- Veterans Affairs, Veterans Health Administration (MO)
- …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 ... determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply.… more
- Providence (Mission Hills, CA)
- … Utilization Management , medical necessity, and patient status determination. The Utilization Management RN must effectively and efficiently manage a ... **Description** Provide prospective, retrospective, and concurrent utilization reviews for our LA ministries. Conduct clinical...**Required Qualifications:** + Associate's Degree in Nursing. + California Registered Nurse License upon hire. + 2… more
- HCA Healthcare (Tallahassee, FL)
- …active FL RN licenserequiredwithin90 days of hire** + **Advanced Practice Registered Nurse license is acceptable for position if current and compliant** ... medical necessity, admission status, level of care, and resource management . The RN CM Care Coordinator will...+ **Certification in Case Management , Nursing, or Utilization Review ,… more
- HCA Healthcare (Tallahassee, FL)
- … license is acceptable for position if current and compliant + Certification in Case Management , Nursing, or Utilization Review , preferred + Three years of ... and assess observation patients for appropriateness in observation status + Performs utilization management reviews and communicates information to third party… more
- Veterans Affairs, Veterans Health Administration (MO)
- … nurse independently provides patient-centered and recovery-oriented care, milieu management , and maintains self-awareness while caring for patients living with ... the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Beth Israel Lahey Health (Cambridge, MA)
- …SKILLS, AND ABILITIES REQUIRED** 1. RN with experience in risk management , quality assessment, or utilization management . 2. Strong spreadsheet, ... on the key performance indicators and quality measures, the RN specialist also aims to foster a culture of...reduce serious safety events and improve patient outcomes. The nurse works with clinical staff to review … more
- Baylor Scott & White Health (Temple, TX)
- …for assessing and coordinating patient care across the continuum to include case management , social work, utilization review and care coordination to ... problem solving related to care coordination, discharge planning, case management and utilization review . Monitors...- 5 Years of Experience - CERTIFICATION/LICENSE/REGISTRATION - & Registered Nurse ( RN ) As a… more
- PeaceHealth (Bellingham, WA)
- **Description** PeaceHealth is seeking a RN Admissions/ Utilization Behavioral Health - Care Management for a Full Time, 1.00 FTE, Day position. The salary ... diagnostics. + Preferred: Third party reimbursement knowledge. + Preferred: Utilization Review experience, someone who can talk...someone who can talk to providers. **Credentials** + Required: Registered Nurse in state of practice +… more
- Houston Methodist (Sugar Land, TX)
- …Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical denial management ... clinical nursing/patient care experience which includes three years in utilization review , case management or...nongovernmental payers preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
- MTC (Raymondville, TX)
- …the use of appropriate sanitation methods. + Practice basic cost containment and utilization management for detainee care and facility operations. + Maintain ... Detention Facility in Raymondville, TX** is seeking a dedicated RN to provide compassionate care and support to individuals...of all medical records. Observe applicable HIPAA rules. + Review medical files to determine all provided services are… more