- Excellus BlueCross BlueShield (Rochester, NY)
- …This position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ... regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review . Refer to and work closely with Case Management to address member… more
- Dartmouth Health (Lebanon, NH)
- …leadership, communication and computer skills desired. Required Licensure/Certifications - Licensed Registered nurse with NH eligibility * Remote:Fully Remote * ... Area of Interest:Nursing * Pay Range:$79,747.20/Yr. - $127,587.20/Yr. (Based on 40 hours per week, otherwise pro rata) * FTE/Hours per pay period:.01 hrs/per week (per diem/temp) * Shift:Rotating * Job ID:35880 Dartmouth Health offers a total compensation… more
- 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
- Katmai (Fort Carson, CO)
- …or American Red Cross. + Three (3) years within the last four (4) years as a registered nurse in utilization management. + One (1) year of experience in ... **SUMMARY** Provide a comprehensive utilization review (UR) and utilization...full, active, and unrestricted license to practice as a registered nurse . + Must be a graduate… more
- McLaren Health Care (Port Huron, MI)
- …related duties as required and directed. **Qualifications:** Required ⦁ State licensure as a registered nurse ( RN ) ⦁ Bachelor's degree in nursing from ... **Department:** Utilization Review **Daily Work Times:** 8:00am-4:30pm **Hours Per Pay Period:** 40 **Position Summary:** Responsible for determining the… more
- Beth Israel Lahey Health (Burlington, MA)
- …the medical necessity of the hospital care. Using the concepts of utilization review , clinical documentation improvement and revenue integrity, these specialized ... the medical necessity of the hospital care. Using the concepts of utilization review , clinical documentation improvement and revenue integrity, these specialized… more
- Penn Medicine (Lancaster, PA)
- …NCLEX within 60 days of starting in their RN role. + A graduate registered nurse may only practice professional nursing under supervision and if the graduate ... that established outcomes are achieved through availability and appropriated utilization + of human, material and financial resources. +...their NCLEX within 60 days of starting in their RN role.A graduate registered nurse … more
- Adecco US, Inc. (Minneapolis, MN)
- …or local law; and Holiday pay upon meeting eligibility criteria. **IMPORTANT:** This ** Registered Nurse ** role is being recruited for by Adecco's Healthcare & ... week, eight-hour days **Pay:** $40.50 to $42.50 an hour **Responsibilities of the RN Appeals Reviewer :** . Responsible for conducting thorough reviews of member… more
- Tenet Healthcare (Detroit, MI)
- Registered Nurse ( RN ) - Case Manager - 2506003285 Description : Join our dedicated healthcare team where compassion meets innovation! As a Registered ... and is determined by employment status Job Description: The RN Case Manager is responsible to facilitate care along...management experience preferred. 3. License to practice as a Registered Nurse in the State of Michigan.… more
- HCA Healthcare (Richmond, VA)
- …year, nurses at Johnston-Willis Hospital have the opportunity to make a real impact. As a ** Registered Nurse RN Case Manager** you can be a part of change. ... and improve positive outcomes for your patients as a ** Registered Nurse RN Case Manager**...a hospital setting preferred. + Previous case management or utilization review experience preferred. Johnston-Willis Hospital has… more