- Providence (WA)
- …we must empower them. **Required Qualifications:** + Degree in Nursing + Oregon Registered Nurse License + 5+ years clinical experience (Nursing) **Preferred ... License: Oregon and Washington + 1 year Quality management/quality improvement/ utilization review auditing experience, including experience in auditing within… more
- Centene Corporation (New York, NY)
- …**License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required + RN - Registered Nurse - State Licensure preferred Pay Range: ... a fresh perspective on workplace flexibility. **This is a remote role but must reside within New York State.**...care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member… more
- Trinity Health (Livonia, MI)
- …or Nursing or equivalent in experience. Must possess one of the below: + Current Registered Nurse ( RN ) License + Registered Health Information ... Type:** Full time **Shift:** Day Shift **Description:** **POSITION PURPOSE** Work Remote Position At the direction of the Regional Manager, Clinical Documentation… more
- Centene Corporation (New York, NY)
- …**License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required + RN - Registered Nurse - State Licensure preferred Pay Range: ... criteria + Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care +… more
- Trinity Health (Livonia, MI)
- …Nursing or the equivalent in experience. Must possess one of the below: + Current Registered Nurse ( RN ) License + Registered Health Information ... Full time **Shift:** Day Shift **Description:** **POSITION PURPOSE** Work Remote Position Responsible for directing Clinical Documentation Integrity (CDI) activities… more
- Sharecare (Helena, MT)
- …to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they ... utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification… more
- Veterans Affairs, Veterans Health Administration (Las Vegas, NV)
- …and analytical review of clinical information. Responsibilities The Revenue Utilization Review (RUR) Registered Nurse is under the supervision of a ... Summary The Revenue Utilization Review (RUR) nurse ...processes and under moderate supervision and instruction by the registered nurse manager. Responsibilities of the RUR… more
- Highmark Health (Jackson, MS)
- …**Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides ... to appropriate resources for additional support. + Implement care management review processes that are consistent with established industry, corporate, state, and… more
- Sharp HealthCare (San Diego, CA)
- …BBS Licensed Marriage and Family Therapist (LMFT) - CA Board of Behavioral Sciences; California Registered Nurse ( RN ) - CA Board of Registered Nursing ... BLS Healthcare) - American Heart Association -REQUIRED + California Registered Nurse ( RN ) - CA...in use.Is knowledgeable of current laws and regulations regarding Utilization Review and Discharge Planning.Morning arrival time… more
- North Shore Community Health (Gloucester, MA)
- …community healthcare delivery. The Primary Care Team Nurse Care Manager (PC team RN CM) is a registered nurse whose primary responsibility is managing ... care teams, and community care providers, the PC team RN CM coordinates the overall health care utilization...Perform nurse visits independently and within the registered nurse scope of practice outlined by… more