- Universal Health Services (Fremont, CA)
- …our team and love what you do! We are currently hiring a per diem Utilization Management Registered Nurse (RN) for Fremont Hospital! The per diem Utilization ... admissions for continued stay reviews including completion of certifications. The Utilization Management RN will interface with managed care organizations, external… more
- Trinity Health (Hartford, CT)
- …that care efficiently to control costs. **What you will do:** + As a ** Utilization Management Registered Nurse RN** you will conduct prospective, concurrent and ... in Nursing BSN degree + **Licensure** : Current Licensure as a registered nurse RN in Connecticut + **Experience:** Five years of diversified, progressive experience… more
- Emory Healthcare/Emory University (Lithonia, GA)
- …Are YOU ready to join us? **Description** JOB DESCRIPTION: The (RUN) Resource Utilization Nurse is primarily responsible for supporting the critical care units ... **Overview** Heart. Soul. Expertise. That's what defines an Emory nurse . No matter where you are in your nursing...direct patient care assignment as needed while the primary nurse is off unit with another patient, and assisting… more
- UCLA Health (Los Angeles, CA)
- …leader with: + Current CA LVN licensure required + Two or more years of utilization review/ utilization management experience in an HMO, MSO, IPA, or health plan ... environment + Previous clinical experience + Experience drafting and issuing compliant adverse organization determinations + In-depth knowledge of health plan, DMHC, CMS, HIPPA, and NCQA requirements + Expertise in abstracting and interpreting medical… more
- Conviva (Frankfort, KY)
- …a part of our caring community and help us put health first** The Utilization Management Nurse utilizes clinical nursing skills to support the coordination, ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse work assignments are varied and frequently… more
- University Medicine (East Providence, RI)
- …to assist the patient to the right level of care and decrease unnecessary utilization . The nurse case manager is an active participant in the coordination ... SUMMARY: Reporting to the Manager of Case Management, the nurse case manager is responsible for providing comprehensive screenings, assessment, care coordination… more
- Veterans Affairs, Veterans Health Administration (Sheridan, WY)
- …orientation, competencies and providing quality improvement and enhance outcomes utilization . This nurse integrates outpatient knowledge, skills, abilities, ... Responsibilities VA offers a comprehensive total rewards package: VA Nurse Total Rewards The Registered Nurse (RN)...package: VA Nurse Total Rewards The Registered Nurse (RN) is responsible and accountable for all elements… more
- Johns Hopkins University (Baltimore, MD)
- …become a confident independent practitioner. For the division, the fellowship allows for better utilization of nurse practitioners in our specialty, as we are in ... to acquire further expertise in these clinical areas. The Nurse Practitioner Fellowship Program also provides a means to...Program also provides a means to help transition the nurse practitioner into a career in the specialty of… more
- AmeriHealth Caritas (Newark, DE)
- ** Utilization Management Plan Oversight Manager, Registered Nurse (must reside in DE)** Location: Newark, DE Primary Job Function: Medical Management ID**: 34207 ... for UM DE, and serves as SME for clinical components DE Medicaid Utilization Management Program. Works in close collaboration with all departments to achieve… more
- McLaren Health Care (Bay City, MI)
- …to D/C). 4. Identifies unsigned level of care (LOC) orders; communicates with utilization management nurse and obtains orders from providers. 5. Reviews current ... top decile performance in length of stay, cost efficient resource utilization , preventing readmissions and unnecessary emergency room visits. Works collaboratively… more