- US Tech Solutions (Columbia, SC)
- **Duration: 3+ Months Contract (Possible Extension)** **Job Description:** + Must be an RN in SC and have an active and unrestricted SC RN license. + ... - M-F 8:30am - 5pm. + Onsite training for the first week. Remote once training is complete. + Experience: Hospital experience, UM experience. + Description:… more
- Sanford Health (Bemidji, MN)
- …for Nursing Commission for Nursing Education Accreditation (NLN CNEA). Currently holds an unencumbered registered nurse ( RN ) license with the State Board of ... time **Weekly Hours:** 40.00 **Salary Range:** $27.50 - $38.50 **Department Details** Remote work Available! **Job Summary** Conduct level of care medical necessity… more
- University of Rochester (Rochester, NY)
- …majority of work is remote with some on-site requirements as needed. Qualifications: RN with Utilization Review experience preferred; 3-5 years of recent ... of the individual, and internal equity considerations._ **Responsibilities:** The Utilization Management (UM) RN position spans the...Social Work, Patients, and various insurance companies. The UM RN is responsible for the review of… more
- Trinity Health (Silver Spring, MD)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Job Title:** RN Case Manager - Utilization Management **Employment Type:** Full Time ... Cross Hospital **Position Purpose:** As a Case Manager in Utilization Management, you will be the key to ensuring...care and address clinical documentation needs for accurate case review and status determination. + Oversee the continuity of… more
- Children's Mercy Kansas City (Kansas City, MO)
- …+ Experience in Utilization Review + One of the following: Licensed RN - MO, Registered Nurse Multistate License Missouri required upon hire + ... training oversight of programs and services. Responsible for effective utilization review and proper resource management of...One of the following: Licensed RN - Kansas, Registered Nurse … more
- Centene Corporation (Tallahassee, FL)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... Complies with all policies and standards. **This is a remote position. Ideal candidate will be located in eastern...abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with… more
- AmeriHealth Caritas (LA)
- …Degree in Nursing (ASN) required; Bachelor's Degree in Nursing (BSN) preferred. + An active Registered Nurse ( RN ) license in good standing is required. + 3+ ... efficiently document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria, care coordination,… more
- Centene Corporation (Tallahassee, FL)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... perspective on workplace flexibility. NOTE: This is a fully remote role. Preference will be given to applicants who...Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with… more
- AmeriHealth Caritas (Washington, DC)
- …efficiently document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria, care coordination, ... Demonstrated ability to meet productivity standards in a fast-paced, high-volume utilization review environment. + Current driver's license required… more
- Adecco US, Inc. (Minneapolis, MN)
- …the direct supervision of an RN or MD. . Performs utilization review activities, including pre-certification, concurrent, and retrospective reviews according ... turn around times. . Reviews, documents, and communicates all utilization review activities and outcomes including, but...** : . Knowledge of Home Health processes. . Registered Nurse with a current license to… more