- Alameda Health System (Oakland, CA)
- …nursing background. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California. Preferred ... Director, Utilization Management + Oakland, CA + Highland General Hospital...the utilization of healthcare services, including appropriateness, efficiency, and medical necessity of treatments and procedures. + Analyze data… more
- Commonwealth Care Alliance (Boston, MA)
- …staff selection, training, and performance monitoring and * Leads the Utilization Management team in managing and continuously improving UM program design, ... or Health related field preferred Required Licensing: * active RN license required Required Experience: * 7-10 years *...minimum five (5) years of leadership experience in Utilization Management ( UM ) or nursing leadership to include… more
- TEKsystems (Canoga Park, CA)
- …for a Licensed Vocational Nurse (LVN) or Registered Nurse ( RN ) with hands-on experience in Utilization Management ( UM ) and a strong understanding ... LVN or RN license (California) + 2+ years of experience in Utilization Management ( UM ) + Hands-on experience with HMO/Medicare claims, audits, and denials +… more
- HCA Healthcare (Englewood, CO)
- …Licensure/Certification/Registration: o Current licensure in the State of Colorado as a Registered Nurse , or current active multistate nursing licensure, or LCSW ... years UM /CM experience required. o One to three years charge/lead/supervisory/ management experience required, in UM /CM department role preferred. Able to… more
- UCLA Health (Los Angeles, CA)
- …- $341,800/annually Qualifications We're seeking an experienced leader with: + A Registered Nurse License, Advanced Practice Provider ( Nurse Practitioner ... programs and medical services with an emphasis on optimizing Utilization Management for the Faculty Practice Group (FPG) Management Services Organization… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests ... of services and care. * Provides referrals to Case management , Disease Management , Appeals & Grievances, and...* Current Licensed Practical Nurse (LPN) or Registered Nurse ( RN ) with state… more
- Brighton Health Plan Solutions, LLC (NC)
- …BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests ... of services and care. * Provides referrals to Case management , Disease Management , Appeals & Grievances, and...requirements. * Duties as assigned. Essential Qualifications * Current Registered Nurse ( RN ) with state… more
- Veterans Affairs, Veterans Health Administration (Seattle, WA)
- … professional nurse who exemplifies leadership and oversees registered nurse ( RN ) and advanced medical support assistant (AMSA) staff within ... Washington. The Nurse Manager directly supervises the RN Utilization Management /Discharge Planners, AMSA Discharge Coordinators,...RNs, and Traveling Veteran Coordinators. Responsibilities The Nurse Manager (NM) is a registered… more
- UPMC (Coudersport, PA)
- …+ Basic Life Support (BLS) OR Cardiopulmonary Resuscitation (CPR) + Driver's License + Registered Nurse ( RN ) OR Temporary Practice Permit (TPP) + Act ... UPMC Home Health is hiring a Registered Nurse for the area. Are...of care in collaboration with physicians, patients, and utilization management ( UM ) professionals to meet physicians' orders… more
- University of Michigan (Ann Arbor, MI)
- …directly relate to this position. **Job Summary** Under direct supervision from a Registered Nurse or other designated supervision, provide direct patient care ... patient care and related duties. **Desired Qualifications + Completion of a Certified Nurse Aide or Certified Medical Assistant program + Basic computer skills… more