- Providence (Seward, AK)
- …+ Graduation from accredited school of Nursing. + Upon hire: Alaska Registered Nurse License. + 2 years Clinical nursing experience. **Preferred ... best people, we must empower them. **This Care Manager RN position is a Remote work opportunity,...+ 3 years Clinical nursing experience. + 1 year Utilization Management- review and Discharge-planning experience. + Experience… more
- CVS Health (Austin, TX)
- …with heart, each and every day. **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and the candidate can live in any ... state. As a Utilization Management Nurse Consultant, you will utilize...goals and expectations. **Preferred Qualifications:** + 1+ years' experience Utilization Review experience + 1+ years' experience… more
- CenterWell (Lillington, NC)
- …of Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse ( RN ) license or Compact State RN ... clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the...A minimum of 2 years of experience as a Registered Nurse ( RN ). + Previous… more
- CenterWell (Atlanta, GA)
- …of Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse ( RN ) license or Compact State RN ... clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the...A minimum of 2 years of experience as a Registered Nurse ( RN ). + Home… more
- CVS Health (Columbus, OH)
- …Microsoft Office Applications (Outlook, Teams, Excel) **Preferred Qualifications** - Utilization review experience preferred - Knowledge of Medicare/Medicaid ... operation and work schedule may include weekends, holidays, and evening hours._ **UM Nurse Consultant** Fully Remote - WFH **Schedule** - Mon-Fri 10:30AM-7PM with… more
- University of Miami (Miami, FL)
- …SCCC Business Operations has an exciting opportunity for a full time Utilization Review Case Manager to work to work remote . The incumbent conducts initial, ... concurrent and retrospective chart reviews for clinical utilization and authorization. The Utilization Review Case Manager coordinates with the healthcare… more
- CenterWell (San Juan, PR)
- …community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that focuses on excellent… more
- CenterWell (Austin, TX)
- …and the healthcare industry as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part...skills to make an impact** **Role Essentials** + Active RN license + Possession of or ability to obtain… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …of Primary Function/General Purpose of Position** In the capacity of a Care Transition Nurse / Registered Nurse ( RN ), provide and facilitate coordination ... in Nursing (required) Bachelor's Degree in Nursing (BSN) (preferred) **Licensing/ Certifications:** Registered Nurse with active License in State of Patient Care… 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 ... on-site at an assigned hospital daily from 9am-3pm, working remote for the remaining hours. The Acute Care Manager,...patients' progress and adjust and plan accordingly + Understanding utilization review and how to leverage with… more