- MTC (Livingston, TX)
- …in Livingston, Texas,** has a unique and rewarding challenge for a dedicated nurse . Help us provide essential care where your expertise will directly impact the ... use of appropriate sanitation methods. + Practice basic cost containment and utilization management for detainee care and facility operations. + Maintain absolute… more
- US Tech Solutions (Branchburg, NJ)
- …on an **acute/critical care** unit, organ donation/transplant unit, in tissue/blood banking, utilization review and/or case management with critical care skill ... Tissue/Blood banking * Critical care skill set. The chart review is critical, and the candidate must have knowledge...US Tech Solutions:** US Tech Solutions is a global staff augmentation firm providing a wide range of talent… more
- US Tech Solutions (Columbia, SC)
- …up review determinations. Identifies and makes referrals to appropriate staff (Medical Director, Case Manager, Preventive Services, Subrogation, Quality of Care ... promote quality, cost effective outcomes. + Performs medical or behavioral review /authorization process. Ensures coverage for appropriate services within benefit and… more
- Blue KC (MO)
- …and regularly attends client meetings (with benefits managers and executives) to review health outcomes and cost information. + Actively monitors care management ... special consideration (eg, benefits) should be made. + Participate in existing client utilization and renewal meetings or tell our clinical value story as requested.… more
- US Tech Solutions (MI)
- …with regulatory and accreditation guidelines and company policies and procedures **Skills:** + Utilization review + RN + Assure care + Clinical practice + ... + Through the use of clinical tools and information/data review , conducts comprehensive assessments of referred member's needs/eligibility and determines… more
- MTC (Chaparral, NM)
- …use of appropriate sanitation methods. 6. Practice basic cost containment and utilization management for patient care and facility operations. 7. Maintain absolute ... and confidentiality of all medical records; observe applicable HIPAA rules. 8. Review medical files to determine all provided services are documented. 9. Closely… more
- Molina Healthcare (NM)
- **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN (preferred) or LPN with a compact license who resides in New Mexico or Texas. This team ... long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired...Any of the following: Completion of an accredited Registered Nurse (RN), Licensed Vocational Nurse (LVN) or… more
- Prime Healthcare (Inglewood, CA)
- …and communicating status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently and ... institution in a Health and Human Services field is highly preferred. 2. Utilization Review /Case Management experience is highly preferred. 3. 1+ year of… more
- Prime Healthcare (Ontario, CA)
- …and communicating status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently and ... a Health and Human Services field is highly preferred.2. Utilization Review experience is highly preferred.3. Clinical...interpersonal skills to build effective partnering relationships with physicians, nurse staff , coding staff and… more
- Molina Healthcare (Spokane, WA)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care… more