- AmeriHealth Caritas (Washington, DC)
- …(BSN) preferred + Minimum of 3 years of diverse clinical experience as a Registered Nurse in an Intensive Care Unit (ICU), Emergency Department (ED), ... reviews within a managed care organization preferred **Licensure** + Active and unencumbered Registered Nurse license in the District of Columbia + Valid and… more
- CenterWell (Shelby, NC)
- …reliable transportation. + A minimum of 2 years of experience as a Registered Nurse ( RN ). + Home health experience is strongly preferred. + Management ... of Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse ( RN ) license or Compact State RN… more
- CareFirst (Baltimore, MD)
- …in addition to the required work experience. **Licenses/Certifications Upon Hire Required:** + RN - Registered Nurse - State Licensure And/or Compact ... expected to work a portion of their week from home and a portion of their week at a...standards and federal/state regulations and general principles relating to utilization review . + Computer skills, including Microsoft… more
- CenterWell (Atlanta, GA)
- …**Required Experience/Skills:** + A minimum of 2 years of experience as a Registered Nurse ( RN ). + Home health experience is required. + Management and ... of Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse ( RN ) license or Compact State RN… more
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as an Inpatient Authorization Review Services Registered Nurse or Licensed Practical Nurse -NICU ... difference. We are looking for a dedicated Inpatient Authorization Review Services Registered Nurse or...care contracting, experienced preferred. + Currently licensed as a registered nurse ( RN ) in the… more
- CVS Health (Phoenix, AZ)
- …+ Clinical experience in ER, ICU, or Critical Care preferred. + Managed Care/ Utilization Management experience. + Experience with Claims Review processes + ... weekends or holidays) Location: 100% Remote (Must have Arizona RN license or compact license that includes Arizona.) Candidate...the lives of patients? Join Mercy Care as a Utilization Management Clinical Consultant and become part of a… more
- CenterWell (Madison, FL)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- Louisiana Department of State Civil Service (Jackson, LA)
- …that honors service through care. Minimum Qualifications Possession of a current Louisiana Registered Nurse license or a temporary permit or multi-state license ... issued by a Nursing Licensure Compact (NLC/eNLC) state to practice as a registered nurse plus one of the following: Three years of experience as a licensed … more
- Children's Home Healthcare (Albuquerque, NM)
- …for Home Health services from insurance company. 7. Attend quarterly Utilization Review meetings as designated by the Director of Professional Services. ... NOT APPLY IF YOU DO NOT HAVE A VALID RN LICENSE* Children's Home Healthcare is now...CPR + At least 2 years experience as a Registered Nurse + At least 1 year… more
- Molina Healthcare (Orem, UT)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet ... (Team will work on set schedule) Looking for a RN with experience with appeals, claims review ,...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more