- YesCare Corp (Brentwood, TN)
- …+ Assist in completion of special projects on an as needed basis. **Key Qualifications:** + Registered Nurse ( RN ) active license + No less than 5 years' ... part of a team that is transforming lives through care and expertise. **Key Responsibilities:** + The nurse...and standards of best practice. + Facilitate quality health care intervention recommendations. + Review and assess… more
- Spira Care, LLC (Kansas City, KS)
- …Minimum Qualifications + Associate or bachelor's degree in nursing + Valid and active Registered Nurse ( RN ) in Kansas and Missouri or multi-state compact ... passionate about helping people achieve their health goals. The Care Guide, RN is an integral role...5 years' experience, including at least three years of Care /Case/Disease Management, Health Plan, or Utilization Review … more
- Providence (Olympia, WA)
- …people, we must empower them. **Required Qualifications:** + Upon hire: Washington Registered Nurse License + 3 years of Nursing **Preferred Qualification:** ... **Description** The Utilization Review (UR) Nurse has a strong...Associate's Degree in Nursing + 3 years of Utilization Review , Care Management, Quality Management, and/or Discharge… more
- HonorHealth (AZ)
- …institution RequiredExperience3 years Registered Nurse in an acute care setting. Required1 year experience in UR/ UM or Case Management RequiredLicenses ... -- because it does. Learn more at HonorHealth.com. Responsibilities Job SummaryThe Utilization Review RN Specialist reviews and monitors utilization of health … more
- Actalent (Atlanta, GA)
- …Customer Service, Claims, Contracts and Benefits - Appeals, and Risk Management. Essential Skills + Registered Nurse ( RN ) with a valid license in GA or ... Job Title: Utilization Review - FULLY REMOTE Job Description This role...UM ). + 1+ years of experience in managed care . Additional Skills & Qualifications + Experience with MCG… more
- Virginia Mason Franciscan Health (Silverdale, WA)
- …experience. **Licensure and Certifications:** Required + Current licensure as a Registered Nurse in the state of Washington ( RN -WA). + BLS required within 3 ... **Job Summary and Responsibilities** **JOB SUMMARY / PURPOSE** The Care Coordinator RN is responsible for overseeing...Preferred + Certified Case Manager (CCM), Accredited Case Manager (ACM- RN ), or UM Certification preferred **Where You'll… more
- Molina Healthcare (UT)
- …to other clinical programs. * Collaborates with multidisciplinary teams to promote Molina care model. * Adheres to utilization management ( UM ) policies and ... experience with MCG guidelines. At least 2 years of experience with inpatient concurrent review , prior authorization and managed care ; Acute care hospital… more
- Blue KC (MO)
- …of URAC and NCQA(R) guidelines and state and federal regulations. + Valid and active Registered nurse ( RN ) in Missouri and Kansas. + Case Management ... in FACETS UM system in accord with UM concurrent review guidelines. Consults with Medical...management and clinical transplant experience + Valid and active Registered nurse ( RN ) licensure in… more
- HCA Healthcare (Gainesville, FL)
- …that invests in you as a Inpatient Authorization Review Services Behavioral Health Registered Nurse ( RN ) or Licensed Mental Health Counselor (LMHC) or ... our team. **Job Summary and Qualifications** The Inpatient Authorization Review Services Behavioral Health Registered Nurse... contracting, experienced preferred. + Currently licensed as a registered nurse ( RN ) in the… more
- Corewell Health (Dearborn, MI)
- … management, utilization review , home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan Upon Hire required + ... and discharge planning of all hospitalized patients. + Identifies patients that need care management services (ie utilization review ; care coordination;… more