- Commonwealth Care Alliance (Boston, MA)
- …timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role ... Utilization Management , the Nurse Utilization Management (UM) Reviewer is...**Essential Duties & Responsibilities:** + Conducts timely clinical decision review for services requiring prior authorization in a variety… more
- BroadPath Healthcare Solutions (Tucson, AZ)
- **Overview** BroadPath is seeking a highly motivated and results-oriented ** Utilization Management (UM) Nurse ** . Our ideal **UM Nurse ** will ensure ... policy, regulatory, and Health Plan guidelines. + Apply case management skills to members who have been identified as...years of experience in Managed Care, Provider Office, or Utilization Review organization required. + Knowledge of… more
- Commonwealth Care Alliance (Boston, MA)
- … Management is responsible for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible ... reports to the Director of Utilization Management - Oversees clinical decision review for...reviews). - Hire, train and mentor UM staff, including nurse reviewers and support personnel. - Act as liaison… more
- Geisinger (Wilkes-Barre, PA)
- Job Title: RN - Graduate Registered Nurse (Geisinger South Wilkes-Barre)Location: Wilkes-Barre, PennsylvaniaJob Category: Inpatient RN - Registered Nurse , ... and Nursing SupportSchedule: Rotation Work Type: Full timeDepartment: Talent Management Nursing & Nursing Support TeamDate Posted: 04/29/2025Job ID: R-77853Job… more
- Geisinger (Scranton, PA)
- Job Title: RN - Graduate Registered Nurse (Geisinger Community Medical Center, Scranton)Location: Scranton, PennsylvaniaJob Category: Inpatient RN - Registered ... Nurse , Nursing and Nursing SupportSchedule: Rotation Work Type: Full...and Nursing SupportSchedule: Rotation Work Type: Full timeDepartment: Talent Management Nursing & Nursing Support TeamDate Posted: 04/29/2025Job ID:… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …of healthcare services provided to all admitted patients. Using a value-based approach the Utilization Review Nurse ensures that care is administered via ... Work That Matters.** **Overview** **Purpose Statement/Position Summary:** The Utilization Nurse is responsible for utilization review including medical… more
- Skaggs Community Hospital Association (Branson, MO)
- …patient care team toward goal achievement in accordance with Standards of Nurse Anesthesia Practice, National Standards of Care as identified by respective ... to other team members. Excellent communication skills, leadership ability, time management , and problem solving skills required. * Job Requirements ◦ Education… more
- Alameda Health System (San Leandro, CA)
- Nurse , Care Management + San Leandro, CA + San...in Case Management in an acute setting or utilization review at a medical group or health plan. ... Management provides Care Coordination, Compliance, Transition Coordination, and Utilization Management . **DUTIES & ESSENTIAL JOB FUNCTIONS** NOTE:The… more
- Katmai (Fort Carson, CO)
- …all levels of health care management to include outside agencies. Performs utilization management activities to optimize cost, quality, and access to care. ... those required of any military or government civil service nurse of similar experience and in similar duty assignments....and employ safe work habits. + Utilize available information management systems in daily practice for patient care and… more
- Luke Staffing (Glendale, CO)
- **REGISTERED NURSE ** **SITE OF SERVICE:** Department of Veterans Affairs, Eastern Colorado Healthcare System (ECHCS), 4100 E. Mississippi Ave, Glendale, CO 80246 ... AM - 5:30 PM (excluding federal holidays) **POSITION OVERVIEW:** The Registered Nurse (RN) will provide on-site professional nursing services to beneficiaries of the… more
