- Rochester Regional Health (Rochester, NY)
- Job Title: Utilization Review Specialist (RN) Department: Utilization Management Location: Rochester General Hospital Hours Per Week: 40 Hours (Full-Time) ... Days SUMMARY:The Utilization Review Specialist actively participates in the utilization management of patients and evaluating hospital admissions with the… more
- Community Health Systems (Franklin, TN)
- … preferred + 2-4 years of clinical experience in utilization review, case management , or acute care nursing required + 1-3 years work experience in care ... and efficiency of hospital services to ensure compliance with utilization management policies. This role conducts admission...Nursing required + Bachelor's Degree in Nursing… more
- University of Utah Health (Salt Lake City, UT)
- …communication skills. + Demonstrated knowledge of payers, payer systems, cost effective utilization management and InterQual criteria. + The ability to ... and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** +… more
- Catholic Health Services (Melville, NY)
- …Utilization and Appeals Coordinator will perform activities to help facilitate utilization management and appeals functions to include coordination of ... payment related activities. Position Responsibilities: + Prepares necessary documentation for utilization management and appeals processes, performs data … more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …* 3+ years nursing experience (pediatric experience preferred) * Utilization management and/or discharge planning experience preferred * Strong knowledge ... rewarding. **It's Work That Matters.** **Overview** **Purpose Statement/Position Summary:** The Utilization Nurse is responsible for utilization review… more
- UTMB Health (Galveston, TX)
- …consumption, and achieve positive patient outcomes. + Educates the Medical Staff and Nursing Staff on Utilization Management and provides specific ... Utilization Mgt (10hr shifts) **Galveston, Texas, United States** Nursing & Care Management UTMB Health Requisition...school of professional nursing and current Texas Nursing licensure as a professional registered nurse .… more
- Trinity Health (Maywood, IL)
- …in collaboration with attending physicians. + Actively participates in the Utilization Management committee. + Additional responsibilities as needed. **We ... Position is hybrid, must reside in Illinois. The **Regional Utilization Review Documentation Specialist** nurse works with...area of nursing granted by a national nursing organization preferred. + Case Management certification… more
- Saint Francis Health System (Tulsa, OK)
- …in the Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to improvement of internal ... completed the basic professional curricula of a school of nursing as approved and verified by a state board...and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License, or Clinical Social Worker (LCSW), or Professional… more
- CaroMont Health (Gastonia, NC)
- …fax, Provider Link, or telephonically. Gathers and disseminates Utilization Management information to medical staff departments, Nursing departments, Care ... to practice in NC (NC license or multi-state (compact) license). Certification in Utilization Review / Management , Quality and/or Case Management preferred.… more
- Sanford Health (Fargo, ND)
- …various other nursing interventions. Functions within the scope and standards of nursing practice as outlined in the Nurse Practice Act and Administrative ... ** **Job Summary** Provides expertise and leadership to ensure effective resource management for patient care delivery across the care continuum for assigned patient… more