- BayCare Health System (Bradenton, FL)
- …the area of responsibility. + Ensure quality assurance program and utilization review is followed in accordance with Home Care protocol. + Oversees and ... Participates with Case Manager on initial Plan of Care review with a focus on quality, utilization ...Knowledge of regulatory standards appropriate to position. **Requirements:** + RN ( Registered Nurse ) License +… more
- Providence (Olympia, WA)
- **Description** The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization ... must empower them. **Required Qualifications:** + Upon hire: Washington Registered Nurse License + 3 years of...Or Associate's Degree in Nursing + 3 years of Utilization Review , Care Management, Quality Management, and/or… more
- BayCare Health System (Dunedin, FL)
- …within the area of responsibility + Ensure quality assurance program and utilization review is followed in accordance with Home Care protocol + Oversees and ... Participates with Case Manager on initial Plan of Care review with a focus on quality, utilization ...Health RN visit experience. **Required Credentials:** + RN ( Registered Nurse ) License +… more
- LA Care Health Plan (Los Angeles, CA)
- …requirements for health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... Utilization Management Admissions Liaison RN II...review and authorization for alternate levels of care, home health, durable medical equipment, and other discharge needs.… more
- Humana (Jackson, MS)
- …an impact** **Use your skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...in an acute care setting + Previous experience in utilization management/ utilization review for a… more
- PeaceHealth (Bellingham, WA)
- …of psychiatric diagnostics. + Preferred: Third party reimbursement knowledge. + Preferred: Utilization Review experience, someone who can talk to providers. ... **Description** PeaceHealth is seeking a RN Admissions/ Utilization Behavioral Health - Care...**Credentials** + Required: Registered Nurse in state of practice +… more
- ChenMed (Philadelphia, PA)
- …RN with bachelor's degree in a related clinical field preferred + A valid, active Registered Nurse ( RN ) license in State of employment required + Compact ... will provide warm hand off to the Community Care Nurse when patient is discharged to home ...required + A minimum of one (1) year of utilization review and/or case management, home… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …This position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ... regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review . Refer to and work closely with Case Management to address member… 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 of...One of the following: Licensed RN - Kansas, Registered Nurse … more
- CVS Health (Austin, TX)
- …in clinical setting with diverse cultural dynamics of clinical staff and patients. Registered Nurse ( RN ) required. Licensed Clinical Social Worker (LCSW) ... care experience is in behavioral health) **Preferred Qualifications** + 1+ years' experience Utilization Review experience + 1+ years' experience Managed Care +… more