- Children's Mercy Kansas City (Kansas City, MO)
- …of, and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including patient ... To provide leadership to integrated inpatient teams; assists Director in the management of department; including personnel and fiscal management and development… more
- Grace Hospital (Morganton, NC)
- …patients and their families ." THE POSITION Join our dynamic healthcare team as a Utilization Management RN Weekender, where you will play a vital role in ... Blue Ridge HealthCare Hospitals - Morganton Clinical Case Management THE ORGANIZATION At UNC Health Blue Ridge,...delivery. Must have licenses to practice as a Registered Nurse in North Carolina and have practiced 3 years… 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. ... + Bachelor's Degree or Associate's Degree in Nursing + 3 years - Utilization Review, Care Management , Quality Management , and/or Discharge planning… more
- Sharp HealthCare (San Diego, CA)
- …1 **Shift Start Time** **Shift End Time** Other; California Licensed Vocational Nurse (LVN) - CA Board of Vocational Nursing & Psychiatric Technicians **Hours** ... care. **Required Qualifications** + Other : Graduate of an accredited Licensed Vocational Nurse (LVN) program. + California Licensed Vocational Nurse (LVN) - CA… more
- Centene Corporation (Harrisburg, PA)
- …28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive ... Analyzes BH member data to improve quality and appropriate utilization of services + Interacts with BH healthcare providers...Certified Behavior Analyst (BCBA) required + RN - Registered Nurse - State Licensure and/or Compact State Licensure RN… more
- Centene Corporation (Carson City, NV)
- …28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive ... Analyzes BH member data to improve quality and appropriate utilization of services + Provides education to providers members...Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required… more
- Emanate Health (Covina, CA)
- …Requirement :** **Minimum Experience Requirement :** Minimum of three years of utilization management experience. Experience in quality- related job preferred. ... the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity by applying… more
- TEKsystems (Los Angeles, CA)
- …Nurse (LVN) or Registered Nurse (RN) with hands-on experience in Utilization Management (UM) and a strong understanding of HMO/Medicare claims processes. ... LVN or RN license (California) + 2+ years of experience in Utilization Management (UM) + Hands-on experience with HMO/Medicare claims, audits, and denials +… more
- Prime Healthcare (Lynwood, CA)
- …to compassion, quality, and service! Responsibilities Responsible for the quality and resource management of all patients that are admitted to the facility from the ... admission and across the continuum of the health care management . Works on behalf of the advocate, promoting cost...accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum… more
- Ventura County (Ventura, CA)
- …and patient-centered care. Under general direction, the Senior Medical Management Nurse is responsible for performing utilization review, case management ... Senior Medical Management Nurse - VCHCP Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5113983)...in Case Management , CCM. + Experience with Utilization Management and/or Quality Assurance in a… more