- University of Miami (Miami, FL)
- …25% 1. Ensures that each clinic is well prepared consi sting of all medical records (print and electronic) are up to date with all pertinent tests received ... any abnormal results (non - critical values) to the nurse who in turn will contact the physician accordingly...physician accordingly 5. Ens ures that patients receive appropriate medical pre - op medical clearances 6.… more
- UPMC (Altoona, PA)
- …patients' plans of care in collaboration with physicians, patients, and utilization management ( UM ) professionals to meet physicians' orders and patients' needs. ... + RN will coordinate case management activities across...Licensure, Certifications, and Clearances: + Current licensure as a Registered Professional Nurse either in the state… more
- UPMC (West Mifflin, PA)
- **UPMC Home Health is Hiring Registered Nurses ( RN 's) for the** **Elizabeth and Mon Valley areas** Are you a nurse looking for a rewarding career where you ... patients' plans of care in collaboration with physicians, patients, and utilization management ( UM ) professionals to meet physicians' orders and patients' needs.… more
- US Tech Solutions (Columbia, SC)
- **Duration: 3+ Months Contract (Possible temp to hire)** **Job Description:** + Must be an RN in SC and have an active and unrestricted SC RN license. + ... be moved to work remote. + Prefer 2 yrs. UM and/or appeals experience. + Experience with prior insurance,...and/or appeals experience. + Experience with prior insurance, utilization management , case management , surgical or behavioral health… more
- Centers Plan for Healthy Living (Margate, FL)
- …Living is currently accepting applications for Full Time Registered Nurse without experience. The Utilization Management Clinical Reviewer works within ... or support in their home to improve their quality of life. Utilization Management Clinical Reviewer will assess and process all authorization requests to determine … more
- CVS Health (Harrisburg, PA)
- …both verbal and written **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must have active ... RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will...our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company… more
- TEKsystems (Rockville, MD)
- …company, is hiring for a Remote Quality Assurance Analyst and is looking for UM Nursing experience. Job Description: + Their process includes the following: + Double ... They may have some quick turnaround cases, so time management is going to be important. + Going through...authorizations Qualifications to Apply: + A Nursing Degree either RN ($31.50/hour) or LPN ($29/hour) and everything active +… more
- LA Care Health Plan (Los Angeles, CA)
- …for health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted California ... required to achieve that purpose. Job Summary The Utilization Management ( UM ) Admissions Liaison RN ...Works with UM leadership, including the Utilization Management Medical Director, on requests where determination… more
- CVS Health (Richmond, VA)
- … management regarding physical and behavioral health clinical issues as they relate to medical management ( UM , CM, DM) provider and system of care issues, ... broader Plan operations. **Required Qualifications:** + Must reside within Virginia. + Registered Nurse with 5 years Behavioral Health Experience or Behavioral… more
- LA Care Health Plan (Los Angeles, CA)
- …an enthusiastic team player. Must be able to work independently. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... achieve that purpose. Job Summary The Supervisor of Utilization Management ( UM ) RN is responsible...Off (PTO) + Tuition Reimbursement + Retirement Plans + Medical , Dental and Vision + Wellness Program + Volunteer… more