- Blue KC (MO)
- …and state and federal regulations. + Valid and active Registered nurse ( RN ) in Missouri and Kansas. + Case Management Certification within 3 years of ... medical policy. Opens case and follows NCQA case management standards. Documents transplant authorization, issues authorization letters, and... and clinical transplant experience + Valid and active Registered nurse ( RN ) licensure in… more
- Corewell Health (Grand Rapids, MI)
- …clinical nursing and or case management /managed care or related field Preferred + Registered Nurse ( RN ) - State of Michigan Upon Hire required + ... (4 hours), mostly remote, occasional on-site About the Department: RN UM - Supporting the insurance coordination...prior authorizations, initial reviews, continuous stay reviews and appeals. Nurse Care Manager - Plans and prioritizes care for… more
- Pacific Medical Centers (Renton, WA)
- …+ Coursework/Training Nursing (must be RN ) And + Upon hire: Washington Registered Nurse License + 5 years Clinical experience **Preferred Qualifications:** + ... RN is responsible for the supervision of case management (CM) and utilization management ( UM...Medical Director(s) to develop and implement strategic case management and utilization management yearly goals. Providence… more
- Saint Francis Health System (Tulsa, OK)
- …placement in various levels of care and receipt of necessary services. The Utilization Management ( UM ) Registered Nurse will communicate with providers ... Nursing. Licensure, Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License. Work Experience: Minimum 2 years of… more
- Providence (Santa Rosa, CA)
- **Description** RN Manager - Case Management unit at Santa Rosa Memorial Hospital, CA. This position is Full-time and will work 8-hour Day Shifts. Providence ... department direction and has daily operations oversight of the RN Case Managers in the Care Management ...field - Nursing Preferred. + Bachelor's degree for Case Management / UM Review: Nursing or related field.… 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) ... medical review request and /or denial activities to management as needed. **What you will do in this...care contracting, experienced preferred. + Currently licensed as a registered nurse ( RN ) in the… more
- Henry Ford Health System (Troy, MI)
- …in Utilization or Quality Management , required. CERTIFICATIONS/LICENSURES REQUIRED: + Registered Nurse ( RN ) with current Michigan licensure. Additional ... RN REFERRAL MANAGEMENT COORDINATOR (VIRTUAL) -...looking to grow our Prior Authorization Team with experienced Registered Nurses! We are a team of Registered… more
- Humana (Little Rock, AR)
- …of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require ... courses of action. As a Utilization Management RN working on the OneHome/Home Solutions UM ...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse ( RN ) in a… more
- OhioHealth (Columbus, OH)
- …Resuscitation - American Red Cross, DL - Driver's License - Department of Motor Vehicles, RN - Registered Nurse - Ohio Board of Nursing **Additional Job ... to promote patients' optimal health through disease prevention and management strategies. Evidence-based interventions are applied to populations for...Description:** RN from an accredited school of Nursing with a… more
- ERP International (Macdill AFB, FL)
- **Overview** ERP International is seeking ** Registered ** ** Nurse ( RN )** for Full-Time positions in **Case Management ** at MacDill AFB, FL. Apply online ... Management Specialist (CDMS) o Association of Rehabilitation Nurses: Certified Rehabilitation Registered Nurse (CRRN) o American Board for Occupational Health… more