- Commonwealth Care Alliance (Boston, MA)
- … Management is responsible for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible ... reports to the Director of Utilization Management - Oversees clinical decision review for...reviews). - Hire, train and mentor UM staff, including nurse reviewers and support personnel. - Act as liaison… more
- Commonwealth Care Alliance (Boston, MA)
- …timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role ... Utilization Management , the Nurse Utilization Management (UM) Reviewer is...**Essential Duties & Responsibilities:** + Conducts timely clinical decision review for services requiring prior authorization in a variety… more
- BroadPath Healthcare Solutions (Tucson, AZ)
- **Overview** BroadPath is seeking a highly motivated and results-oriented ** Utilization Management (UM) Nurse ** . Our ideal **UM Nurse ** will ensure ... policy, regulatory, and Health Plan guidelines. + Apply case management skills to members who have been identified as...years of experience in Managed Care, Provider Office, or Utilization Review organization required. + Knowledge of… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …of healthcare services provided to all admitted patients. Using a value-based approach the Utilization Review Nurse ensures that care is administered via ... Work That Matters.** **Overview** **Purpose Statement/Position Summary:** The Utilization Nurse is responsible for utilization review including medical… more
- Geisinger (Wilkes-Barre, PA)
- Job Title: RN - Graduate Registered Nurse (Geisinger South Wilkes-Barre)Location: Wilkes-Barre, PennsylvaniaJob Category: Inpatient RN - Registered ... Program - occurs during your entire first year as a GN!Job Description:The Registered Nurse assesses plans, organizes, performs, and evaluates nursing activities… more
- Geisinger (Scranton, PA)
- Job Title: RN - Graduate Registered Nurse (Geisinger Community Medical Center, Scranton)Location: Scranton, PennsylvaniaJob Category: Inpatient RN - ... at ###@geisinger.edu!EducationGraduate from Specialty Training Program-Nursing (Required)Certification(s) and License(s)Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania;… more
- Stony Brook University (Stony Brook, NY)
- …+ Coordinates the design, development, implementation and monitoring of the organizations case management and utilization review functions. + Manages daily ... but are not limited to:** + Responsible for addressing Utilization management , denials and appeal, discharge and...Qualifications:** * Possession of license to practice as a registered nurse in New York State. *… more
- ERP International (Nellis AFB, NV)
- **Overview** ERP International is seeking a full-time ** Registered Nurse ( RN ) Disease Manager** in support of theMike O'Callaghan Military Medical Center ... managed care principles, military and civilian population healthcare, case management , utilization management , and demand...are required: Minimum of five years of experience as registered nurse with at least 12 months… more
- Alameda Health System (San Leandro, CA)
- …3 years, experience in Case Management in an acute setting or utilization review at a medical group or health plan. Required Licenses/Certifications: Active ... Management provides Care Coordination, Compliance, Transition Coordination, and Utilization Management . **DUTIES & ESSENTIAL JOB FUNCTIONS**...licensure as a Registered Nurse in the State of California,… more
- Katmai (Fort Carson, CO)
- …all levels of health care management to include outside agencies. Performs utilization management activities to optimize cost, quality, and access to care. ... **Job Requirements:** **MINIMUM QUALIFICATIONS** + Associates Degree of Nursing. Registered nurse shall be a graduate from...+ Shall possess a current, active, full and unrestricted Registered Nurses ( RN ) licensed in Colorado or… more
