- ManpowerGroup (Austin, TX)
- …a non-clinical, ** remote ** -review role focused on **prior authorization** and ** utilization management ** -ideal for RNs who thrive in a collaborative, ... We're seeking a dedicated and detail-oriented **Registered Nurse (RN)** to join a dynamic healthcare partnership team supporting Medicaid services in Texas. This is… more
- Actalent (Tigard, OR)
- …+ Knowledge of Medicare and Medicaid regulations preferred. + Understanding of utilization management processes preferred. + Proficient in clinical review, case ... Job Title: Clinical Review Nurse - Concurrent Review Work Environment + This is a 100% remote position + The schedule is Tuesday to Saturday, 10 AM to 7 PM PST.… more
- ChenMed (Houston, TX)
- …and we need great people to join our team. The Registered Nurse , Telehealth is responsible for providing telephonic emergency triage directional patient care ... issues, client counseling, patient advocacy, health education and referral and resource management to ChenMed patients and their families. The incumbent in this role… more
- Virginia Mason Franciscan Health (Bremerton, WA)
- **Responsibilities** **JOB SUMMARY / PURPOSE** **This will be a remote position.** Responsible for the review of medical records for appropriate admission status and ... admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is...hospital clinical experience, or a Masters degree in Case Management or Nursing field in lieu of 1 year… more
- Prime Therapeutics (Atlanta, GA)
- …passion and drives every decision we make. **Job Posting Title** Infusion Referral Nurse Sr- REMOTE **Job Description** Under supervision, is responsible for ... Nursing + Bachelors - Nursing + RN - Registered Nurse , State and/or Compact State Licensure - Care Mgmt...experience. + Experience in managed care, specialty drugs, care management and utilization review. + Meets Credentialing… more
- Virtua Health (Pennsauken, NJ)
- …UR Tech and AA to support UR and revenue cycle process.Position Responsibilities: Utilization Management * Utilizes Payer specific screening tools as a resource ... from the State of New Jersey as a Registered Nurse .Case Management Certification (requirement within one year of… more
- CVS Health (Oklahoma City, OK)
- …in a dynamic, fast-paced setting **Preferred Qualifications** + Experience in ** utilization management ** , **precertification** , or **prior authorization** + ... and every day. **Position Summary** This is a **fully remote role** with a requirement to **reside in Oklahoma**...with a requirement to **reside in Oklahoma** . The nurse in this position uses clinical expertise in a… more
- Baylor Scott & White Health (Dallas, TX)
- …to fit their needs. + Proficiency in discharge planning, setting case management referral standards, reviewing utilization , and categorizing levels of care. ... efficient resource use. **Schedule** + You will work primarily remote . + Will be required to work onsite at...issues or trends impacting specific entities to the appropriate management is expected. + Part of your work will… more
- US Tech Solutions (Columbia, SC)
- …license. + Hours/Schedule - M-F 8:30am - 5pm. + Onsite training for the first week. Remote once training is complete. + A typical day would like in this role: We ... and work remotely. Detail Oriented, Good Communication Skills, Time Management , Organization, Team Oriented, but able to work independently. **Responsibilities:**… more
- Ochsner Health (New Orleans, LA)
- …of hospital-based experience in discharge planning, case management or utilization review. **Certifications** Required - Current registered nurse license in ... a patient's hospitalization, which includes a review of the appropriate utilization of resources, balanced with the patient's right to self-determination. Reviews… more