- Henry Ford Health System (Detroit, MI)
- …five years. Experience: + Minimum of three years of recent acute care nursing experience. + Prior case management experience is highly preferred. Certifications: ... Proficiency with computers, electronic health records (EHR), database systems, and utilization review/case management documentation systems. + Knowledge of CMS,… more
- Health Care Service Corporation (Mobile, AL)
- … + Three to Five (3-5) years recent experience in an acute-care environment, case- management , or utilization management position (experience can be a ... outcomes for customers. **Required Job Qualifications:** + Current Licensure as a registered nurse , in the state of residence in good standing. + Associates degree,… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- … nursing experience with advanced level pediatric clinical experience and utilization management and/or discharge planning experience. Thorough knowledge of ... **It's Work That Matters.** **Overview** **Purpose Statement/Position Summary:** The Nurse Care Manager performs complex discharge planning for patients...managed care, utilization management , discharges planning, and continuous quality… more
- US Tech Solutions (LA)
- …outside the walls of a hospital setting in a specialty area of the nursing field providing utilization management prior authorization reviews. Build strong ... indicated by staffing and business needs. **Duties:** + **Registered Nurse with current license in LA state of employment.... experience with a minimum of 1 year in utilization management / prior authorization review experience. **Experience**… more
- Rochester Regional Health (Rochester, NY)
- …New York State as a Registered Nurse PREFERRED QUALIFICATIONS: + Case Management or Utilization Management experience + Bachelor's Degree EDUCATION: ... efficient utilization of resources. Carries out activities related to utilization management , discharge planning, care coordination and referral to other… more
- Veterans Affairs, Veterans Health Administration (Wilkes Barre, PA)
- …at improving patient flow, care coordination, and organizational performance. Applying utilization management principles to support cost-effective and timely ... Summary The Registered Nurse Patient Flow & Nursing Care...(BMS), Emergency Department Integrated System (EDIS), and other capacity management tools. Serving as the Nursing Care… more
- ERP International (Yuma, AZ)
- …algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management ... databases for community resources, etc. + Integrate CM and utilization management (UM) and integrate nursing...the certifications below **OR** Possess a Master's Degree in Nurse Case Management from a program accredited… more
- HCA Healthcare (Tallahassee, FL)
- …is acceptable for position if current and compliant** + **Certification in Case Management , Nursing , or Utilization Review, preferred** + **Three years ... location._** It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential...observation patients for appropriateness in observation status + Performs utilization management reviews and communicates information to… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role BHPS provides Utilization Management (UM) services to its clients, ensuring high-quality, clinically sound decision-making. The Clinical Appeal ... and Grievance Nurse is responsible for conducting daily clinical and benefit...accurate decisions + Ensure strict adherence to Appeals and Utilization Management (UM) processes and regulatory and… more
- Veterans Affairs, Veterans Health Administration (South Jordan, UT)
- …knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ... for own professional growth. Advocate fiscal responsibility in the management of patient care through effective utilization ...requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse… more