- Nuvance Health (Norwalk, CT)
- …for effective fiscal management of department/departments to ensure proper utilization of financial resources. Demonstrates ability to analyze and understand ... data in order to support and justify business decisions. 7. Facilitates interdisciplinary and interdepartmental communication for effective departmental operations. Works collaboratively with physicians and other leaders in the organization. 8. Ensures… more
- US Tech Solutions (MI)
- …with regulatory and accreditation guidelines and company policies and procedures **Skills:** + Utilization review + RN + Assure care + Clinical practice + Medcompass ... **Experience:** + 3 years Clinical practice experience, eg, hospital setting, alternative care setting such as home health or ambulatory care required. + Healthcare and/or managed care industry experience. + Case Management experience preferred-- Position… more
- Northwell Health (Forest Hills, NY)
- …Management, preferred.Minimum five (5) years clinical experience as a registered nurse . Prior experience in utilization management and/or discharge planning, ... Applies clinical expertise and medical appropriateness criteria to resource utilization and discharge planning. Job Responsibility 1. Coordinates and facilitates… more
- Mohawk Valley Health System (Utica, NY)
- …Services. + Familiarizes self with each unit's activities and benchmarks through staffing utilization reports, and dialogues with charge nurse , nurse manager ... + Reviews performance and management indicator reports. + Maintains staff utilization policies and procedures. + Promotes effective communication and teamwork within… more
- Pacific Medical Centers (Seattle, WA)
- …functions needed to support a smooth, efficient referral process; assists the utilization review and case management nurse with management of referrals ... and monitoring or institutional patients. Providence caregivers are not simply valued - they're invaluable. Join our team at Pacmed Clinics DBA Pacific Medical Centers in our culture of patient-focused, whole-person care built on understanding, commitment, and… more
- Travelers Insurance Company (St. Paul, MN)
- …and communicate denials to impacted parties. + Identify the need for and engage nurse resource for utilization review when appropriate. + File appropriate state ... forms. + In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the… more
- Covenant Health Inc. (Alcoa, TN)
- …Parkwest Medical Center. Assures that productivity targets are met. + Coordinates the utilization management plan for physicians and nurse practitioners with the ... and specialists within the Covenant Health system to facilitate awareness and utilization of services. + Responsible for hiring, training, completion of performance… more
- Grifols Shared Services North America, Inc (Minneapolis, MN)
- …institutions aligned with customer segmentation and enhance formulary and dosing protocols. * Utilization of Managed Markets, Marketing, Ig Nurse Educators, MSL, ... Centers ie neurology department with residents and fellows, Infusion Suite Nurse , Clinical Pharmacists, DOP for formulary consideration and specialty pharmacy etc.)… more
- Centene Corporation (Austin, TX)
- …Licensure required or + NP - Nurse Practitioner - Current State's Nurse Licensure required + Resource Utilization Group (RUG) certification must be obtained ... within 90 days of hire required Pay Range: $36.21 - $65.09 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible… more
- CVS Health (AZ)
- …licensure in state of residence - 3+ years of acute experience as a Registered Nurse - 1+ years of Utilization Management experience - Must have experience using ... per year - Occasional travel less than 5% to complete audits/meetings - Utilization Management is a 24/7 operation and work schedules will include weekends,… more
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