- TEKsystems (Los Angeles, CA)
- …for a Licensed Vocational Nurse (LVN) or Registered Nurse ( RN ) with hands-on experience in Utilization Management (UM) and a strong understanding ... Location: West Hills/Canoga Park 91305 Compensation: LVN $38-$40 hourly RN $45-$50 hourly Overview: The Retro Claims Reviewer is... license (California) + 2+ years of experience in Utilization Management (UM) + Hands-on experience with… more
- UNC Health Care (Kinston, NC)
- …clinical experience as a Registered Nurse required. + 2 years utilization review, care management , or compliance experience preferred. + Minimum 1 year ... management preferred. + **LICENSURE/REGISTRATION/CERTIFICATION** + Licensed to practice as a Registered Nurse in the state of North Carolina. **Job Details**… more
- Georgetown Behavioral Health Institute (Georgetown, TX)
- …Knowledgeable of insurance coverage and billing practices preferred. Previous experience in utilization review or case management desirable. + Knowledge, Skills ... bed inpatient behavioral health hospital and seeking a full-time Outpatient Utilization Review Coordinator. This position is responsible for working with insurance… more
- Banner Health (AZ)
- …employment options by offering remote and hybrid work settings. The Registered Nurse RN Medical Management Services is required to be technologically ... payers, community agencies, provider networks, and regulatory agencies. MINIMUM QUALIFICATIONS Requires Registered Nurse ( RN ) licensure in the state of… more
- Tenet Healthcare (Detroit, MI)
- Registered Nurse ( RN ) -...for case management scope of services including: Utilization Management supporting medical necessity and denial ... Description : Join our dedicated healthcare team where compassion meets innovation! As a Registered Nurse with us, you'll have the opportunity to make a… more
- ERP International (Luke AFB, AZ)
- **Overview** ERP International is seeking a full time ** Registered Nurse - Case Management ** in support of the56th Medical Group at Luke AFB, AZ ... and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case...full, active, and unrestricted license to practice as a Registered Nurse , any state. Clinical Certification:** Certified… more
- Jennie Stuart Medical Center, Inc. (Hopkinsville, KY)
- Jennie Stuart Health is seeking a dedicated Case Management Nurse to join our healthcare team on a PRN basis. This role is integral to our patient care system, ... psychosocial support throughout the continuum of care. The Case Management Nurse will be based at our...teamwork + Experience with InterQual criteria + Understanding of utilization management + Knowledge of CMS regulations… more
- WellSpan Health (York, PA)
- …2 years of RN experience required + Field of Experience in Utilization Management , Case Management , or Clinical Nursing Specialty. Preferred ... **Essential Functions:** + Reviews assigned patients for medical necessity, utilization management , and appropriateness of setting for...**Licenses:** + Licensed Registered Nurse … more
- Sharp HealthCare (La Mesa, CA)
- …3 Years Recent acute care nursing experience or case management experience. + California Registered Nurse ( RN ) - CA Board of Registered Nursing ... Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA...and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge… more
- WellSpan Health (Lebanon, PA)
- …**Duties and Responsibilities** + Reviews assigned patients for medical necessity, utilization management , and appropriateness of setting for continued ... quality and cost of care efforts. + Liaisons between utilization management team, third party payers, and..., or Clinical Nursing Specialty. Preferred **Licenses:** + Licensed Registered Nurse Upon Hire Required or +… more