- UPMC (Harrisburg, PA)
- …+ Basic Life Support (BLS) OR Cardiopulmonary Resuscitation (CPR) + Driver's License + Registered Nurse ( RN ) OR Temporary Practice Permit (TPP) + Act ... Registered Nurse Home Health Harrisburg Are...of care in collaboration with physicians, patients, and utilization management ( UM ) professionals to meet physicians' orders… more
- Molina Healthcare (Meridian, ID)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... member care. We are seeking a candidate with a RN licensure that has previous UM and...promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. **Required Qualifications**… more
- Molina Healthcare (San Antonio, TX)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. Required Qualifications...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- University of Southern California (Alhambra, CA)
- …InterQual guidelines, and Medicaid/Medicare contracts and benefit systems. Required Licenses/Certifications: + Req Registered Nurse - RN (CA DCA) + Req Basic ... related to the status and processing of requests received from ambulatory care management nurse . 8. Assesses ongoing discharge planning needs and documents is… more
- Dignity Health (Santa Maria, CA)
- … Management or Nursing field in lieu of 1 year experience. + Current California Registered Nurse ( RN ) license. + Graduate of an accredited school of ... (5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case Manager (ACM- RN ), or UM Certification preferred + Knowledge of managed care and… more
- 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' ... pre-established review parameters under the direction of the YesCare Medical Director. + Identify and document comparisons with community...to ensure resources are maximized. + Work with other UM inpatient and outpatient nurse reviewers to… 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 ... within hospital Preferred + Certified Case Manager (CCM), Accredited Case Manager (ACM- RN ), or UM Certification preferred **Where You'll Work** Virginia Mason… more
- Corewell Health (Dearborn, MI)
- …in care management , utilization review, home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan Upon Hire required + ... observation or inpatient services. + May review cases for medical necessity, uses InterQual and/or other UR/ UM ...of care. Uses defined resources to guide decisions, including Medical Director Care Management , Physician Advisors, and… more
- Molina Healthcare (Spokane, WA)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary The Care Review Clinician ( RN ) provides support for clinical member services review...promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. Required Qualifications… more
- HonorHealth (AZ)
- …acute care setting. Required1 year experience in UR/ UM or Case Management RequiredLicenses and CertificationsRegistered Nurse ( RN ) State And/Or Compact ... area. The comprehensive network encompasses nine acute-care hospitals, an extensive medical group with primary, specialty and urgent care services, a cancer… more