- Dignity Health (Gilbert, AZ)
- …of the Director of Care Management, performs criteria-based concurrent and retrospective utilization review to support and encourage the efficient and effective ... + Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is warranted… more
- Hackensack Meridian Health (Hackensack, NJ)
- …Preferred: 1. Not Applicable. Licenses and Certifications Required: 1. NJ State Professional Registered Nurse License. 2. Advance Practice Nurse License. 3. ... **The Per Diem Advanced Practice Nurse (APN) for Utilzation Review utilizes a patient-centered coordinated care model, demonstrating competencies in leadership,… more
- UCLA Health (Los Angeles, CA)
- Description At UCLA Health, the Utilization Management (UM) Review Nurse plays a vital role in ensuring the delivery of high-quality, evidence-based care. ... documentation related to prior authorization requests for medical services. The UM Review Nurse applies clinical judgment, regulatory standards, and established… more
- Veterans Affairs, Veterans Health Administration (Leavenworth, KS)
- …and analytical review of clinical information. Responsibilities The Revenue Utilization Review (RUR) Registered Nurse is under the supervision of a ... Summary The Revenue Utilization Review (RUR) nurse ...clinical registered nursing experience, experience with authorizations, utilization review , or insurance authorization experience; critical… more
- Dartmouth Health (Lebanon, NH)
- …leadership, communication and computer skills desired. Required Licensure/Certifications - Licensed Registered nurse with NH eligibility * Remote:Fully Remote * ... Area of Interest:Nursing * Pay Range:$79,747.20/Yr. - $127,587.20/Yr. (Based on 40 hours per week, otherwise pro rata) * FTE/Hours per pay period:.01 hrs/per week (per diem/temp) * Shift:Rotating * Job ID:35880 Dartmouth Health offers a total compensation… more
- Huron Consulting Group (Chicago, IL)
- …Management is responsible for planning, organizing, developing, and directing implementation of the Utilization Review Plan and the overall operation of the ... + Staff Acquisition and Support: Leads and manages the utilization review staff and function for the...Criteria and Milliman Care Guidelines (MCG) preferred. + Current RN license from Maryland Board of Nursing. + CCM… more
- CVS Health (Columbus, OH)
- …of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review , you'll play a vital role in ... phone, computer, etc. and clinical documentation systems. + 1+ Year of Utilization Review Management and/or Medical Management experience. + Commitment to… more
- Ochsner Health (New Orleans, LA)
- …case management or utilization review . **Certifications** Required - Current registered nurse license in state of practice. Basic Life Support (BLS) from ... and implement discharge plans based on patient's individualized needs. Registered Nurse ( RN ) Case Manager...of the conditions of participation as it relates to utilization review and discharge planning. + Maintains… more
- Ventura County (Ventura, CA)
- Senior Registered Nurse - Hospital Management Utilization Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061650) Apply Senior ... Registered Nurse - Hospital Management Utilization Salary $118,668.43...general and specialized principles, practices, techniques and methods of utilization review /management, discharge planning or case management.… more
- Commonwealth Care Alliance (Boston, MA)
- …clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA ... CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is… more