- LA Care Health Plan (Los Angeles, CA)
- …Licensed Clinical Social Worker (LCSW); Current and unrestricted California License or Registered Nurse ( RN ); current and unrestrited California License. ... Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance Salary Range Disclaimer: The expected pay… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Registered Nurse IDepartment: Utilization Management Location: Rochester General Hospital Hours Per Week: 40 hours (Full-Time)Schedule: Monday ... Responsibilities include concurrent (as needed) and retrospective reviews. The Utilization Management Nurse will act...- Basic Life Support - American Heart Association (AHA), RN - Registered Nurse -… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …more **Description** We're seeking under the direction of the ** Utilization Management Appeals Professional, Registered Nurse ** is responsible for ... members of the patient care team, Medical Directors and Utilization Management leadership regarding trends in clinical...+ License - Must have a valid, active unencumbered Registered Nurse license or temporary permit approved… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …And more **Description** The ** Utilization Review (UR) Specialist** is a Registered Nurse responsible for conducting thorough medical necessity reviews to ... extended recovery admissions as required based on Emory Healthcare's Utilization Management Plan and the UR Department...+ Licensure - Must have a valid, active unencumbered Registered Nurse license approved by the Georgia… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …mentorship, _development,_ and leadership programs + And more **Description** The Clinical ** Utilization Review Nurse Preceptor (UR RN Preceptor)** will ... be responsible for training, mentoring, and coaching for the Utilization Review Department. The UR RN Preceptor...authorization, compliance and regulatory standards, and case management systems. + The UR RN Preceptor… more
- Ventura County (Ventura, CA)
- Per Diem Registered Nurse II/III - Utilization Management ... II + Six (6) months of experience in Utilization Management Per Diem RN III ... VCMC Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5009956) Apply Per Diem Registered Nurse II/III - Utilization Management VCMC… more
- Molina Healthcare (Milwaukee, WI)
- …and monitoring clinical and non-clinical team activities to facilitate integrated, proactive utilization management , ensuring compliance with regulatory and ... and Monitoring team responsible for prior authorizations, inpatient/outpatient medical necessity/ utilization review, and/or other utilization management … more
- Catholic Health Initiatives (College Station, TX)
- …order to be considered for the Manager, Care Management postion.** + **Must be a Registered Nurse ( RN )** + **Must have have a minimum of Five (5) years ... Management a. Serves as a clinical resource for utilization management , compliance for the...and 3 years leadership experience Required License and Certification: Registered Nurse ( RN ) Required Minimum… more
- Ascension Health (Baltimore, MD)
- …coordinate compliance to federally mandated and third party payer utilization management rules and regulations. **Requirements** Licensure / Certification / ... **Details** + **Department:** Utilization Management + **Schedule:** Part-time. Monday-Friday,...Registration: + Registered Nurse credentialed from the Maryland Board… more
- Penn Medicine (Lancaster, PA)
- …placement in position for incumbents who started after 07/01/2020. + A graduate registered nurse may only practice professional nursing under supervision and if ... the graduate registered nurse holds a current temporary practice... nurse is practicing. + All Clinical Nurse 1 RN 's will be required to… more
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