- Veterans Affairs, Veterans Health Administration (Biloxi, MS)
- Summary The Registered Nurse - Assistant Chief of Quality Management provides day-to-day oversight of work performed by a staff of professionals engaged in ... to): Supervises QM Programs for the following - Accreditation, Utilization Management , Flow Control Center, Infection Control,...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Northwell Health (Staten Island, NY)
- …care according to regulatory standards. + * Performs concurrent utilization management using Interqual criteria. + Conducts chart review for appropriateness ... license to practice as a Registered Professional Nurse in New York State. + Case Management... and clinical pathways, variance analysis and trending, quality management / utilization review and home care/discharge… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …safe discharge coverage for all hospital units. + Participates in utilization management initiatives/opportunities for improvement through departmental committee ... assignments. Qualifications: + Registered Nurse , Licensed Practical Nurse ...Florida. + 3 years minimum experience in discharge planning, utilization management , or case management .… more
- HonorHealth (AZ)
- …management , social services, and case management for managed care plans. Utilization review is performed and processed in accordance with health plan ... Oversees clinical operations for managed care plan contracts including utilization management , case management , and...Certifications + Other Accredited Case Manager - Preferred + Registered RN Or Licensed Social Worker (LCSW,… more
- HCA Healthcare (Richmond, VA)
- …set us apart from any other healthcare provider. We are seeking a(an) Case Manager Registered Nurse RN PRN to join our healthcare family. **Benefits** ... for patient care. Apply today for our Case Manager Registered Nurse RN PRN opportunity.... RN years demonstrated leadership experience + Commercial Utilization Management and/or Case Management … more
- Guthrie (Sayre, PA)
- …experience: five (5) years of experience in an acute care setting with strong care management , utilization review , and payer knowledge. A Case Management ... levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care...degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant… more
- Emory Healthcare/Emory University (Duluth, GA)
- … of medical necessity for all inpatients, concurrent stay documentation per utilization management plan, verification and correction of patient status, ... Monitoring of observation patients per hospital policy; + Maintains documentation of utilization review function per hospital policy and federal and state… more
- Elevance Health (Grand Prairie, TX)
- ** Nurse Reviewer I** **Location:** Virtual: This...hospital setting or minimum of 1 year of prior utilization management , medical management and/or ... an accommodation is granted as required by law. The ** Nurse Reviewer I** will be responsible for...required. **Preferred Skills, Capabilities, and Experiences:** + Familiarity with Utilization Management Guidelines, ICD 10 coding, and… 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
- AdventHealth (Hinsdale, IL)
- …. BSN . Health-related Master's degree or MSN . Prior Care Management / Utilization Management experience **LICENSURE, CERTIFICATION OR REGISTRATION ... satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily...REQUIRED:** . State of Illinois registered nurse license **LICENSURE, CERTIFICATION OR REGISTRATION… more