- Houston Methodist (Houston, TX)
- …HMWB (Willowbrook) HMTW (The Woodlands), HMSL (Sugar Land), HMCY (Cypress) At Houston Methodist, the Registered Nurse ( RN ) PRN position is a licensed staff ... prioritize daily tasks. Provides input into the unit resource utilization including unit capital and operational budget needs. +...a healthcare environment **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
- WestCare Foundation (Henderson, NV)
- … RN and/or Bachelors or Masters level CADC/LADC with 2 years utilization review experience, preferred experience working with individuals with psychiatric or ... substance use disorder Experience and Competencies: + Proven experience in conceptualizing a case and creating a clinical impression to present to all involved and approved parties, including managed care representatives + Knowledge of CPT, ICD 9 & ICD 10… more
- Prime Healthcare (Inglewood, CA)
- …to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians. ... outcomes and reducing readmissions. #LI-CC2 Qualifications Required qualifications: 1. CA Registered Nurse 2. Bachelor's of Science in Nursing3. Grandfathered… more
- UNC Health Care (Morrisville, NC)
- …People** - Operational oversight of centralized and site-specific UM teams, including utilization review nurses and support staff. Cultivate and empower ... unique communities we serve. **Summary** : The **Executive System Director of Utilization Management (UM)** is a strategic and operational leader responsible for… more
- Molina Healthcare (Yonkers, NY)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... emergency room. Preferred Experience Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
- Molina Healthcare (North Las Vegas, NV)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... unit (ICU) or emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG… more
- Molina Healthcare (Sparks, NV)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... attitude for success **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). RN licensure preferred… more
- CVS Health (Carson City, NV)
- …cardiology **Preferred Qualifications** -1+ years' experience in either Precertification or Utilization Review -1+ years' experience Managed Care -Strong ... And we do it all with heart, each and every day. **Position Summary** **This Utilization Management (UM) Nurse Consultant role is fully remote but must reside in… more
- Villa of Hope (Rochester, NY)
- …JOB SUMMARY: Under the general direction of the Nurse Manager, the Intake Coordinator- RN is a Registered Nurse who will assist in supervising Clinical ... director of LHTC and administrative team, including billing and utilization review . + Triages potential admissions and...or leaving against medical advice. MINIMUM QUALIFICATIONS: + NYS Registered Nurse license + Bachelor degree preferred… 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