- Providence (Mission Hills, CA)
- …strong clinical background combined with well-developed knowledge and skills in Utilization Management , medical necessity, and patient status determination. The ... **Description** **RN Utilization Review - Remote. This position will work... Utilization Management RN must effectively and efficiently manage a diverse… more
- BriteLife Recovery (Englewood, NJ)
- …compliance. + Maintain compliance with payer policies, HIPAA regulations, and internal utilization management protocols. + Monitor trends in denials, approvals, ... need from you? + Minimum of 2-3 years of experience in utilization review, case management , or insurance coordination in a behavioral health or substance use… more
- Martin's Point Health Care (Portland, ME)
- …of clinical nursing experience as an RN, preferably in a hospital setting + Utilization management experience in a health plan UM department Required License(s) ... been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as is responsible for ensuring the receipt of high quality,… more
- Providence (Polson, MT)
- …Accountabilities include assessment and planning, coordination of care, resource utilization management and/ or review, discharge planning, documentation ... upon hire: Montana Registered Nurse License + 1 year experience in care management or utilization review in any setting or + Upon hire successful completion of… more
- Actalent (Rancho Cordova, CA)
- …in good standing + 2-3 years of clinical experience in prior authorization, case management , or utilization management + Familiarity with InterQual or MCG ... Utilization Review Nurse About the Role We're looking...obtain additional clinical information when needed + Support denial management , including appeals and peer‑to‑peer review processes + Ensure… more
- Providence (Olympia, WA)
- …a strong clinical background blended with well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. ... Degree or Associate's Degree in Nursing + 3 years - Utilization Review, Care Management , Quality Management , and/or Discharge planning **Why Join… more
- Dignity Health (Rancho Cordova, CA)
- … Utilization Review (UR) LVN, you will use clinical judgement in providing utilization management (UM) services. The focus is to provide high quality, ... all work activities. **Job Requirements** **Minimum Qualifications:** - 3 years Managed Care/ Utilization Management (UM) experience. 5 years LVN experience. -… more
- Integra Partners (Troy, MI)
- …of Durable Medical Equipment (DME) and related requests to support Integra's Utilization Management (UM) operations. This full-time, salaried role functions ... no current or past OIG or state sanctions + Experience performing utilization management or clinical review activities + Strong written and verbal communication… more
- Truman Medical Centers (Kansas City, MO)
- …**Work Schedule** 7:30AM - 4:00PM **Hours Per Week** 40 **Job Description** The Utilization Management Nurse (UM RN) collaborates with members of the healthcare ... solving, and proficient organization and planning skills Preferred Qualifications: + Utilization Management experience + Experience with managed care,… more
- US Tech Solutions (Chicago, IL)
- …HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE 1 YEAR OF UTILIZATION ... in state of residence + Must have prior authorization utilization experience + Experience with Medcompass **Skills:** + MUST...with Prior Authorization? + Do you have experience with Utilization Review? + Do you have an Active Registered… more