- GE Aerospace (Lynn, MA)
- …levels of the organization and functions of the Part Family including **Operators, Support Staff, and the Leadership Team** to help progress **FLIGHT DECK** and ... of Lean principles. + Partner, develop and execute standard **Capacity Utilization ** process in partnership with the local Operations, Lean and Industrial… more
- Molina Healthcare (Rio Rancho, NM)
- …remote opportunity for a NM, TX or a multi-state licensed RN with Utilization Management experience to join our Inpatient reviewing team. Previous UM experience with ... especially with Outlook, Excel, Teams, and One Note. Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying… more
- Houston Methodist (The Woodlands, TX)
- …years in case management **LICENSES AND CERTIFICATIONS** **Required** + RN - Registered Nurse - Texas State Licensure - Texas Board of Nursing_PSV Compact Licensure ... and federal programs + Comprehensive knowledge of discharge planning, utilization management, case management, performance improvement and managed care… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- …individuals facing mental health challenges, while working behind the scenes? If so, ** Utilization Management** might be the perfect fit for you\! In this role, ... Health settings** \(both inpatient and outpatient\)\. + Prior experience in ** Utilization Management** or **Managed Care** \. + Strong **communication and… more
- Penn Medicine (Lancaster, PA)
- …physician, nurse and patient regarding the contents, therapeutic action, utilization and possible adverse reactions or interactions of medication. + Responds to ... teaching aides or computer-generated warning or supplemental information. + Conducts drug utilization reviews to assure the quality of drug use. Determines if… more
- Henry Ford Health System (Troy, MI)
- …judgment and applying appropriate medical necessity criteria. Provides clinical utilization management expertise to provide education, formal and informal and ... ancillary departments, physicians, and payers. EDUCATION AND EXPERIENCE: + Registered Nurse with a valid, unrestricted, State of Michigan License required. +… more
- Molina Healthcare (Houston, TX)
- JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for verifying ... cost-effective member care. We are seeking candidates with a RN licensure, Utilization Management knowledge and Medicare Appeals is strongly preferred. Work hours… more
- Dentsply Sirona (Pensacola, FL)
- …in patient care or revenue opportunity.** + **Partners with internal teams to support patient retention, reorder patterns, and long-term utilization of urology ... diagnosis codes, product categories (eg, catheters, drainage supplies), and utilization justification for accuracy and completeness.** + **Maintains a thorough… more
- Intermountain Health (Las Vegas, NV)
- …plan of care or specific interventions, as appropriate. + **Patient Support ** : Supports patient self-management and behavior change using motivational interviewing ... : Conducts root cause analysis of extended post-acute stays, inappropriate utilization , readmissions, and tracks key data elements or metrics. Identifies, analyzes,… more
- Centers Plan for Healthy Living (Margate, FL)
- …For Healthy Living is currently accepting applications for Full Time Registered Nurse without experience. The Utilization Management Clinical Reviewer works ... members who are in need of additional care or support in their home to improve their quality of...in their home to improve their quality of life. Utilization Management Clinical Reviewer will assess and process all… more