- Elevance Health (Los Angeles, CA)
- …weekends.** **(Saturday 8am-12pm CST, with a comp day during the week)** The ** Nurse Reviewer I** will be responsible for conducting preauthorization, out of network ... ambulatory or hospital setting or minimum of 1 year of prior utilization management, medical management and/or quality management, and/or call center experience; or… more
- SUNY Upstate Medical University (Syracuse, NY)
- …preparing regulatory notices for delivery to the patient Minimum Qualifications: NYS Licensed/ Registered (or eligible) RN , Bachelor's Degree in Nursing, and a ... This is achieved through a thorough chart review and utilization of first-level screening criteria to ensure patients are...minimum of three years post RN licensure acute care nursing experience, or Associate's Degree… more
- Billings Clinic (Billings, MT)
- …triage room, if Chief complaint is emergent will immediately notify Triage Nurse . Obtains and/or records vital signs, including height and weight and places ... on white board for RN charts and documents in patients record according to...and patient/visitor problems to the ED Physician AND Primary Nurse /or ED Charge Nurse . * Documents all… more
- Prime Healthcare (Harlingen, TX)
- Overview We are seeking aMedical Surgical Clinical RN Supervisor,sometimes referred to as our Med Surg Clinical Nurse Supervisor or Med Surg Clinical House ... Supervisor. The Medical Surgical Clinical RN Supervisor is responsible for leading and coordinating activities on the Med-Surg unit to promote high-quality,… more
- SUNY Upstate Medical University (Syracuse, NY)
- …coordinating, facilitating and monitoring resources to achieve optimal clinical outcomes, utilization of services and financial goals. Oversees the discharge process ... discharge services that are available. Minimum Qualifications: NYS licensed RN (or eligible), Bachelor's degree in Nursing or a...plus a minimum of three (3) years acute care RN or acute care, transitional care, or chronic care… more
- Bassett Healthcare (Cooperstown, NY)
- …and enjoy the best quality of life possible. What you'll do The Discharge Nurse is accountable for the delivery of safe patient care utilizing the nursing process. ... The Discharge Nurse assesses, plans, delivers, coordinates, integrates, and evaluates nursing...and managerial observation + Demonstrates consideration of safety, effective utilization of equipment and materials, and cost in managing… more
- Highmark Health (Annapolis, MD)
- …**Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides ... **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or provider operations and/or… more
- UNC Health Care (Rocky Mount, NC)
- …and cost-efficient care of patients through such case management functions as utilization review and discharge planning. May facilitate the execution of existing ... for pathways, protocols, or guidelines that could improve patient care and utilization of resources. 2. Performs concurrent and retrospective admission and continued… more
- HCA Healthcare (Nashville, TN)
- …TriStar Skyline Medical Center, our nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want to create your own personal career ... and supports changes that improve quality of care, service and operations. + RN 's Only - Performs medical screenings on all patients entering admission department. +… more
- Humana (Juneau, AK)
- …**Use your skills to make an impact** **Required Qualifications** + 2+ years Utilization Management experience + Active RN license in the state(s) in ... of our caring community and help us put health first** The Pre-Authorization Nurse 2 reviews prior authorization requests for appropriate care and setting, following… more