- Banner Health (Tucson, AZ)
- …of a bachelor's degree in case management or health care. Requires current Registered Nurse ( RN ) license in state worked. For assignments in an ... resources that promote a healthy work-life balance. As the Registered Nurse RN Case Manager...networks, and regulatory agencies. Must possess knowledge of case management or utilization review as… more
- Banner Health (Sun City, AZ)
- …of a bachelor's degree in case management or health care. Requires current Registered Nurse ( RN ) license in state worked. For assignments in an ... lives, we want to hear from you. As the RN Case Manager in Care Coordination, you will have...regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as… more
- Banner Health (Phoenix, AZ)
- …of a bachelor's degree in case management or health care. Requires current Registered Nurse ( RN ) license in state worked. For assignments in an ... lives, we want to hear from you. As the RN Case Manager in Care Coordination, you will have...regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as… more
- CVS Health (Phoenix, AZ)
- …in ER, ICU, or Critical Care preferred. + Managed Care/ Utilization Management experience. + Experience with Claims Review processes + Demonstrate making ... weekends or holidays) Location: 100% Remote (Must have Arizona RN license or compact license that includes Arizona.) Candidate...the lives of patients? Join Mercy Care as a Utilization Management Clinical Consultant and become part… more
- Sanford Health (Rapid City, SD)
- …preferred. Experience in medical necessity review preferred. Currently holds an unencumbered registered nurse ( RN ) license with the State Board of ... Hours:** 40.00 **Department Details** Join our team as a Utilization Review and Case Management ...Nursing and/or possess multistate licensure if in a Nurse Licensure Compact (NLC) state. Obtains and subsequently maintains… more
- HCA Healthcare (Aventura, FL)
- …HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a(an) Registered Nurse Case Mgr RN PRN with HCA Florida Aventura ... in our organization. We are looking for an enthusiastic Registered Nurse Case Mgr RN ...years of critical care experience + Certification in case management or utilization review preferred… more
- US Tech Solutions (RI)
- …MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1 YEAR OF ... **Job Description:** + Responsible for the review and evaluation of clinical information and documentation....UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG. + MUST HAVE… more
- SUNY Upstate Medical University (Syracuse, NY)
- …Microsoft applications, Zoom/WebEx platforms, etc. Preferred Qualifications: Utilization management or utilization review experience, experience with ... contracts with reimbursement entities. This is achieved through a thorough chart review and utilization of first-level screening criteria to ensure patients… more
- Northwell Health (Staten Island, NY)
- …care according to regulatory standards. + * Performs concurrent utilization management using Interqual criteria. + Conducts chart review for appropriateness ... license to practice as a Registered Professional Nurse in New York State. + Case Management... and clinical pathways, variance analysis and trending, quality management / utilization review and home care/discharge… more
- Elevance Health (Tampa, FL)
- …practitioners responsible for coordinating member service, utilization , access, care management and/or concurrent review to ensure cost effective ... reside in the state of Florida* The **Manager of Utilization Management ** is responsible for managing a...would provide an equivalent background. + Current active unrestricted RN , PA, LSW, LCSW, LPC, LMHC or other accepted… more