- CenterWell (Shelby, NC)
- …of Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse ( RN ) license or Compact State RN ... clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the...A minimum of 2 years of experience as a Registered Nurse ( RN ). + Home… more
- University of Michigan (Ann Arbor, MI)
- …certificationOR Associate degree RN + At least 2-5 years of experience in Utilization Management , Appeals Management or Case Management + ... self-directed and work independently **Desired Qualifications + Experience with a case management / utilization management software program and EPIC (MiChart)… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …to ensure optimal and cost-effective health outcomes. Required Skills and Experience * Registered nurse with current MN license and with no restrictions * ... Blue Cross and Blue Shield of Minnesota Position Title: RN Specialist Complex Case Management - Transplant...* 2+ years of managed care experience; eg case management /health coach, utilization management and/or… more
- Henry Ford Health System (Troy, MI)
- …Nurse ! We are a team of Registered Nurses (3 and counting) and Utilization Review Coordinators (4) that review appeals for medical necessity using ... + Responsible for investigating Provider Appeal requests and Code Review inquiries for all Utilization Management...Microsoft Word. Excel and Access preferred. CERTIFICATIONS/LICENSURES REQUIRED: + Registered Nurse ( RN ) with current… more
- Nuvance Health (Danbury, CT)
- …Required: Master's degree in Nursing, Social Work or a related field required. Current CT Registered Nurse ( RN ) license. Minimum of 5 years of progressive ... with CMS, Joint Commission, and other regulatory bodies related to discharge planning, utilization review , and care transitions. 6. Monitor and analyze key… more
- University of Southern California (Arcadia, CA)
- …Education: Bachelors Degree Nursing Minimum Skills: Possess basic computer skills. Required Certifications: Registered Nurse - RN (CA Board of Registered ... outside referring physicians andmedical groups.* Communicates with insurance company utilization review and authorization personnel.* Gathers and...RN experience in assigned area of Nursing. A registered nurse with current RN … more
- HCA Healthcare (Derry, NH)
- …+ Associate Degree in Nursing, Bachelors strongly desired, Master preferred + Active NH Registered Nurse license or compact state Registered Nurse ... medical necessity, admission status, level of care, and resource management . + The RN Case Manager Team...supporting a balance of optimal care and appropriate resource utilization . + The RN Case Manager Team… more
- The County of Los Angeles (Los Angeles, CA)
- …the following: + Additional experience in clinical nursing. + Supervisory** experience in Utilization Review and/or Case Management . SPECIAL REQUIREMENT ... CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board...of staff, and evaluating employee performance. For this examination, Utilization Review is defined as provides technical… more
- Brockton Hospital (Brockton, MA)
- …of five years clinical experience in an acute care facility required. Prior experience in case management , utilization review or discharge planning required. ... of our patients. Provides medical-surgical pediatric and obstetrical case management services to Brockton Hospital patients. Responsible for assuring continuity… more
- Community Health Systems (Foley, AL)
- …or physician education experience required + Experience in ICU/Critical Care, case management , utilization review , quality, or inpatient coding preferred ... professionalism, collaboration, and leadership in interdisciplinary environments **Licenses and Certifications** + RN - Registered Nurse - State Licensure… more