- Waystar (Atlanta, GA)
- …end user adoption of best practice workflows. We are specifically seeking an experienced Utilization Review Nurse who will serve as an integral contributor ... **ABOUT THIS POSITION** The Clinical Product Consultant for Utilization Management is a member of...Bachelor of Science in Nursing (BSN) or equivalent (with RN licensure) + 8+ years of clinical experience in… more
- Molina Healthcare (Orem, UT)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Houston Methodist (Houston, TX)
- …HMWB (Willowbrook) HMTW (The Woodlands), HMSL (Sugar Land), HMCY (Cypress) At Houston Methodist, the Registered Nurse ( RN ) PRN position is a licensed staff ... a healthcare environment **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -...clinical judgment to work autonomously as defined by the Nurse Practice Act + Demonstrates proficient time management… more
- St. Bernard's Medical Center (Jonesboro, AR)
- …continuity of care and cost effectiveness through the integration and functions of case management and utilization review . The person in this position is ... + JOB REQUIREMENTS + Education + Current Arkansas State RN or LPN license. + Experience + Nurse with previous case management experience preferred, but not… more
- Highmark Health (Pittsburgh, PA)
- …advisor and third party payers. + Maintains a working knowledge of care management , care coordination changes, utilization review changes, authorization ... :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Registered nurse who is proficient in the...as an educational resource to all AHN staff regarding utilization review practice and governmental commercial payer… more
- CVS Health (Baton Rouge, LA)
- …each and every day. **Position Summary** The Utilization Management Nurse Consultant (UMNC) for NICU Concurrent Review conducts high-acuity, timely, and ... integrity and compliance. * Participate in quality improvement, policy review , and education related to NICU and special populations..., and education related to NICU and special populations utilization management . * Serve as a clinical… more
- CVS Health (Baton Rouge, LA)
- …we do it all with heart, each and every day. **Position Summary** The Utilization Management Nurse Consultant (UMNC) for Prior Authorization conducts ... improvement, policy review , and education related to utilization management . * Serve as a clinical...and data integrity **Required Qualifications** * Active, unrestricted Louisiana RN license or compact license * Minimum 3 years… more
- Mohawk Valley Health System (Utica, NY)
- …population. Provides direct oversight of the case manager's daily operations of utilization review practice, processes and procedures ensuring accurate member ... RN Supervisor Case Management - Full...Performs related duties as assigned. Education/Experience Requirements REQUIRED: + Registered Nurse licensed in State of New… more
- Baylor Scott & White Health (Dallas, TX)
- …or related field preferred. Master's degree preferred. 2. 5+ years of experience in case management , social work, utilization review , or related field. 3. 1+ ... , social services, coordination of patient care, patient access, utilization management , and discharge planning. Directs the...years of experience in a leadership role preferred. 4. Registered Nurse ( RN ) or Licensed… more
- Texas Health Resources (Dallas, TX)
- …experience required. * One year of hospital case management experience is preferred. * RN - Registered Nurse Upon Hire Req or LMSW - Licensed Master ... all available resources. Assesses patient information utilizing psychological and medical knowledge. Utilization Review and Management * Performs effective … more