- Albany Medical Center (Albany, NY)
- …Day (United States of America) Salary Range: $71,612.39 - $110,999.20 Responsible for Utilization Management , Quality Screening and Delay Management for ... assigned patients. * Completes Utilization Management and Quality Screening for assigned patients.* Applies MCG...Triad Team and health care team. Minimum Qualifications:* Registered nurse with a New York State current license.* Bachelor's… more
- Martin's Point Health Care (Portland, ME)
- …experience as an RN, preferably in a hospital setting + 2+ years of utilization management experience in a health plan UM department Required License(s) and/or ... "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as is responsible...to lower/higher levels of care, makes referrals for care management programs, and performs medical necessity reviews for retrospective… more
- Actalent (Rancho Cordova, CA)
- Utilization Review Nurse About the Role...2-3 years of clinical experience in prior authorization, case management , or utilization management + ... We're looking for a Utilization Review (UR) Nurse to join our team and support high‑quality, cost‑effective patient care from a fully remote environment. This… more
- Cedars-Sinai (Los Angeles, CA)
- … Review Case Manager - PER DIEM - 8 Hour Days **Department** : Utilization Management **Business Entity** : Cedars-Sinai Medical Center **Job Category** : ... **What will you be doing in this role?** The Utilization Review Case Manager validates the patient's placement to...Association or American Red Cross required + Certified Case Management RN preferred **Experience:** + A minimum of 5… 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 ... 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior...in state of residence + Must have prior authorization utilization experience + Experience with Medcompass **Skills:** + MUST… more
- UNC Health Care (Kinston, NC)
- …applied clinical experience as a Registered Nurse required. + 2 years utilization review, care management , or compliance experience preferred. + Minimum 1 ... support the clinical documentation specialists and Patient Financial Services. Supports the Utilization Review Nurse team when necessary by applying established… more
- Beth Israel Lahey Health (Burlington, MA)
- …weekends. This position is on-site at Lahey Hospital and Medical Center. The Utilization Analyst works with physicians, the payers and inpatient case management ... medical necessity of the hospital care. Using the concepts of utilization review, clinical documentation improvement and revenue integrity, these specialized case… more
- US Tech Solutions (May, OK)
- …HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review. . MUST HAVE 1 YEAR OF UTILIZATION ... . 1+ years of inpatient hospital experience . Registered Nurse in state of residence . Must have prior...in state of residence . Must have prior authorization utilization experience . Able to work in multiple IT… more
- Sanford Health (Rapid City, SD)
- …community. **Job Summary** Provides expertise and leadership to ensure effective resource management for patient care delivery across the care continuum for assigned ... patient wellness through evidenced based practice, improved care outcomes, efficient utilization of health services, and appropriate level of care for patients… more
- Actalent (Houston, TX)
- …and appropriate setting of care. Qualifications: + 4+ years experience in utilization management and utilization review/managed care/hospital setting as ... "Urgent Hiring for " Utilization Review RN" Job Description: + Perform concurrent reviews to assess member's overall health. + Review the type of care being delivered… more