- The Laurels of Fulton (Chesaning, MI)
- …with American Association of Nursing Assessment Coordinators (AANAC) requirements. Qualifications * Registered Nurse ( RN ) * AANC certification a plus. ... Are you an experienced MDS nurse interested in the next step? The MDS...* Assesses resident through physical assessment, interview and chart review . * Discusses resident care needs with care givers,… more
- Battelle Memorial Institute (Tampa, FL)
- …two years' nursing experience + Current, full, active, and unrestricted license as a Registered Nurse in any US State, the District of Columbia, Guam, Puerto ... (HRA) business line is seeking a highly motivated, full-time ** Nurse Case Manager** to join our team in support...professional parameters + Knowledge and skill in using pre-established utilization review criteria to recognize and report… more
- University of New Mexico - Hospitals (Albuquerque, NM)
- …patient responses to interventions in collaboration with quality assurance and utilization review , maintaining interdependent follow-up as necessary * VARIANCES ... case manager social work staff. Responsible for the initial review , triage and assignment of patients to case managers...by anticipating patient needs in collaboration with physicians, staff RN 's, and other health care team members * INTERVENTIONS… more
- Commonwealth Care Alliance (Boston, MA)
- …understanding of CCA's mission, value-based approach, and expectations for quality, utilization , and member experience. - Address provider inquiries related to care ... coordination, utilization management, and program participation, collaborating with internal teams...BH and Health Home providers. - Participate in case review meetings and rounds as needed to enhance coordination… more
- Parexel (Juneau, AK)
- …reproducible research practices like version control and literate programming. + BSN, RN , RPh, Pharm D, PA, MPH, or other applicable health professional credentials, ... solutions, and ensure high-quality, compliant data. + Use surveillance tools to review data at an aggregate level, identifying patterns or anomalies to ensure… more
- Luke Staffing (Agana Heights, GU)
- …Government and professional clinical standards and clinical protocols. . Participate in Utilization Management/Case Management meetings to review and identify . ... of newly assigned unit personnel. . Collaborate in the review of unit standing operating procedures. . If directed,...services. . Provide patient referrals. Interface with the MTF RN Case Manager(s) in the development and implementation of… more
- ERP International (Camp Pendleton, CA)
- **Overview** ERP International, LLC is seeking a **Licensed Vocational / Practical Nurse ** for a full-time position supporting the **Branch Health Clinics** at ... Recognize urgent or emergent patient care situations, seek assistance of the RN and/or MD/DO, and initiate appropriate emergency interventions as directed. - Perform… more
- Commonwealth Care Alliance (Boston, MA)
- …clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring ... Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day… more
- Ascension Health (St. Charles, IL)
- **Details** + **Department:** Utilization Review + **Schedule:** Part-Time, Partially Remote, Monday - Friday; 9am - 1pm. + **Hospital:** Ascension Saint Joseph ... Provide health care services regarding admissions, case management, discharge planning, and utilization review . + Review admissions and service requests… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …to help us transform healthcare? Bring your true colors to blue. The RoleThe RN Utilization Management Reviewer is responsible for facilitating care for ... benefit to provide the best quality care. The TeamThe RN Utilization Management Reviewer is...+ Licensure in additional states a plus. + For registered nurses only: a bachelor's degree in (BSN) preferred.… more
