- Katmai (Fort Carson, CO)
- …Red Cross. + Three (3) years within the last four (4) years as a registered nurse in utilization management. + One (1) year of experience in UR/UM and three ... **SUMMARY** Provide a comprehensive utilization review (UR) and utilization management...active, and unrestricted license to practice as a registered nurse . + Must be a graduate from a college… more
- University of Utah Health (Salt Lake City, UT)
- …advancement, and overall patient outcomes. **Responsibilities** + Applies approved utilization criteria to monitor appropriateness of admissions with associated ... stay. + Discusses with physicians the appropriateness of resource utilization . + Tracks length of stay (LOS) and resource...Required** + Current license to practice as a Registered Nurse in the State of Utah, or obtain one… more
- CVS Health (Columbus, OH)
- …and work schedule may include weekends, holidays, and evening hours._ **UM Nurse Consultant** Fully Remote- WFH **Schedule** - Mon-Fri 10:30AM-7PM with alternate ... weekends and holidays **Position Summary:** UM Nurse Consultant Utilizes clinical experience and skills in a...to promote quality effectiveness of Healthcare Services and benefit utilization Consults and lends expertise to other internal and… more
- US Tech Solutions (Chicago, IL)
- …Plan Activities **Experience:** + 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior authorization utilization experience ... and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE 1 YEAR OF... Review? + Do you have an Active Registered Nurse License? **About US Tech Solutions:** US Tech Solutions… more
- CVS Health (Austin, TX)
- …opportunities to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal and external ... constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with productivity and… more
- Albany Medical Center (Albany, NY)
- …States of America) Salary Range: $71,612.39 - $110,999.20 Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients. * ... Completes Utilization Management and Quality Screening for assigned patients.* Applies...Triad Team and health care team. Minimum Qualifications:* Registered nurse with a New York State current license.* Bachelor's… more
- Sanford Health (Rapid City, SD)
- …time **Weekly Hours:** 40.00 **Department Details** Join our team as a Utilization Review and Case Management Manager and lead a high-impact, data-driven program ... while optimizing value across the care continuum. You'll shape and execute utilization strategies that become the standard for how we coordinate care, authorize… more
- CVS Health (Austin, TX)
- …external constituents in the coordination and administration of the utilization /benefit management function.* Meet set productivity and quality expectations ... other events as directed. **`** **Required Qualifications** + Registered Nurse + Education:Diploma RNacceptable;Associate degree/BSN preferred, 3+ years of… more
- US Tech Solutions (Hopewell, NJ)
- …7. Advocates for the member/family among various sites to coordinate resource utilization and evaluation of services provided. 8. Encourages member participation and ... of care. 11. Understands fiscal accountability and its impact on the utilization of resources, proceeding to self-care outcomes. 12. Evaluates care by problem… more
- US Tech Solutions (May, OK)
- …experience as an RN . 1+ years of inpatient hospital experience . Registered Nurse in state of residence . Must have prior authorization utilization experience ... and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review. . MUST HAVE 1 YEAR OF... management review. . MUST HAVE 1 YEAR OF UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG. . MUST… more