- CenterWell (Anderson, SC)
- …proactive and sustained engagement in improving health outcomes, optimizing resource utilization , and ensuring effective panel management . + **Focus on ... part of our caring community and help us put health first** The Nurse Practitioner, Paneled applies advanced education and clinical competencies to achieve optimal… more
- Molina Healthcare (AZ)
- …Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG ... with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At… more
- Molina Healthcare (Madison, WI)
- …(ICU) or emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG ... with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At… more
- Molina Healthcare (CA)
- …care unit (ICU) or emergency room. Previous experience in Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG ... with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At… more
- STG International (Milledgeville, GA)
- …FUNCTIONS: + Ensure the facility meets the minimum staffing levels for nurses and nurse aides; complete required posting of nursing staff data as required. + Ensure ... forms, reports, evaluations, studies, charting, etc., as necessary. + Periodically review the department's policies and procedures manuals, job descriptions, etc.,… more
- Elevance Health (Indianapolis, IN)
- …in an ambulatory or hospital setting or minimum of 1 year of prior utilization management , medical management and/or quality management , and/or ... ** Nurse Reviewer I** **Virtual:** This role enables associates...required. **Preferred Skills, Capabilities, and Experiences:** + Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding,… more
- Veterans Affairs, Veterans Health Administration (Phoenix, AZ)
- …possesses intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation ... for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care. Responsibilities… more
- CVS Health (Austin, TX)
- …Registered Nurse (RN) states. This role is a blended role doing both Case Management and Utilization Management . The RN Case Manager is responsible for ... years' experience in critical care + 6+ months case management or utilization management experience...+ Must be able to obtain multi state Registered Nurse (RN) licensures **Preferred Qualifications** + Case Management… more
- Cabinet Peaks Medical Center (Libby, MT)
- …Services, Imaging Services, Laboratory Services, Nutrition and Diabetes Education, Quality Risk Management , Utilization Review and Risk Management , ... Cabinet Peaks Medical Center is looking for a Nurse House Manager to join our Nursing Administration...utilization of personnel. Experience 5+ years' experience in management and supervisory nursing role required. Experience in Obstetrics,… more
- Veterans Affairs, Veterans Health Administration (Walla Walla, WA)
- …the least restrictive, most cost-effective manner, through use of outpatient utilization management criteria, clinical practice guidelines, clinical pathways and ... Veteran medical care and services based on a clinical review . Responsibilities The incumbent will function in an independent...utilization of the nursing process. The RCP Clinical Nurse Coordinator is responsible for the triage and care… more