- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) PRN position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... resource to the physicians and provides education and information on resource utilization and national and local coverage determinations (LCDs & NCDs). This position… more
- Commonwealth Care Alliance (Boston, MA)
- …is responsible for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for conducting ... 013650 CCA-Auth & Utilization Mgmt Position Summary: Commonwealth Care Alliance's (CCA)...reviews). * Hire, train and mentor UM staff, including nurse reviewers and support personnel. * Act as liaison… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role The Director, Utilization Management (UM) will manage the Utilization Management team consisting of Clinicians and Non-Clinical support staff from ... onboardings with time sensitive requirements. + Support and grow the utilization management team through strong professional relationships, mentorship, modelling of… more
- Corewell Health (Southfield, MI)
- Scope of Work This role includes accountability for utilization review (UR) and may include admission, concurrent, and retrospective reviews. Coordinates activities ... adequate and complete documentation received by the physician/provider and utilization reviews. Initiates concurrent appeals to address patient class/status… more
- Ochsner Health (Lafayette, LA)
- …or other related MCO departments/functions. **Certifications** Required - Current registered nurse (RN) license in state of practice. *MSW accepted in lieu ... of registered nurse (RN) licensure. Preferred - Certification in Case Management (CCM) or Certified Professional in Healthcare Management (CPHM). **Knowledge Skills… more
- LifePoint Health (Hickory, NC)
- *Registered Nurse (RN), Clinical Case Manager* PRN * * *Your experience matters* At Frye Regional Medical Center, we are driven by a profound commitment to ... as an employee, but as a person. As a*registered nurse (RN)*joining our team, you're embracing a vital mission...outcome of care management as prescribed in the initial Utilization Review Plan with regard to resources, appropriateness of… more
- Molina Healthcare (Oakland, CA)
- …Practical Nurse (LPN) Program **Required Experience** + Minimum two years Utilization Review experience. + Knowledge of audit processes and applicable state ... contained in the delegation agreement. **KNOWLEDGE/SKILLS/ABILITIES** The Delegation Oversight Nurse is responsible for ensuring that Molina Healthcare's UM… more
- STG International (Milledgeville, GA)
- …FUNCTIONS: + Ensure the facility meets the minimum staffing levels for nurses and nurse aides; complete required posting of nursing staff data as required. + Ensure ... (inspections) made by authorized government agencies as requested. + Audit nursing documentation in the clinical record for appropriate...+ Coordinate with the scheduler to ensure a Registered Nurse (RN) is on duty at least 8 hours… more
- Veterans Affairs, Veterans Health Administration (Salt Lake City, UT)
- …departmental staff to ensure compliance with Telehealth protocols and standards. Analyze audit results to identify areas for improvement, and present findings in ... career advancement. 9. Resource and Safety Management: Identify and assess resource utilization and safety issues, and take appropriate actions to address them. 10.… more
- Elderwood (Lake Placid, NY)
- Salary $74,000 to $96,525 / year Overview RN - MDS Nurse Assessor Pay Rate Range:$74,000 - $96,525 / year (Earn more with experience!) NEW:Gas Allowance Benefit for ... Full-time and Part-time positions Are you a Registered Nurse (RN) with Medicare experience? Do you consider yourself an expert in assessment and reimbursement… more
Recent Searches
- account executive midwest potential (United States)
- part time summer help (United States)
- laborer summer help (United States)
- Technical Program Manager XR (New Mexico)
Recent Jobs
-
Applications Development Senior Programmer Analyst
- Citigroup (Irving, TX)
-
Security Engineer
- Cisco (Fulton, MD)