- Children's Mercy Kansas City (Kansas City, MO)
- …experience + Experience in Utilization Review + One of the following: Licensed RN - MO, Registered Nurse Multistate License Missouri required upon hire ... oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including patient...+ One of the following: Licensed RN - Kansas, Registered Nurse … more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …and may require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for ... performance review /*License/Certifications:*/ * Possession of a valid license as a Registered Nurse issued by the State of Minnesota. **Title:** *Staff … more
- State of Colorado (Sterling, CO)
- …Rights MINIMUM QUALIFICATIONS: + Applicant must possess a current, valid license as a Registered Nurse from the Colorado Board of Nursing or any state ... years of full-time experience providing patient care as a Registered Nurse . W ork experience less than...assessment, written performance assessment or it may include a review of your application material and your responses to… more
- CaroMont Health (Gastonia, NC)
- …are accurately determined. Refers to physician advisor and /or second level reviewer when necessary. Documents initial review , communications, and referrals in ... Job Summary: Completes initial review for medical necessity for all admissions in...denials. Composes a detailed summary of care and sends appeals to MCO, Medicare, or RAC for reversal of… more
- State of Colorado (Denver, CO)
- …About the Position: This position works under the supervision and direction of a registered nurse and assists with psychiatric and medical nursing care of ... Care: + Under the direction and supervision of a registered nurse , engage with patients to establish...and interventions before providing care, whenever possible + Assists RN and MHC to complete precaution levels and accountability… more
- State of Colorado (Garfield County, CO)
- …night shifts to include holiday & weekends as needed + Must possess a valid Registered Nurse License ( RN ) from the Colorado Department of Regulatory Agencies ... of Employment & Appeal Rights Education/Licensure/Certification/Experience: Current, valid licensure as a Registered Nurse from the Colorado Board of Nursing or… more
- Houston Methodist (Sugar Land, TX)
- …care for government and nongovernmental payers preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- ... Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical denial management and … more
- Sacramento County (Sacramento, CA)
- …of Supervising Public Health Nurse : + Must possess and maintain a current Registered Nurse License and Public Health Nurse Certificate issued by the ... improperly rejected may request the Employment Services Division to review its decision to reject the application. If the...to this class must possess and maintain a current Registered Nurse license and Public Health … more
- Community Health Systems (Franklin, TN)
- …Knowledge of HIPAA regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or ... **Job Summary** The Remote PRN Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital… more
- Sharp HealthCare (San Diego, CA)
- …+ 3 Years case management, utilization review , care coordination experience. + California Registered Nurse ( RN ) - CA Board of Registered Nursing ... Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA...Cycle/HIM regarding RAC decision to appeal, denials, input into appeals , share findings with providers. Review all cases… more