- NCH (Naples, FL)
- …* Minimum of Associate Degree required; Bachelor's Degree preferred. * Licensed as a Registered Nurse in the state of Florida. * 5+ years CDI auditing/SLR ... at regular scheduled CDI team meetings as well as other meetings (ie UM /Quality etc). * Collaborative interaction with physicians and/or other clinicians to enhance… more
- Tufts Medicine (Burlington, MA)
- …technology. **Job Description** **Minimum Qualifications:** 1. BSN degree 2. Licensed as a Registered Nurse 3. Five (5) years relevant experience in the ... revenue cycle and hospital departments, such as Coding, Utilization Management ( UM ), Case Management, Quality and Physician advisors and leaders. The Director… more
- University of Michigan (Ann Arbor, MI)
- …weight, oxygen saturation and pain scores; reports abnormal values to RN . Obtains other measurements (ie, head circumference, abdominal girth) per unit ... getting a patient out of bed as delegated by RN . Ensures that alarms are "on" when activity is...facility (ie rehab) OR + Completion of a Certified Nurse Assistant (CNA) program Must be able to perform… more
- University of Michigan (Ann Arbor, MI)
- …height/length, weight, oxygen saturation and pain scores; reportsabnormal values to RN . Obtains other measurements (ie, head circumference, abdominal girth) perunit ... orgetting a patient out of bed as delegated by RN . + Ensures that alarms are on when activity...facility (ie rehab) OR + Completion of a Certified Nurse Assistant (CNA) program + Must be able to… more
- CVS Health (Columbus, OH)
- …24/7 operation and work schedule may include weekends, holidays, and evening hours._ ** UM Nurse Consultant** Fully Remote- WFH **Schedule** - Mon-Fri Standard ... work schedule with alternate weekends and holidays **Position Summary:** UM Nurse Consultant Utilizes clinical experience and...function. **Required Qualifications** 2+ years of experience as an RN Active and unrestricted RN licensure in… 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 ... times are not permitted. **Required Qualifications** + Active, unrestricted RN license in your state of residence with multistate/compact...a managed care setting). + Ability to provide on-call UM coverage for nights and weekends on a rotational… more
- CVS Health (Phoenix, AZ)
- …the lives of patients facing complex medical journeys. As a Utilization Management ( UM ) Nurse Consultant specializing in Oncology and Transplant, you'll play a ... shift times are not permitted. **Required Qualifications** + Active, unrestricted RN license in your state of residence with multistate/compact licensure privileges.… more
- Elevance Health (Atlanta, GA)
- …necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to Peer Reviewers as ... equivalent background. + Current active unrestricted license such as RN LCSW LMSW LMHC LPC LBA (as allowed by...if all of the following criteria are met: performs UM approvals only, reviews requests for Applied Behavioral Analysis… more
- AnMed Health (Anderson, SC)
- …regulatory compliance. Qualifications: Requires current SC RN . Minimum of two years of clinical experience required. UM experience preferred but not required. ... Responsible for performing daily operations of Utilization Management ( UM ) program including certification management, medical necessity determinations, performance… more
- Commonwealth Care Alliance (Boston, MA)
- …responsible for providing leadership and subject matter expertise to our utilization management ( UM ) group. This role is a key role in helping our organization ... efficiency and effectiveness. + Partner with the VP of UM to direct the efforts of the utilization review...applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance is an… more