- Kadlec (Richland, WA)
- …recent inpatient clinical experience in an acute care facility. + Previous Case Management , discharge planning or utilization review experience. **Why Join ... care. Has the overall accountability for the integrated responsibilities of case management ; utilization management , discharge planning, facilitation and… more
- Independent Health (Buffalo, NY)
- …with regulatory standards, clinical criteria, and member benefit contract. **Qualifications** + Registered Nurse ( RN ) with active, current, unrestricted NYS ... credentials preferred. + Four (4) years of clinical experience required. Utilization Management experience preferred. + Comprehensive knowledge and experience… 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
- Emory Healthcare/Emory University (Atlanta, GA)
- …and leadership programs + And more **Description** We're seeking an **Inpatient Registry Utilization Review Nurse (PRN)** who is responsible for conducting ... physician and/or physician advisor. This individual will: + Perform utilization review by completing a timely and...patient and hospital financial risk. + Initiate and facilitate RN to RN discussion and/or Physician to… more
- Sutter Health (San Francisco, CA)
- …in nursing, case management or related field. **CERTIFICATION & LICENSURE** + RN - Registered Nurse of California (required) + CCM-Certified Case Manager ... Manager is responsible for Care Coordination, Care Transitions, Discharge Planning and Utilization Management throughout the acute care patient experience. The … more
- HCA Healthcare (Mcallen, TX)
- …to physicians, patients, families and caregivers **What qualifications you will need:** + ( RN ) Registered Nurse + Bachelors Degree Preferred, or Associate ... 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
- HCA Healthcare (Houston, 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 opening. We promptly review … more
- Northwell Health (Staten Island, NY)
- **Req Number** 167724 Registered Nurse Case Manager - FlexStaff Serves as liaison between the patient and facility/physician. Ensures a continuum of quality ... + Facilitates patient management throughout hospitalization + Performs concurrent utilization management using evidence based medical necessity criteria +… more
- AdventHealth (Palm Coast, FL)
- …and experiences you'll need to succeed:** **Minimum qualifications** : + Associate's degree Nursing or RN Diploma degree. + Registered Nurse ( RN ) State ... satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily...+ Health-related Master's degree or MSN. + Prior Care Management / Utilization Management experience. + ACM/CCM… more
- CVS Health (Phoenix, AZ)
- …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
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