- Fairview Health Services (Forest Lake, MN)
- …for services provided + Completes the requirements of various payers and utilization management reviewers to obtain authorization for treatment. Demonstrates the ... to health/wellness issues for clients and their families. Serves as a nursing liaison between the physician and the interdisciplinary team. Effectively communicates… more
- Elevance Health (Ashburn, VA)
- …services in multiple states. **Preferred Skills, Capabilities and Experiences:** + Utilization Management ; discharge planning in an inpatient setting, home ... ** Nurse Case Manager I** **LOCATION** **: Ashburn, VA.... Case Manager I** is responsible for performing care management within the scope of licensure for members with… more
- Sea Mar Community Health Centers (Seattle, WA)
- …assist providers in procedures. + Facilitate emergency referrals according to the utilization management guidelines when the referral coordinator is unavailable. ... patients who have yet to be seen. Responsible for management of nurse visit encounters. These will...staff. + The RN/LPN will work closely with the Nurse Manager and Nursing Supervisors in assisting… more
- ChenMed (Miami, FL)
- …our team. The Physician Reviewer is the primary physician reviewer for Utilization Management /Clinical Appropriateness review cases in our organization. Other ... Process and Quality improvement in our developing area of Delegated Utilization Management . **ESSENTIAL JOB DUTIES/RESPONSIBILITIES:** + Provides Delegated… more
- Beth Israel Lahey Health (Cambridge, MA)
- …completed). **KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED** 1. RN with experience in risk management , quality assessment, or utilization management . 2. Strong ... to the Director of Quality & Patient Safety, the Quality and Patient Safety nurse specialist plays a role in reviewing publicly reported quality data by leading the… more
- Access Dubuque (Dubuque, IA)
- …- Rehab Registered Nurse MercyOne Registered Nurse (PRN) Rehab MercyOne Utilization Management Nurse Cottingham & Butler/ SISCO Neonatal - Nurse ... JumpStart Registered Nurse **MercyOne** 1 Positions ID: TRHEUS00615924MERCYO Posted On...outpatient and community services. MercyOne operates two hospital-based skilled nursing units and a 40-bed nursing home.… more
- HCA Healthcare (Nashville, TN)
- …required (LPC, LMFT, LCSW, LADAC) + Previous experience in Needs Assessment and Utilization Management strongly preferred. + Familiarity with required DSM V-R ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...want to create your own personal career path in nursing ? HCA Healthcare is your career destination! Our scale… more
- CareFirst (Baltimore, MD)
- …home or other levels of care. Utilizing experience and skills in both care management and utilization management , the Onsite Clinical Navigator will leverage ... Required. **Experience:** 5 years clinically related experience working in Care Management , Home Health, Discharge Coordination and/or Utilization Review.… more
- Magellan Health Services (Boise, ID)
- …the management , direct supervision and coordination of clinical and/or nonclinical management staff, including utilization management and intensive care ... management staff, providing expertise in designated programs. + Assists clinical management in the development and on-going management of designated staff. +… more
- UPMC (Coudersport, PA)
- …establish patients' plans of care in collaboration with physicians, patients, and utilization management (UM) professionals to meet physicians' orders and ... UPMC Home Health is hiring a Registered Nurse for the area. Are you a ...and compassionate registered nurses to join our home health nursing team! You'll work in a home setting with… more