- Providence (Olympia, WA)
- …people, we must empower them. **Required Qualifications:** + Upon hire: Washington Registered Nurse License + 3 years of Nursing **Preferred Qualification:** ... **Description** The Utilization Review (UR) Nurse has a strong clinical background blended with...blended with well-developed knowledge and skills in Utilization Management ( UM ), medical necessity and patient status determination. This individual… more
- Tenet Healthcare (Detroit, MI)
- …Description : Join our dedicated healthcare team where compassion meets innovation! As a Registered Nurse with us, you'll have the opportunity to make a ... RN Utilization Review - Case Management - 2506004107...an authorization process Closes open cases on the incomplete UM Census Completes the Medicare Certification Checklist on applicable… more
- Molina Healthcare (Sparks, NV)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. Required Qualifications * At least 2 years experience,… more
- Corewell Health (Royal Oak, MI)
- …experience in care management, utilization review, home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan License Upon ... review cases for medical necessity, uses InterQual and/or other UR/ UM Committee-approved medical necessity screening criteria, when appropriate. Works… more
- Spira Care, LLC (Kansas City, KS)
- …Minimum Qualifications + Associate or bachelor's degree in nursing + Valid and active Registered Nurse ( RN ) in Kansas and Missouri or multi-state compact ... helping people achieve their health goals. The Care Guide, RN is an integral role within the Care Team...athena EMR application + Intermediate level knowledge of FACETS UM , CM and claims applications + Intermediate level knowledge… more
- Molina Healthcare (Madison, WI)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **_Wisconsin RN license required_** JOB DESCRIPTION Job SummaryProvides support...the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. Required Qualifications * At least… more
- Pacific Medical Centers (Renton, WA)
- …+ Coursework/Training Nursing (must be RN ) And + Upon hire: Washington Registered Nurse License + 5 years Clinical experience **Preferred Qualifications:** + ... **Description** The Supervisor Care Management RN is responsible for the supervision of case...the supervision of case management (CM) and utilization management ( UM ) functions of US Family Health Plan to achieve… more
- Molina Healthcare (Dallas, TX)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. Required Qualifications * At least 2 years experience,… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …varied clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, ... Associates degree required. Bachelor's degree preferred. + Active NYS RN or Registered Dietician or Physical Therapist...Certification required + Broad understanding of multiple areas (ie UM and CM). At this level, incumbent is required… more
- Molina Healthcare (North Las Vegas, NV)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. Required Qualifications * At least 2 years experience,… more