- Hackensack Meridian Health (Edison, NJ)
- …to transform healthcare and serve as a leader of positive change. The **Care Management , Care Coordinator, Utilization Management ** is a member of the ... Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to.... **Licenses and Certifications Required:** + NJ State Professional Registered Nurse License. + AHA Basic Health… more
- CVS Health (Baton Rouge, LA)
- …And we do it all with heart, each and every day. **Position Summary** The Utilization Management Nurse Consultant (UMNC) for NICU Concurrent Review conducts ... review, and education related to NICU and special populations utilization management . * Serve as a clinical...detail and data integrity **Required Qualifications** * Active, unrestricted RN license in Louisiana or a compact license. *… more
- CareFirst (Baltimore, MD)
- …in addition to the required work experience. **Licenses/Certifications Upon Hire Required:** + RN - Registered Nurse - State Licensure And/or Compact ... **Resp & Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination… more
- Saint Francis Health System (OK)
- …in various levels of care and receipt of necessary services. The Utilization Management (UM) Registered Nurse will communicate with providers the details ... Nursing. Licensure, Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License. Work Experience: Minimum 2 years of… more
- Molina Healthcare (North Las Vegas, NV)
- … management or equivalent combination of relevant education and experience. * Registered Nurse ( RN ) Clinical licensure and/or certification required ONLY ... deadlines. * Excellent organizational, problem-solving and critical-thinking skills. Preferred Qualifications * Registered Nurse ( RN ). License must be active… more
- US Tech Solutions (Hopewell, NJ)
- …**Additional licensing, certifications, registrations:** 1. Requires an active New Jersey Registered Nurse License. **Knowledge:** - Prefers proficiency in the ... case/care management principles. - Prefers working knowledge of principles of utilization management . - Prefers basic knowledge of health care contracts and… more
- Prime Healthcare (Inglewood, CA)
- …Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patients ... outcomes and reducing readmissions. #LI-CC2 Qualifications Required qualifications: 1. CA Registered Nurse 2. Bachelor's of Science in Nursing3. Grandfathered… more
- Penn Medicine (Lancaster, PA)
- …6:30am-9am. No holidays _Penn Medicine Lancaster General Health is looking for an experienced RN to join our Utilization Management Specialist team! In this ... we'd love to hear from you!_ **Summary** : The Utilization Management Specialist - Admissions is responsible...assigned. **Minimum Required Qualifications:** + Current licensure as a Registered Nurse , issued by the Pennsylvania Board… more
- CVS Health (Phoenix, AZ)
- …that promote high-quality healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. ... listening, and use of a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM specialty teams as needed,… more
- Sanford Health (Rapid City, SD)
- …experience preferred. Experience in medical necessity review preferred. Currently holds an unencumbered registered nurse ( RN ) license with the State Board of ... providing direct supervision of all departmental staff. Maintains a standardization of utilization management process to ensure all policies and procedures are… more