- UNC Health Care (Raleigh, NC)
- …_We are currently seeking an experienced nurse to join our dynamic team as an RN Utilization Manager. Role is full time, 40 hours per week, on site._ Become ... reviews in accordance with federal regulations & the Hospitals? Utilization Management Plan. In addition, the ...date. **Licensure/Certification Requirements:** * Licensed to practice as a Registered Nurse in the state of North… more
- 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
- Nuvance Health (Carmel, NY)
- …Licensure as RN required; LMSW /LCSW preferred; Case management certification preferred. 2.Work Experience:3 years ... Leadership experience preferred; Utilization review, discharge planning or case management experience preferred. Location: Carmel-PHC 670 Stoneleigh Avenue… more
- Veterans Affairs, Veterans Health Administration (Tacoma, WA)
- …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 ... Demonstrates the following core informatics functions to include content management , application support, health information technology system optimization, enterprise… 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
- Swedish Health Services (Seattle, WA)
- …strong clinical background blended with a well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. ... reports cases and problems appropriate for secondary review to Case Management leadership, the Medical Director or...an accredited school of nursing. + Upon hire: Washington Registered Nurse License + 3 years … more
- Veterans Affairs, Veterans Health Administration (Huntington, WV)
- …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 ... Summary The Assistant Nurse Manager (ANM) Primary Care supports the NM...(may be extended up to two years on a case -by- case -basis.) NOTE: Grandfathering Provision - All persons… more
- Elevance Health (Charleston, WV)
- …staff supervision. **Preferred Skills, Capabilities, and Experiences:** + Previous experience in case management / utilization management with a broad ... and substance abuse or substance abuse disorder assessment coordination implementation case planning monitoring and evaluating to promote quality member outcomes to… 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
- 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