- Cleveland Clinic (Port Saint Lucie, FL)
- …of eligibility (CTM, ACM, CCM or AHA) + Two years of recent experience in utilization review , quality or care management + Knowledge of acute care and ... accreditation requirements + Experience in discharge planning and quality improvement Our caregivers continue to create the best outcomes for our patients across each of our facilities. Click the link and see how we're dedicated to providing what matters most… more
- Guthrie (Binghamton, NY)
- …leadership and autonomy in nursing practice. + Preferred experience with care management/ utilization review , and payer knowledge. + RN considered. Education: + ... Completion of an accredited LPN program Licenses: + The Wellness Nurse must be licensed in both New York and Pennsylvania. + The applicant must have a current license as a Practical Nurse in their state of practice prior to position start date. + Additional… more
- Elevance Health (Tampa, FL)
- …or equivalent. Requires a minimum of 4 years of clinical experience and/or utilization review experience. Current active, valid and unrestricted LPN/LVN license ... or RN license and/or certification to practice as a health professional within the scope of licensure in applicable state(s) or territory of the United States required. Multi-state licensure is required if this individual is providing services in multiple… more
- Sedgwick (Concord, CA)
- …and physician filings and decisions on appropriate treatments recommended by utilization review . + Maintains professional client relationships. **ADDITIONAL ... FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). + Travels as required. **QUALIFICATIONS** **Education & Licensing** Bachelor's degree from an accredited college or university preferred.… more
- Ventura County (Ventura, CA)
- …in-services and staff development programs; + May participate in quality assurance/ utilization review or other non-direct patient care nursing assignments; ... and + Performs other related duties as required. Typical Qualifications These are entrance requirements to the exam process and assure neither continuance in the process nor placement on an eligible list. EDUCATION, TRAINING, and EXPERIENCE Requires six (6)… more
- Fairview Health Services (Bloomington, MN)
- …may include prior authorizations, vacation supplies, dose changes, price check and drug utilization review . + Process new and refill prescriptions in the ... computer system quickly and accurately; including entering refill authorization requests and entering and calculating complex prescriptions such as compounds and injectables. + Demonstrate comprehensive knowledge of the computer system. Utilize the reporting… more
- Genesis Healthcare (NM)
- …experience. 5. Experience in business/development preferred. 6. Prior experience in utilization review or discharge planning preferred. 7. Certifications: CCM, ... LPN or CIRS preferred. Benefits *Variable compensation plans *Tuition, Travel, and Wireless Service Discounts *Employee Assistance Program to support mental health *Employee Foundation to financially assist through unforeseen hardships *Diverse, Equitable, and… more
- Prime Healthcare (Boonton Township, NJ)
- …meetings as required to ensure continuity of care. Completes all required utilization review tasks as assigned. For Outpatient and Residential services/programs ... transportation to client residence and/or transportation of clients may be required. Qualifications EDUCATION, EXPERIENCE, TRAINING 1. A master's degree from an accredited college or university in counseling, psychology, social work, or other health-related… more
- Virginia Mason Franciscan Health (Seattle, WA)
- …located within hospital + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used We deliver inspired people to do meaningful ... work. We are an equal opportunity/affirmative action employer. **Where You'll Work** Virginia Mason Franciscan Health brings together two award-winning health systems in Washington state CHI Franciscan and Virginia Mason. As one integrated health system with… more
- BriteLife Recovery (West Kill, NY)
- …Maintain compliance with regulatory, licensing, and accreditation standards (eg, audits, utilization review , quality assurance). + Participate in performance ... improvement, quality assurance, and compliance activities. + Special Projects, on call and other duties as assigned. What we need from you? + Complete all annual education requirements. + Maintain active state Physician Assistant license and DEA registration… more
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