- Albany Medical Center (Albany, NY)
- …Day (United States of America) Salary Range: $71,612.39 - $110,999.20 Responsible for Utilization Management , Quality Screening and Delay Management for ... assigned patients. * Completes Utilization Management and Quality Screening for assigned patients.* Applies MCG...with Triad Team and health care team. Minimum Qualifications:* Registered nurse with a New York State… 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...months of Prior Authorization. Education: . Active and unrestricted RN licensure in state of residence **About US Tech… more
- Prime Healthcare (Lynwood, CA)
- …experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum 5 ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/236088/ rn -case-manager utilization… more
- Huron Consulting Group (Chicago, IL)
- …the expert you are now and create your future. The Manager of Utilization Management is responsible for planning, organizing, developing, and directing ... Review Plan and the overall operation of the Utilization Management Department in accordance with federal,...Criteria and Milliman Care Guidelines (MCG) preferred. + Current RN license from Maryland Board of Nursing. + CCM… more
- Centene Corporation (Sacramento, CA)
- …degree and 4+ years of related experience. Knowledge of utilization management principles preferred. Must have a CA RN License **License/Certification:** + ... ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks... RN - Registered Nurse - State Licensure and/or Compact State Licensure required… more
- Cleveland Clinic (Cleveland, OH)
- …+ Graduate of an accredited School of Nursing + Current state licensure as a Registered Nurse ( RN ) + Basic Life Support (BLS) Certification through the ... most respected healthcare organizations in the world. As a Utilization Management Specialist, you will perform UM...Three years of equivalent full-time clinical experience as a Registered Nurse + Analytical ability required to… more
- CVS Health (Harrisburg, PA)
- …setting required for either BH or RN -1+ years of utilization review/ utilization management required (ie concurrent review, pre-certifications) for ... to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and...they work (LMSW, LCSW, LISW, LPC, LMFT etc.) or Registered Nurse in state of residence -3+… more
- Emanate Health (Covina, CA)
- …Requirement :** **Minimum Experience Requirement :** Minimum of three years of utilization management experience. Experience in quality- related job preferred. ... States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity… more
- Dignity Health (Gilbert, AZ)
- …and Responsibilities** Under the general direction of the Director of Care Management , performs criteria-based concurrent and retrospective utilization review to ... years of nursing experience + Certified Case Manager (CCM), Accredited Case Manager (ACM- RN ), or UM Certification + Utilization Review experience **Where You'll… more
- Centene Corporation (New York, NY)
- …and determination of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls; managing them in a ... license; and a NYS Driver's License or Identification card.** **Position Purpose:** The Utilization Review Nurse I provides first level clinical review for all… more