- Catholic Health (Buffalo, NY)
- …with Weekend and Holiday Rotation Hours: 8:00 am to 4:00 pm Summary: The Registered Nurse (RN) Care Manager - Utilization Review, as an active member of the ... nursing clinical skills and discharge planning principles, the RN Care Manager , Utilization Review collaborates with the interdisciplinary team to maintain… more
- UPMC (Hanover, PA)
- **UPMC is hiring a part time Professional Care Manager for our Utilization Review department in Hanover! This is a part time, day shift position with a rotating ... weekend and holiday schedule.** **Purpose:** The Care Manager (CM) coordinates the clinical and financial plan for patients. Performs overall utilization … more
- Veterans Affairs, Veterans Health Administration (Little Rock, AR)
- Summary Under the supervision of the Nurse Manager , the Utilization Management Nurse will ensure that patients meet appropriate admission and continued ... follow-up has been determined and implemented. Responsibilities Under the supervision of the Nurse Manager , the Utilization Management Nurse will… more
- Elevance Health (Woodbridge, VA)
- RN Utilization Review Nurse (Washington DC Medicaid) JR149756 **Location** : This role requires associates to be in-office 4 days per week, Monday - Thursday, ... located at 609 H. Street NE. The **Medical Management Nurse ** is responsible for review of the most complex...management experience and requires a minimum of 2 years clinical , utilization review, or managed care experience;… more
- Adecco US, Inc. (Houston, TX)
- …. Preferred certifications include Certified Case Manager (CCM) or Certified Utilization Review Nurse (CURN). **Pay Details:** $85,000.00 to $110,000.00 per ... & Life Sciences is assisting a client hire a Utilization Review Nurse in Houston, TX! This...License in Texas . 2 to 3 years of clinical nurse /case management experience . 2 to… more
- University of Utah Health (Salt Lake City, UT)
- …to UR committee any case that surpasses expected LOS, expected cost, or over/under- utilization of resources. + Performs verbal/fax clinical review with payer as ... advancement, and overall patient outcomes. **Responsibilities** + Applies approved utilization criteria to monitor appropriateness of admissions with associated… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates,...implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service,… more
- 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 use ... with applicable standards and regulations and provide information and education to clinical care providers in order to achieve optimal clinical , financial,… more
- Beth Israel Lahey Health (Plymouth, MA)
- …establish the appropriate level of care using Interqual criteria. + Integrates clinical knowledge with billing knowledge to review, evaluate, and appeal clinical ... the denial management, documentation, and appeals process. + Collaborates with UR Manager and/or physician advisor regarding cases that do not meet established… more
- Beth Israel Lahey Health (Burlington, MA)
- …taking a job, you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital and Medical ... 8:00am-4:30pm Weekend and holiday rotations required **Job Description:** The Inpatient Registered Nurse (RN) Case Manager for Hospital at Home Care Transitions… more
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