI)
- …To discuss this amazing opportunity, reach out to our Talent Acquisition Specialist Aditya Khandelwal at email address ###@generistek.com can be reached on # ... Timing : Nights (7:00pm to 7:30am) Position Summary: The Registered Nurse position provides quality, professional, general nursing care to patients. Responsible… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... to support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and… more
- HonorHealth (AZ)
- …here -- because it does. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
- Nuvance Health (Danbury, CT)
- …other duties as required. Education: ASSOCIATE'S LVL DGRE Required: 3 Years of Utilization Review experience(or a certification ACMA, MCG, Interqual) Required : ... (2nd week) ; rotate one weekend per month Summary: The purpose of the Utilization Management Nurse is to support the physician, the interdisciplinary team, and… more
- LifePoint Health (Louisburg, NC)
- …a valid job field* **Organization:** **Maria Parham Franklin* **Title:** *Registered Nurse Utilization Review Coordinator* **Location:** *NC-Louisburg* ... Registered Nurse (RN) Utilization Review ...Registered Nurse (RN) Utilization Review Job Type: Full Time...of those we serve. Connect with our RN recruiting specialist . Do you need more time to complete an… more
- Alameda Health System (Oakland, CA)
- …knowledge of current trends and changes in healthcare delivery as it pertains to utilization review (eg, medical necessity, level of care) by participating in ... System Utilization Management SUM Specialist + Oakland,...Expeditiously refer cases to the internal/external Physician Advisor for review of requests that may not meet medical necessity… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front end operations of the Case Management Department by ... Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A. Clinical/Technical/Service**… more
- Cambridge Health Alliance (Cambridge, MA)
- …team leader in multi-disciplinary team discussion regarding treatment planning, treatment review , quality assurance and utilization review ... Nurse Practitioner - Clinical Specialist II (APRN), Psychiatry **Requisition Number:** CHAP-2270 **Cambridge Health Alliance (CHA)** , a well-respected,… more
- Commonwealth Care Alliance (Boston, MA)
- …for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for conducting centralized ... reviews). * Hire, train and mentor UM staff, including nurse reviewers and support personnel. * Act as liaison...Skills & Abilities (must have): * Expertise in managing utilization review processes including prior authorization, concurrent… more
