- CVS Health (Austin, TX)
- … states. This role is a blended role doing both Case Management and Utilization Management . The RN Case Manager is responsible for telephonically and/or ... - Through the use of clinical tools and information/data review , conducts an evaluation of member's needs and benefit...as an RN - 6+ months Case Management or Utilization Management experience… more
- Logan Health (Kalispell, MT)
- …settings, ensuring seamless coordination of services for optimal patient outcomes. Inpatient Utilization Management + Manage and review inpatient services ... Logan Health Medical Center is looking for a PRN RN to join our Case Management Team!...Health, State, and Federal requirements as they relate to Utilization Review , Discharge Planning, and Care Coordination… more
- Centers Plan for Healthy Living (Margate, FL)
- …applications for Full Time Registered Nurse without experience. The Utilization Management Clinical Reviewer works within a multidisciplinary team to ... in their home to improve their quality of life. Utilization Management Clinical Reviewer will...education, and preventative interventions are maintained. Qualifications: + Active RN license, entry level RN welcome +… more
- Community Health Systems (Hattiesburg, MS)
- …4-6 years of clinical nursing experience required + 3-5 years of experience in care management or utilization review required + 1-3 years of leadership ... cases not meeting criteria to the Physician Advisor or Utilization Management Committee and ensures appropriate follow-up....care and continuous quality improvement. **Licenses and Certifications** + RN - Registered Nurse -… more
- University of Southern California (Los Angeles, CA)
- …populations. The RN case manager role integrates the functions of utilization management , quality management , discharge planning assessment, and ... Pref Bachelor's Degree Nursing + Pref 1 year Case management or utilization review experience...the last three years preferred. Required Licenses/Certifications: + Req Registered Nurse - RN (CA… more
- McLaren Health Care (Bay City, MI)
- …barriers to D/C). 4. Identifies unsigned level of care (LOC) orders; communicates with utilization management nurse and obtains orders from providers. 5. ... required and directed. _Required:_ + State licensure as a Registered Nurse ( RN ) + Bachelor's...of acute hospital care experience** _Preferred:_ + Experience in utilization management /case management , critical care,… 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
- 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
- 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
- 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