- MTC (Livingston, TX)
- …the use of appropriate sanitation methods. + Practice basic cost containment and utilization management for detainee care and facility operations. + Maintain ... plan **Make a Difference Where It Matters!** Operated by Management & Training Corporation, the **IAH Detention Facility in...has a unique and rewarding challenge for a dedicated nurse . Help us provide essential care where your expertise… more
- Northwell Health (Manhasset, NY)
- …+ Facilitates patient management throughout hospitalization. + Performs concurrent utilization management using evidence based medical necessity criteria. + ... Submits data to management regarding case management and/or quality initiatives....entry date. + Current License to practice as a Registered Professional Nurse in New York State… more
- St. Luke's University Health Network (Allentown, PA)
- …hospital setting required. + Prefer minimum of 2-5 years' experience in case management and/or utilization management . + Prefer financial experience related ... regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials for medical necessity and… 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
- Penn Medicine (Lancaster, PA)
- …placement in position for incumbents who started after 07/01/2020. + A graduate registered nurse may only practice professional nursing under supervision and if ... the graduate registered nurse holds a current temporary practice... nurse is practicing. + All Clinical Nurse 1 RN 's will be required to… more
- UCLA Health (Los Angeles, CA)
- Description At UCLA Health, the Utilization Management (UM) Review Nurse plays a vital role in ensuring the delivery of high-quality, evidence-based ... to prior authorization requests for medical services. The UM Review Nurse applies clinical judgment, regulatory standards,...+ A minimum of three years of experience in utilization management , preferred + Team leading or… more
- AdventHealth (Killeen, TX)
- …Higher Required + 2 years Registered Nurse Work Experience Required + Registered Nurse ( RN ) License Required **Preferred qualifications:** + 5 years ... satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily...Registered Nurse Work Experience Preferred + Certified Case Manager (CCM)… more
- HCA Healthcare (Tomball, TX)
- …Healthcare Tomball we support our colleagues in their positions. Join our Team as a(an) Registered Nurse RN Case Manager PRN and access programs to assist ... gain certifications and job skills. Apply today for our Registered Nurse RN Case Manager...utilization **What qualifications you will need:** + Current RN License in the State of Texas or Multi-State… more
- UPMC (Pittsburgh, PA)
- …within one year of hire or 1 year health plan management experience required + Registered Nurse ( RN ) + Act 34 *Current licensure either in the state ... Plan is seeking a full-time Professional Care Manager, Supervisor to join our Utilization Management (UM) Clinical Operations team. This position follows a… more
- Hartford HealthCare (Hartford, CT)
- …Glastonbury, Enfield, Farmington, West Hartford and Avon offices. Bachelor's Degree required . CT- Registered Nurse ( RN ) license- preferred * Minimum of 2 ... The primary responsibility of the Metabolic and Bariatric Surgical/Medical Clinical Reviewer (MBSCR) is to ensure the accurate and timely collection, documentation,… more