- McLaren Health Care (Bay City, MI)
- …barriers to D/C). 4. Identifies unsigned level of care (LOC) orders; communicates with utilization management nurse and obtains orders from providers. 5. ... **Three years of acute hospital care experience** _Preferred:_ + Experience in utilization management /case management , critical care, or patient… more
- UNC Health Care (Kinston, NC)
- …applied clinical experience as a Registered Nurse required. + 2 years utilization review , care management , or compliance experience preferred. + Minimum ... to support the clinical documentation specialists and Patient Financial Services. Supports the Utilization Review Nurse team when necessary by applying… more
- Cedars-Sinai (Los Angeles, CA)
- …has named us one of America's Best Hospitals. Summary of Essential Duties: + The Utilization Management (UM) Registered Nurse - Medicare Short Stay & ... Coordination **Req ID** : 14355 **Working Title** : Registered Nurse - Utilization Review Case Manager... Case Manager - 8 Hour Days **Department** : Utilization Management **Business Entity** : Cedars-Sinai Medical… more
- Centers Plan for Healthy Living (Margate, FL)
- …accepting applications for Full Time Registered Nurse without experience. The Utilization Management Clinical Reviewer works within a multidisciplinary ... care or support in their home to improve their quality of life. Utilization Management Clinical Reviewer will assess and process all authorization requests… more
- Evolent (Lansing, MI)
- …the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks ... physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care… more
- Hartford HealthCare (Hartford, CT)
- …The primary responsibility of the Metabolic and Bariatric Surgical/Medical Clinical Reviewer (MBSCR) is to ensure the accurate and timely collection, documentation, ... over the course of the patient's care through effective utilization of the hospital and surgeons' office record systems....departments, and others whose support is necessary for the management and success for the program. . Serves as… more
- Nuvance Health (Poughkeepsie, NY)
- …Team Leaders via program dashboard on quality and process measures.Participates in quarterly Utilization Review . 7.Prepares reports to DQS and Clinical Team as ... *Description* Summary: *Purpose: *The Quality Systems Reviewer assists in the implementation of the Agencyi? 1/2s Performance Improvement, Risk Management ,… more
- The County of Los Angeles (Los Angeles, CA)
- …may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience whose primary charge is ... UTILIZATION REVIEW NURSE SUPERVISOR I Print...of Los Angeles, a Utilization Review Nurse is an RN that has Case Management … more
- Ventura County (Ventura, CA)
- …the Senior Medical Management Nurse is responsible for performing utilization review , case management , and quality improvement functions to ensure ... Senior Medical Management Nurse - VCHCP Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5113983)..., Disease Management , Quality Assurance, HEDIS and/or Utilization Review . NECESSARY SPECIAL REQUIREMENTS + Must… more
- George C. Grape Community Hospital (Hamburg, IA)
- Quality/ Utilization Review Nurse Position Summary: The Quality/ Utilization Review Nurse is responsible for evaluating the medical necessity, ... years of clinical nursing experience (acute care preferred). o Prior experience in utilization review , case management , quality improvement, and infection… more
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