- Truman Medical Centers (Kansas City, MO)
- …help shape smarter, more effective care delivery across the healthcare continuum. As a ** UM Nurse ** , you'll play a critical role in supporting interdisciplinary ... 7:00AM - 3:30PM **Hours Per Week** 4 **Job Description** **Utilization Management Nurse ( UM RN)** _Optimize Care. Improve Outcomes. Elevate the Patient… more
- CVS Health (Little Rock, AR)
- …promote high-quality healthcare for members. We are seeking a dedicated Utilization Management ( UM ) Nurse to join our remote team. **Position Summary** The Team ... (preferably in a managed care setting). + Ability to provide on-call UM coverage for nights and weekends on a rotational schedule. **Preferred Qualifications**… more
- Mount Sinai Health System (New York, NY)
- …to appropriate departments + Monitors Concurrent Nurse denial phone calls for UM Nurse to follow + Prioritizes work as per department protocol (IPRO ... Implements first step of appeals process to assist Appeals Nurse and Enter Denial information in Allscripts + Meets...Discharge Appeals / Insurance requests) + Support Appeals Nurse / Manager by confirming status of denials +… more
- Humana (Baton Rouge, LA)
- …of our caring community and help us put health first** The Compliance ( UM ) Coordinator 2 issues notice of adverse benefit determination letters for Medicaid line ... ensure adherence to contractual and accreditation requirements. The Compliance ( UM ) Coordinator 2 performs varied activities and moderately complex… more
- Magellan Health Services (Boise, ID)
- …Doctoral level provider. General Job Information Title Clinical Manager, Behavioral Health ( UM ) -Licensed, Remote in Idaho Grade 27 Work Experience - Required ... Mgmt, PC - Professional Counselor - Care MgmtCare Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care MgmtCare Mgmt License and Certifications… more
- Magellan Health Services (Boise, ID)
- …that directly influence quality of care. General Job Information Title Care Manager ( UM /UR) - Remote, Idaho Licensed Grade 24 Work Experience - Required Clinical ... - Care Mgmt, LSW - Licensed Social Worker - Care Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care Mgmt License and Certifications - Preferred… more
- Trinity Health (Darby, PA)
- …of Science in Nursing (BSN) required. + **Licensure/Certification:** + Active Registered Nurse license in the State of Pennsylvania required. + Case Management ... certification from an accredited organization preferred. + **Experience:** + Minimum of 3 years of clinical experience, with emphasis on medical/surgical nursing. + Experience in Case Management, Discharge Planning, and Utilization Management preferred. +… more
- Centers Plan for Healthy Living (Margate, FL)
- …For Healthy Living is currently accepting applications for Full Time Registered Nurse without experience. The Utilization Management Clinical Reviewer works within a ... multidisciplinary team to help identify and manage members who are in need of additional care or support in their home to improve their quality of life. Utilization Management Clinical Reviewer will assess and process all authorization requests to determine… more
- University of Michigan (Ann Arbor, MI)
- …Time** Full-Time **Regular/Temporary** Regular **FLSA Status** Nonexempt **Organizational Group** Um Hospital **Department** MM Mich Visiting Nurse Assoc ... REGISTERED NURSE (Michigan Visiting Nurses) Apply Now **Mission Statement**...Night Shift Weekend Differential- $6.90 / hour + Charge Nurse Differential- $1.00 / hour The benefit package includes:… more
- LA Care Health Plan (Los Angeles, CA)
- …of direct patient care that may include at least 2 years of relevant Licensed Vocational Nurse (LVN) experience in a UM or CM capacity substituted for 1 year of ... Managed Long Term Services and Supports Nurse Specialist RN II Job Category: Clinical Department:...adhere to regulatory mandates that apply to Utilization Management ( UM ) and Care Management (CM). This position is responsible… more