- Molina Healthcare (Yonkers, NY)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... Experience Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines. MULTI… more
- Molina Healthcare (North Las Vegas, NV)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines. **WORK… more
- State of Colorado (Pueblo, CO)
- …are understood, actionable, and tied to CMHHIP's improvement goals. + Participate in utilization management and review activities when requested, applying ... Nurse I - RN Critical Incident/Occurrence...listed. + Description + Benefits + Questions Department Information Registered Nurse I-Full Time CMHHIP This position… more
- Providence (Walla Walla, WA)
- **Description** The Inpatient Registered Nurse ( RN ) Care Manager provides professional, comprehensive, patient centric care management services for at ... Accountabilities include assessment and planning, coordination of care, resource utilization management and/ or review ,...Degree Nursing degree/diploma upon hire + Upon hire: Washington Registered Nurse License + 2 years Acute… more
- Northwell Health (Bay Shore, NY)
- …Performs retrospective reviews as required. + * Participates in the maintenance of Utilization Management , Discharge Planning and Case Management statistics ... of all changes in policies and procedures relating to Utilization Management , Discharge Planning and Case ...field, preferred. + Current license to practice as a Registered Professional Nurse in New York State.… more
- Dartmouth Health (Bennington, VT)
- …of clinical nursing experience required. Prior experience in utilization review , discharge planning and/or case management preferred. VT Nursing License ... The Health Resource Manager is responsible for providing case management services for SVMC sub acute patients.The case manager...required by date of employment. Case Management Certification required within 2 years of employment. *… more
- Veterans Affairs, Veterans Health Administration (Topeka, KS)
- Summary The Registered Nurse ( RN ) Referral Coordination Team (RCT) delivers fundamental knowledge-based care to assigned clients while developing technical ... Nurse 1, Level 1 Referral Coordination Team (RCT) Registered Nurse ( RN ) is responsible...intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards,… more
- CVS Health (Richmond, VA)
- …including NCQA standards. **Required Qualifications** + Candidate must have an active and unrestricted Registered Nurse ( RN ) License in Virginia OR Compact ... Prior Authorizations, Coordination with PCP and Specialty providers, Condition Management information and education, Medication management , Community...Registered Nurse ( RN ) License in state of residence… more
- Tufts Medicine (Melrose, MA)
- …role is essential in developing and maintaining an infrastructure for the systematic review and management of complex patients. The position will work closely ... managers, TMIN Practice Optimization Coaches (POMs) and primary care providers to review patient records, analyze data, and identify practice and patient outlier … more
- Dartmouth Health (Bennington, VT)
- …into a BSN program may be considered.Prior experience in utilization review , discharge planning and/or case management preferred.3-5years of recent clinical ... required. BSN preferred. Prior experience in utilization review , discharge planning and/or case management preferred....utilization review , discharge planning and/or case management preferred. VT Nursing License required by date of… more