- Hackensack Meridian Health (Belle Mead, NJ)
- …Preferred: + Master's Degree. Licenses and Certifications Preferred: NJ State Professional Registered Nurse License or NJ Licensed Social Worker. 175164 Minimum ... healthcare and serve as a leader of positive change. The ** Utilization Management Coordinator** utilizes clinical knowledge and understanding of behavioral health… more
- CareFirst (Baltimore, MD)
- …in addition to the required work experience. **Licenses/Certifications Upon Hire Required:** + RN - Registered Nurse - State Licensure And/or Compact ... & Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination of health… more
- US Tech Solutions (May, OK)
- …of experience as an RN . 1+ years of inpatient hospital experience . Registered Nurse in state of residence . Must have prior authorization utilization ... and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review. . MUST HAVE 1 YEAR OF...months of Prior Authorization. Education: . Active and unrestricted RN licensure in state of residence **About US Tech… more
- Sanford Health (Rapid City, SD)
- …experience preferred. Experience in medical necessity review preferred. Currently holds an unencumbered registered nurse ( RN ) license with the State Board of ... Hours:** 40.00 **Department Details** Join our team as a Utilization Review and Case Management Manager and lead a...Nursing and/or possess multistate licensure if in a Nurse Licensure Compact (NLC) state. Obtains and subsequently maintains… more
- US Tech Solutions (Hopewell, NJ)
- …**Additional licensing, certifications, registrations:** 1. Requires an active New Jersey Registered Nurse License. **Knowledge:** - Prefers proficiency in the ... extends or Convert** **Job Description:** **his position is responsible for performing RN duties using established guidelines to ensure appropriate level of care as… more
- Albany Medical Center (Albany, NY)
- …by assuring communication with Triad Team and health care team. Minimum Qualifications:* Registered nurse with a New York State current license.* Bachelor's ... States of America) Salary Range: $71,612.39 - $110,999.20 Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients. *… more
- UNC Health Care (Kinston, NC)
- …+ Minimum 3-5 years of applied clinical experience as a Registered Nurse required. + 2 years utilization review, care management, or compliance experience ... denials management preferred. + **LICENSURE/REGISTRATION/CERTIFICATION** + Licensed to practice as a Registered Nurse in the state of North Carolina. **Job… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Manager of Utilization Review oversees a team of utilization review nurses and coordinators, ensuring compliance with clinical regulatory ... standards, and enhancing the overall utilization review process to optimize patient care and manage...+ 3-5 years work experience in healthcare as a nurse required + 1-3 years work experience in Care… more
- Hackensack Meridian Health (Edison, NJ)
- … utilization management. **Licenses and Certifications Required:** + NJ State Professional Registered Nurse License. + AHA Basic Health Care Life Support HCP ... and serve as a leader of positive change. The **Care Management, Care Coordinator, Utilization Management** is a member of the healthcare team and is responsible for… more
- Huron Consulting Group (Chicago, IL)
- …expert you are now and create your future. The Manager of Utilization Management is responsible for planning, organizing, developing, and directing implementation of ... the Utilization Review Plan and...Care Criteria and Milliman Care Guidelines (MCG) preferred. + Current RN license from Maryland Board of Nursing. + CCM or… more