- Providence (Spokane, WA)
- **Description** The Inpatient Registered Nurse ( RN ) Care Manager provides professional, comprehensive, patient centric care management services for at risk ... in Nursing degree/diploma upon hire + Upon hire: Washington Registered Nurse License + 2 years acute...Inpatient setting + IRR or annual competency testing in Utilization Review **Preferred Qualifications:** + Bachelor's Degree… more
- Nuvance Health (Danbury, CT)
- …the time of review . If unable to resolve, escalate to the PA and Utilization Review (UR) Leadership. * Coordinate with the care team in changing patient ... in Milliman and InterQual Guidelines required * Minimum of 2-3 years experience as Utilization Management Nurse in an acute care setting required, minimum of 4… more
- Tenet Healthcare (Detroit, MI)
- Registered Nurse ( RN ) - Case Manager - 2506003285 Description : Join our dedicated healthcare team where compassion meets innovation! As a Registered ... and is determined by employment status Job Description: The RN Case Manager is responsible to facilitate care along...management experience preferred. 3. License to practice as a Registered Nurse in the State of Michigan.… more
- University of Southern California (Arcadia, CA)
- …Education: Bachelors Degree Nursing Minimum Skills: Possess basic computer skills. Required Certifications: Registered Nurse - RN (CA Board of Registered ... outside referring physicians andmedical groups.* Communicates with insurance company utilization review and authorization personnel.* Gathers and...RN experience in assigned area of Nursing. A registered nurse with current RN … more
- Highmark Health (Pittsburgh, PA)
- **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Registered nurse who is proficient in the coordination of care and manages ... Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory… more
- McLaren Health Care (Flint, MI)
- …organizational goals. Assumes responsibility for the clinical administrative aspects of utilization review and case management. Integrates medical management ... as well as documentation of the case management and utilization management processes. Responsible to collaborate in the delivery...in Nursing, health care or business-related field + Valid RN License in state doing business in + Ten… more
- Highmark Health (Jefferson Hills, PA)
- …including but not limited to: appropriateness of care, documentation requirements, utilization review principles and criteria, insurance benefits and ... outcomes, engages patients/caregivers in their healthcare, and supports effective resource utilization . Serves as key team members in the management of readmissions,… more
- Ventura County (Ventura, CA)
- …candidate is an experienced Mental Health Nurse with a background in utilization review and discharge planning. They also have extensive years of experience ... standards, and active participation in quality and compliance efforts. The Senior Registered Nurse -Mental Health is distinguished from Senior Registered … more
- Baystate Health (Springfield, MA)
- …to this role. **Education:** Bachelors Degree in Nursing (Required) **Certifications:** Registered Nurse - State of MassachusettsState of MassachusettsState of ... - Midpoint - Maximum $46.22 - $53.13 - $62.85 ** RN , Patient Placement Bed Manager** **Part Time - 24...+ Requires a working knowledge of community resources and Utilization /Quality Review standards. Understanding of the hospitals… more
- Penn Medicine (Lancaster, PA)
- …placement in position for incumbents who started after 07/01/2020. + A graduate registered nurse may only practice professional nursing under supervision and if ... the graduate registered nurse holds a current temporary practice... nurse is practicing. + All Clinical Nurse 1 RN 's will be required to… more