- CVS Health (Harrisburg, PA)
- …Degree and Independently licensed Behavioral Health Clinician Or Associate Degree and Licensed Registered Nurse with Psychiatric Experience** + **3 or more years ... BH clinical Experience** + **1 or more years Utilization Management Experience** + **Work at Home role. Can...of residence (LMSW, LCSW, LISW, LPC, or comparable) or Registered Nurse licensure with psychiatric specialty, certification,… more
- Children's Mercy Kansas City (Kansas City, MO)
- …experience + Experience in Utilization Review + One of the following: Licensed RN - MO, Registered Nurse Multistate License Missouri required upon hire ... training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including...+ One of the following: Licensed RN - Kansas, Registered Nurse … more
- Houston Methodist (Katy, TX)
- …with nationally recognized medical necessity review guidelines **LICENSES AND CERTIFICATIONS** **Required** + RN - Registered Nurse - Texas State Licensure - ... At Houston Methodist, the Director Centralized Utilization Review (UR) position is responsible for strategic, administrative, and operational leadership for the … more
- Community Health Systems (Franklin, TN)
- …Knowledge of HIPAA regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or ... **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the...and efficiency of hospital services to ensure compliance with utilization management policies. This role conducts admission and continued… more
- Veterans Affairs, Veterans Health Administration (Smyrna, TN)
- …the integration of VHA and industry best standards. The Revenue Utilization review (RUR) Registered Nurse ( RN ) is an active member of the revenue cycle ... equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion… more
- AmeriHealth Caritas (Washington, DC)
- …(BSN) preferred + Minimum of 3 years of diverse clinical experience as a Registered Nurse in an Intensive Care Unit (ICU), Emergency Department (ED), ... **$5,000.00 SIGN ON BONUS** **Role Overview** Our Utilization Management Reviewers evaluate medical necessity for inpatient...or commercial plan) preferred **Licensure** + Active and unencumbered Registered Nurse license in the District of… more
- New York State Civil Service (Syracuse, NY)
- …all requirements of non-competitive promotion are met.Promotional Field consists of Registered Nurse 1 Psychiatric (including all language parenthetic) ... NY HELP Yes Agency Mental Health, Office of Title Utilization Review Coordinator, (NY HELPS), Hutchings Psychiatric Center, P26038 Occupational Category Health Care,… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …in confidentiality, integrity, creativity, and initiative */License/Certifications:/* * Current Registered Nurse licensure upon hire * National certification ... *_SUMMARY:_* We are currently seeking a* Utilization Review Manager* to join ourTransitional Care Team.This...to 5) years of professional leadership experience (ie, charge nurse , team leader, preceptor, committee chair, etc.) * Five… more
- 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 + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + FTE:1 +… more
- CVS Health (Frankfort, KY)
- …behavioral health clinician with Kentucky state licensure (LCSW, LPCC, LMFT, LPAT) or a Registered Nurse ( RN ) with active current and unrestricted Kentucky ... every day. **Position Summary** This is a fully **remote** Utilization Review Clinical Consultant. **Must reside in the state...OR Minimum of an Associate's in Nursing or Diploma RN for Registered Nurses **Anticipated Weekly Hours**… more