- Veterans Affairs, Veterans Health Administration (Columbia, SC)
- …the continuum of care. Responsibilities The Community Care Nurse (CC) Coordinator Registered Nurse ( RN ) is responsible for executing a streamlined ... of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- UPMC (West Mifflin, PA)
- UPMC Home Health is Hiring a Full-Time Weekend Registered Nurse ( RN ) Are you a nurse looking for a rewarding career where you can provide direct, ... establish patients' plans of care in collaboration with physicians, patients, and utilization management (UM) professionals to meet physicians' orders and… more
- Katmai (Fort Carson, CO)
- …all levels of health care management to include outside agencies. Performs utilization management activities to optimize cost, quality, and access to care. ... **Job Requirements:** **MINIMUM QUALIFICATIONS** + Associates Degree of Nursing. Registered nurse shall be a graduate from...+ Shall possess a current, active, full and unrestricted Registered Nurses ( RN ) licensed in Colorado or… more
- McLaren Health Care (Port Huron, MI)
- …between patients, colleagues and community. 5. Performs concurrent and retrospective utilization management -related activities and functions to ensure that ... **Schedule:** **Position Summary:** Responsible for providing assistance to the RN and SW Care Managers in the coordination of...a HealthCare related field * Two years of case management or utilization review experience * Three… more
- Penn State Health (State College, PA)
- …prohibit or outlaw discrimination._ **Union:** Non Bargained **Position** Practice Site Manager RN Registered Nurse - Windmere Centre **Location** ... + Five (5) years of related experience required. + Currently licensed to practice as a Registered Nurse by state of employment or holds a multistate RN … more
- Aspirus Ironwood Hospital (Duluth, MN)
- …values Every. Single. Day. ASPIRUS ST. LUKE'S HOSPITAL in Duluth, MN is seeking a REGISTERED NURSE - ACUTE CARE COORDINATOR to join our CARE COORDINATION team! ... ensuring implementation and monitoring of compliant documentation strategies and utilization management principles. MINIMUM QUALIFICATIONS + Education: Graduate… more
- University of Southern California (Arcadia, CA)
- …timely and accurate information to payers. The role integrates and coordinates utilization management , care facilitation, and discharge planning functions. The ... to resolve problems with payers as needed. + Completes utilization management for assigned patients. + Coordinates/facilitates.... Licenses and Certifications Minimum (Required) * A current RN licensure in the State of California is required.… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The role of the Nurse , Quality Review Utilization Management (UM) is to evaluate clinical quality and procedures ... within the Utilization Management (UM) program to maximize efficiency,...required work experience. **Licenses/Certifications Upon Hire Required:** + Health Services\ RN - Registered Nurse -… more
- MTC (Raymondville, TX)
- …the use of appropriate sanitation methods. + Practice basic cost containment and utilization management for detainee care and facility operations. + Maintain ... Detention Facility in Raymondville, TX** is seeking a dedicated RN to provide compassionate care and support to individuals...with an acceptable driving record required, unless waived by management . Management & Training Corporation (MTC) is… more
- Molina Healthcare (WI)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The RN Clinical Appeals Nurse provides support...officer on denial decisions. * Resolves escalated complaints regarding utilization management and long-term services and supports… more
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