- 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
- Children's Mercy Kansas City (Kansas City, MO)
- …+ Experience in Utilization Review + One of the following: Licensed RN - MO, Registered Nurse Multistate License Missouri required upon hire + ... training oversight of programs and services. Responsible for effective utilization review and proper resource management...One of the following: Licensed RN - Kansas, Registered Nurse … more
- US Tech Solutions (LA)
- …+ Minimum 3 years nursing experience with a minimum of 1 year in utilization management / prior authorization review experience. **Experience** : ... as indicated by staffing and business needs. **Duties:** + ** Registered Nurse with current license in LA...Utilization Management . Prior Authorization Review experience **About US Tech Solutions:** US Tech Solutions… more
- HCA Healthcare (Cypress, TX)
- …to physicians, patients, families and caregivers **What qualifications you will need:** + ( RN ) Registered Nurse + Bachelors Degree, or Associate Degree ... case management scope of services including + Utilization Management supporting medical necessity and denial...encourage you to apply for our Registered Nurse Case Manager PRN opening. We review … more
- Community Health Systems (Naples, FL)
- …Management is responsible for the planning, coordination, and oversight of care management services, including utilization review , discharge planning, and ... effectively, and in compliance with organizational standards. + Oversees utilization review and discharge planning processes to...systems, and data analysis tools. **Licenses and Certifications** + RN - Registered Nurse -… more
- CVS Health (Topeka, KS)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- Houston Methodist (Sugar Land, TX)
- …Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical denial management ... clinical nursing/patient care experience which includes three years in utilization review , case management or...and nongovernmental payers preferred **LICENSES AND CERTIFICATIONS** **Required** + RN - Registered Nurse -… more
- Crouse Hospital (Syracuse, NY)
- …management of the RN Care Managers in the department, including Utilization Management , Discharge Planning and Denials and Appeals functions. + Assessing ... agreements. Care Coordination Manager Requirements: + Licensed as a Registered Nurse in New York State +...acute care discharge planning + Preferred - Acute care utilization review experience Benefits Overview: + Medical,… more
- Trinity Health (Columbus, OH)
- …5-7 years of clinical nursing experience with at least 2 years experience in utilization review , discharge planning, case management , or disease ... analysis, audit, provider relations and more. **Position Purpose:** The RN Case Manager MCHP is responsible for the coordination...common symptoms they might experience. + Coordinates with the utilization review , case management , discharge… more
- Actalent (Houston, TX)
- "Immediate Hiring for " Utilization Review RN " Job...utilization management and utilization review /managed care/hospital setting as an RN ... Perform concurrent reviews to assess member's overall health. + Review the type of care being delivered and evaluate...& ICU Hospital expereince is Mandatory + Active Compact RN license is Mandatory If you are Interested ,… more