- BriteLife Recovery (Englewood, NJ)
- …assigned What we need from you? + Minimum of 2-3 years of experience in utilization review , case management , or insurance coordination in a behavioral health ... What you will be doing? The Utilization Review (UR) Specialist is a...Maintain compliance with payer policies, HIPAA regulations, and internal utilization management protocols. + Monitor trends in… more
- UNC Health Care (Kinston, NC)
- …clinical experience as a Registered Nurse required. + 2 years utilization review , care management , or compliance experience preferred. + Minimum 1 ... to support the clinical documentation specialists and Patient Financial Services. Supports the Utilization Review Nurse team when necessary by applying… more
- Hartford HealthCare (Willimantic, CT)
- …**Windham Hospital* **Title:** * Registered Nurse Case Manager ( RN ) - Utilization Management * **Location:** *Connecticut-Willimantic-Windham Community ... clinical nursing required. * Two years experience with case management , discharge planning, utilization review ... experience preferred. *LICENSURE/CERTIFICATION* * Current license as a registered nurse in the State of Connecticut.… more
- CVS Health (Lansing, MI)
- … solutions that promote high-quality healthcare for members. **Position Summary** Join our Utilization Management team as a Nurse Consultant, where you'll ... are not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence...experience in Nursing. + At least 1 year of Utilization Management experience in concurrent review… more
- CVS Health (Phoenix, AZ)
- …that promote high-quality healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. ... partial hospitalization and intensive outpatient programs. + At least 1 year of Utilization Management experience in concurrent review or prior… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse ( RN ) who comprehensively conducts ... three years in utilization review and/or case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State… more
- UCLA Health (Los Angeles, CA)
- Description At UCLA Health, the Utilization Management (UM) Review Nurse plays a vital role in ensuring the delivery of high-quality, evidence-based ... to prior authorization requests for medical services. The UM Review Nurse applies clinical judgment, regulatory standards,...+ A minimum of three years of experience in utilization management , preferred + Team leading or… more
- Sutter Health (San Francisco, CA)
- …Med Center Davies **Position Overview:** Conducts preauthorization, concurrent, and retrospective utilization management review using the department's ... and at the appropriate level of care. Coordinates the utilization management , resource management , discharge...an accredited school of nursing **CERTIFICATION & LICENSURE:** + RN - Registered Nurse of California +… more
- Ochsner Health (New Orleans, LA)
- …discharge plans based on patient's individualized needs. Registered Nurse ( RN ) Case Manager - Case Management OMC Jefferson Highway PRN To perform ... discharge planning, case management or utilization review . **Certifications** Required - Current registered nurse license in state of practice. Basic… more
- Vighter Medical Group (Glendale, CO)
- …at the Office of Community Care (OCC) in Glendale, Colorado. As a Case Manager / Utilization Review Nurse , you'll play a key role in coordinating and ... Position Type Full Time Job Shift Any Education Level Registered Nurse ( RN ) Travel Percentage...required. What You'll Do As a Case Manager / Utilization Review RN , you will:… more