- Trinity Health (Troy, NY)
- …often lead to innovative solutions. ** Registered Nurse Professional Utilization Management Nurse - St. Peter's Hospital--Full-TIme TRACK weekends** ... If you are looking for an RN position in Case Management ...accommodate all schedules **What you will do:** + Perform utilization management , both concurrent and retroactive for… more
- Veterans Affairs, Veterans Health Administration (Glendale, CO)
- …knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ... level degree in Nursing may have opportunity to become registered as a nurse with a state...(may be extended up to two years on a case -by- case -basis.) NOTE: Grandfathering Provision - All persons… more
- Veterans Affairs, Veterans Health Administration (East Orange, NJ)
- …knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ... level degree in Nursing may have opportunity to become registered as a nurse with a state...(may be extended up to two years on a case -by- case -basis.) NOTE: Grandfathering Provision - All persons… more
- Veterans Affairs, Veterans Health Administration (St. Cloud, MN)
- …equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion ... providers, and community partners to promote seamless, coordinated care. Apply utilization review criteria and evidence-based standards to ensure safe, efficient,… 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
- Centene Corporation (New York, NY)
- …in Nursing preferred. 3+ years of combined nursing and appeal and grievance, or utilization management or case management experience. Previous ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …cases to the Medical Director for review. Refer to and work closely with Case Management to address member needs. Participates in rotating on-call schedule, as ... depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of… more
- St. Bernard's Medical Center (Jonesboro, AR)
- …REQUIREMENTS + Education + Current Arkansas State RN license. + Experience + RN with previous case management experience preferred, but not necessary. ... continuity of care and cost effectiveness through the integration and functions of case management and utilization review. The person in this position is… more
- Corewell Health (Grand Rapids, MI)
- …nursing and or case management /managed care or related field Preferred + Registered Nurse ( RN ) - State of Michigan Upon Hire required + Basic ... (4 hours), mostly remote, occasional on-site About the Department: RN UM - Supporting the insurance coordination functions for...2 years of relevant experience clinical nursing and or case management /managed care or related field Required… more
- Providence (Mission Hills, CA)
- … Utilization Management , medical necessity, and patient status determination. The Utilization Management RN must effectively and efficiently manage a ... **Description** ** RN Utilization Review at Providence Holy...**Required Qualifications:** + Associate's Degree - Nursing. + California Registered Nurse License upon hire. + 2… more