- 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) or Physician Assistant (PA) for the...(APN) or Physician Assistant (PA) for the Transition Utilzation Review Team utilizes a patient-centered coordinated care model, demonstrating… more
- Saint Francis Health System (Tulsa, OK)
- …participates in the Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to improvement of ... support to the hospital and treatment team throughout the review of patients, their placement in various levels of...Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License, or Clinical Social Worker… more
- Baystate Health (Springfield, MA)
- … Utilization Management** The ** RN Hospital Case Manager** is a registered nurse responsible for the coordination of clinical care, quality, and financial ... and Competencies:** + Requires a working knowledge of community resources and Utilization /Quality Review standards and activities conducted by third party payers… 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
- 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
- Molina Healthcare (Yonkers, NY)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... emergency room. Preferred Experience Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
- Molina Healthcare (North Las Vegas, NV)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... unit (ICU) or emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG… more
- Corewell Health (Dearborn, MI)
- …care management, utilization review , home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan Upon Hire required + ... patients. + Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). +… more
- Corewell Health (Royal Oak, MI)
- …management, utilization review , home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan License Upon Hire required ... patients. 1. Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). 2.… more
- Sutter Health (San Francisco, CA)
- …+ Other: Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** + RN - Registered Nurse of California + CCM - Certified Case Manager ... management within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation status. + Working knowledge of… more