- Houston Methodist (Houston, TX)
- **on site- location 8100 Greenbriar, 77054** + ** Registered Nurse preferred** + ** RN with OR/Procedural experience preferred** At Houston Methodist, the ... clinicians in a financially responsible manner. Under the direction of department management and in collaboration with key stakeholders, the Clinical Value Analysis… more
- BronxCare Health System (Bronx, NY)
- …assist the department's leadership develop strategies for denial prevention, improved utilization management , documentation of medical necessity and identify ... avoidable day and barriers to discharge processes pertaining to utilization management . - Liaisons and coordinates with...department physician advisors and clinical staff. Qualifications - NYS Registered Nurse required - The Appeal Manager… more
- HCA Healthcare (Houston, TX)
- …of scheduling at a center level. Requirements: + Bachelor's degree in nursing, required. + ( RN ) Registered Nurse + 5+ years of clinical experience, required ... labor management , including position control, scheduling excellence, productivity management , and premium pay utilization . Maintains staffing to ensure… more
- Trinity Health (Livonia, MI)
- …or Nursing or equivalent in experience. Must possess one of the below: + Current Registered Nurse ( RN ) License + Registered Health Information ... as it relates to reimbursement and other clinical data quality management for colleague training. Provides quality and productivity monitoring; coordinates and… more
- Beth Israel Lahey Health (Cambridge, MA)
- …**Minimum Qualifications:** 1. Bachelor's degree preferred. 2. Current Massachusetts state license as a Registered Nurse ( RN ). 3. Two years of recent acute ... with Harvard Medical School. The Inpatient Case Manager (CM) performs utilization reviews and coordinates discharge planning for MAH inpatient admissions. Inpatient… more
- Cleveland Clinic (Stuart, FL)
- …Preferred qualifications for the ideal future caregiver include: + Masters degree + Registered Nurse ( RN ) + Certified Patient Safety Professional (CPPS) ... compliance with all standards and favorable performance on safety, quality, utilization , and experience metrics. + Participate in engraining the safety, quality,… more
- HCA Healthcare (Austin, TX)
- …of Science in Nursing (BSN) - preferred Licenses and Certifications * Current State of Texas Registered Nurse ( RN ) license or Compact Registered * BLS ... serve as authority in the absence of other members of the nursing management /administrative team. * You will direct staff members appropriately and effectively in… more
- Bozeman Health (Bozeman, MT)
- …in Nursing; equivalent combination of education and experience considered + Current Montana Registered Nurse ( RN ) licensure + American Heart Association ... and transfer of patients, appropriately guiding physician understanding of admission Utilization Review InterQual criteria + Facilitate and communicate the… more
- Hospice of Michigan (Ann Arbor, MI)
- …CARE Model of Service: courtesy, acknowledgement, response and empathy. Qualifications: + Registered Nurse with a baccalaureate degree in nursing, preferably a ... work with minimal supervision. + Requires knowledge of quality assessment and utilization review functions, principles and practices. + Theoretical and practical… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …true colors to blue. The Role:The Compliance Program Consultant will focus on utilization management compliance and audit readiness activities such as evaluating ... Medical Management 's (HMM) and delegate's compliance with the applicable NCQA utilization management standards and state and federal regulations. The Team:… more