- Prime Healthcare (Inglewood, CA)
- …provides leadership and supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and ... Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patients… more
- CVS Health (Phoenix, AZ)
- …that promote high-quality healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. ... partial hospitalization and intensive outpatient programs. + At least 1 year of Utilization Management experience in concurrent review or prior… more
- Texas Health Resources (Arlington, TX)
- Director Utilization Management -Clinical Review _Are you looking for a rewarding career with family-friendly hours and top-notch benefits? We're looking for ... system services for wholly owned and Partner hospitals for utilization management . Job Duties OPERATIONS: Plans, organizes...3 years previous leadership experience required Licenses and Certifications RN - Registered Nurse Current… more
- Cognizant (Carson City, NV)
- …have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Prime Healthcare (San Dimas, CA)
- …experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum 5 ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/229285/case-manager-%28rn%29 utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilitySan… more
- CVS Health (Phoenix, AZ)
- …a difference in the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Oncology and ... Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective care … more
- Insight Global (Campbell, CA)
- …reviewing medical documentation and applying health plan guidelines - Experience with Utilization Management (UM) - Knowledge of commercial, Medicare, and ... Job Description - Review approximately 60 medical authorization requests per day - Evaluate medical necessity for procedures and care requests - Use internal Access… more
- CVS Health (Columbus, OH)
- …Qualifications** + Licensed independent Behavioral Health clinician (LISW, LPCC, LMFT) or a Registered Nurse ( RN ) with unrestricted Ohio state license with ... Must reside in the state of Ohio. + Managed care/ utilization review experience + Be clinically and...Behavioral Health licensure (LISW, LMFT, LPCC) or if a Registered Nurse Associates degree required and BSN… more
- CVS Health (Frankfort, KY)
- … with behavioral health background. **Preferred Qualifications** + 3 years Managed care/ utilization review experience preferred. + Crisis intervention skills and ... Services (as applicable to hiring program) or Associates degree with a Registered Nurse with Behavioral Health experience/background with 3 years experience.… more
- Ventura County (Ventura, CA)
- Senior Registered Nurse - Hospital Management Utilization Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061650) Apply Senior ... Registered Nurse - Hospital Management Utilization ...general and specialized principles, practices, techniques and methods of utilization review / management , discharge planning or… more