- Humana (Jackson, MS)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Hartford HealthCare (Willimantic, CT)
- …**Windham Hospital* **Title:** * Registered Nurse Case Manager ( RN ) - Utilization Management * **Location:** *Connecticut-Willimantic-Windham Community ... the direction of the Manager of Continuing Care and Utilization Management and in collaboration with physicians,... experience preferred. *LICENSURE/CERTIFICATION* * Current license as a registered nurse in the State of Connecticut.… more
- Cedars-Sinai (CA)
- …as a condition of continued employment. **Req ID** : 13443 **Working Title** : Registered Nurse Care Coordinator- Inpatient Specialty Program - 8 Hour Days $5K ... nurse practitioner and case manager assigned to the SNF 's for continued review and follow up. + Authorizes...TPL carrier of all injured worker cases receiving case management services. + Ensures appropriate utilization of… more
- AmeriHealth Caritas (Washington, DC)
- **$5,000.00 SIGN ON BONUS** **Role Overview** Our Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient services, ensuring ... in the least restrictive and most effective manner. The Utilization Management Reviewer must maintain a strong...of 3 years of diverse clinical experience as a Registered Nurse in an Intensive Care Unit… more
- Sharp HealthCare (La Mesa, CA)
- …3 Years Recent acute care nursing experience or case management experience. + California Registered Nurse ( RN ) - CA Board of Registered Nursing ... Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA...and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge… more
- Alameda Health System (San Leandro, CA)
- Clinical Nurse III, Acute Inpatient Behavioral Health Utilization Management + San Leandro, CA + John George Psychiatric Hospital + JGP Care Coordination + ... fields in EHR. 17. Maintains current knowledge of clinical practice and Utilization Management by literature review, membership in a professional organization.… more
- CenterWell (Austin, TX)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous… more
- ChenMed (Philadelphia, PA)
- …RN with bachelor's degree in a related clinical field preferred + A valid, active Registered Nurse ( RN ) license in State of employment required + Compact ... the remaining hours. The Acute Care Manager, Complex Care ( RN ) is responsible for achieving positive patient outcomes, managing...required + A minimum of one (1) year of utilization review and/or case management , home health,… more
- ChenMed (Newport News, VA)
- …We're rapidly expanding and we need great people to join our team. The Nurse Case Manager 1 ( RN ) is responsible for achieving positive patient outcomes ... post-acute facilities, as well as, their home environments. The Nurse Case Manager 1 ( RN ) role also...preferred providers. + Coordinates the integration of social services/case management functions in the pre-acute, ER, acute and post-acute… more
- Fallon Health (Worcester, MA)
- … Nurse in a clinical setting required. * 2 years' experience as a Utilization Management /Prior Authorization nurse in a managed care payer preferred. * ... degree in nursing required **License/Certifications:** Active and unrestricted licensure as a Registered Nurse in Massachusetts. **Experience:** * A minimum of… more
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