- US Tech Solutions (Columbia, SC)
- …the United States and in the state of hire, OR active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC) **About US Tech ... promote quality, cost effective outcomes. Performs medical or behavioral review /authorization process. Ensures coverage for appropriate services within benefit and… more
- Sharp HealthCare (La Mesa, CA)
- …Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered Nursing ... experience or case management experience. + California Registered Nurse ( RN ) - CA...the department head as indicated. + Utilization review and utilization managementThe RN … more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical ... protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices....using clinical judgment and refer to Medical Directors for review depending on case findings. **Job Requirements**… more
- University of Utah Health (Salt Lake City, UT)
- …of time and attendance of direct reports. + Functions as Case Manager and/or Utilization Review Nurse as necessary. + Tracks and analyzes Case ... responsible for the day to day management of the Case Management Department. + Plans, directs, coordinates and evaluates...**Licenses Required** + Current license to practice as a Registered Nurse in the State of Utah,… more
- Veterans Affairs, Veterans Health Administration (Glendale, CO)
- …intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, ... Applications will be accepted on an ongoing basis. Initial review will be conducted approximately 12/9/25. Then, eligible applicants...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Veterans Affairs, Veterans Health Administration (St. Cloud, MN)
- …internal providers, and community partners to promote seamless, coordinated care. Apply utilization review criteria and evidence-based standards to ensure safe, ... VHA Education Loan Repayment Services program office after complete review of the EDRP application. The EDRP Coordinator(s) can...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Veterans Affairs, Veterans Health Administration (Sioux Falls, SD)
- …equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion ... Employees within the Sioux Falls VA Healthcare System. Responsibilities The Nurse Manager provides leadership to staff, improving performance, satisfaction, and… more
- Fallon Health (Worcester, MA)
- …as other departments by involving inpatient case management with out-patient case management and utilization management to optimize post-acute care. **Manage ... strategic leadership and oversight responsibility for the clinical and operational utilization management activities for all inpatient and outpatient care, and staff… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for evaluating ... nursing*( RN ) experience or * 2 years of recent* utilization review , utilization management*nursing experience.../*License/Certifications:*/ * Possession of a valid license as a Registered Nurse issued by the State of… more
- Highmark Health (Harrisburg, PA)
- …+ Medical/Surgical experience + Utilization Management (UM) or (UR) Utilization Review experience **LICENSES AND CERTIFICATIONS** **Required** + Current ... Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health… more
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