- 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
- 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
- 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
- Providence (Santa Rosa, CA)
- …with management, medical staff and medical center personnel. Provides payor/ utilization review organizations with concurrent retrospective utilization ... **Description** **Care Manager RN - Case Management at Providence Santa Rosa...within 30 days of hire. + Upon hire: California Registered Nurse License. + 2 years Acute… more
- Mohawk Valley Health System (Utica, NY)
- …population. Provides direct oversight of the case manager's daily operations of utilization review practice, processes and procedures ensuring accurate member ... RN Supervisor Case Management - Full Time -...Performs related duties as assigned. Education/Experience Requirements REQUIRED: + Registered Nurse licensed in State of New… more
- Pine Rest Christian Mental Health Services (Grand Rapids, MI)
- …are honored to be a part of this incredible work. What Will You Do?As a Lead Registered Nurse at Pine Rest, you'll be part of tight-knit team that believes in ... patient needs and implements patient-centered, compassionate care. + Responsible for the utilization and continued review of patient care protocols, standards of… more
- Pine Rest Christian Mental Health Services (Grand Rapids, MI)
- …availability will be variable based on staffing needs. What Will You Do? As a Registered Nurse at Pine Rest, you'll be part of tight-knit team that believes ... ultimately help participants live in a more independent setting. RN Shifts available for pick up are 12 hours,...assignments and promoting staff development. + Responsible for the utilization and continued review of patient care… more
- Geisinger (Lewistown, PA)
- …of 2 years-Related work experience (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE ... as part of a shared rotation. Don't worry, we'll review this in your interview. At least two (2)...your interview. At least two (2) years of prior RN experience is required. The ideal candidate will have… more
- Penn State Health (State College, PA)
- …prohibit or outlaw discrimination._ **Union:** Non Bargained **Position** Practice Site Manager RN Registered Nurse - Windmere Centre **Location** ... experience required. + Currently licensed to practice as a Registered Nurse by state of employment or... by state of employment or holds a multistate RN license through the interstate Nurse Licensure… more
- Centene Corporation (New York, NY)
- …Licensure. Hours are M-F 8:30 am - 5:00 pm with holiday rotation.** **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact State ... related to member care, provider interactions, and facilitates operations within utilization management. + Manages prior authorization, concurrent review , and… more
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