- Molina Healthcare (Syracuse, NY)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... and cost-effective member care. The candidate must have a RN licensure and experience with medical surgical,...intensive care unit, or in a telemetry type setting. UM medical review experience highly preferred. Work… more
- Commonwealth Care Alliance (Boston, MA)
- …Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management ( UM ) Reviewer is responsible for day-to-day ... review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key...Ensures accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy +… more
- UPMC (Pittsburgh, PA)
- UPMC Home Health is Hiring a Full-Time Registered Nurse ( RN ) for the Uniontown and Surrounding Areas Are you a nurse looking for a rewarding career where ... patients' plans of care in collaboration with physicians, patients, and utilization management ( UM ) professionals to meet physicians' orders and patients' needs.… more
- Molina Healthcare (Salt Lake City, UT)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal...required. * Serves as a clinical resource for utilization management , chief medical officer, physicians, and member/provider… more
- UCLA Health (Los Angeles, CA)
- Description At UCLA Health, the Utilization Management ( UM ) Review Nurse plays a vital role in ensuring the delivery of high-quality, evidence-based care. ... for reviewing and evaluating clinical documentation related to prior authorization requests for medical services. The UM Review Nurse applies clinical… more
- MVP Health Care (Tarrytown, NY)
- …thinking and continuous improvement. To achieve this, we're looking for a **Professional, Sub-Acute RN UM Reviewer - Medicare** to join #TeamMVP. If you have a ... our Talent team at ###@mvphealthcare.com . **Job Details** **Job Family** ** Medical Management /Clinical** **Pay Type** **Salary** **Hiring Min Rate** **56,200… more
- Veterans Affairs, Veterans Health Administration (Salt Lake City, UT)
- Summary The Utilization Management ( UM ) Registered Nurse ( RN ) executes position responsibilities that demonstrate leadership, experience, and ... qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. Preferred Experience: Master's prepared Registered Nurse . 5 years Utilization Management… more
- University of Michigan (Ann Arbor, MI)
- REGISTERED NURSE : Ambulatory Care Services (Chelsea Health Center Urology Clinic) Apply Now **Mission Statement** Michigan Medicine improves the health of ... world and has been the site of many groundbreaking medical and technological advancements since the opening of the...Recruitment at ###. **Required Qualifications Current licensure as a Registered Nurse in the State of Michigan… more
- University of Michigan (Ann Arbor, MI)
- REGISTERED NURSE : Decentralized Float (Rachel Upjohn Building, Taubman Center, East Ann Arbor) Apply Now **Mission Statement** Michigan Medicine improves the ... opportunity employer. **Job Detail** **Job Opening ID** 270945 **Working Title** REGISTERED NURSE : Decentralized Float (Rachel Upjohn Building, Taubman Center,… more
- University of Michigan (Ann Arbor, MI)
- REGISTERED NURSE : Domino Farms MEND Clinic Apply Now **Responsibilities + Provide the delivery of culturally sensitive team-based care models in delivering ... world and has been the site of many groundbreaking medical and technological advancements since the opening of the...employer. **Job Detail** **Job Opening ID** 270527 **Working Title** REGISTERED NURSE : Domino Farms MEND Clinic **Job… more