- quantum-health (Dublin, OH)
- …and other clinical resources to achieve proper decisions in utilization management reviews. The Pre-Certification Review Nurse - Pharmacy will ... if your experience doesn't match every requirement. About the role The Pre-Certification Review Nurse - Pharmacy is responsible for reviewing and processing… more
- LifeBridge Health (East Case, MD)
- Utilization Review Nurse RN - PRN Baltimore, MD SINAI HOSPITAL UTILIZATION REVIEW PRN - Day shift - 8:00am-4:30pm RN Other 92270 $50.00-$50.00 ... ideas and community-centered care. About the Role/Unit: The PRN Utilization Review RN at Sinai Hospital works...Management process and payors to ensure efficiency of utilization of resources, minimize losses and maximize reimbursement. Key… more
- Katmai (Fort Carson, CO)
- **SUMMARY** Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE eligible beneficiaries within the ... standards for appropriate utilization of services. Perform utilization management / review for medical necessity...within the last four (4) years as a registered nurse in utilization management . +… more
- Providence Health and Services (Tumwater, WA)
- …overtime, premiums, extra shift incentives, or bonus opportunities. PandoLogic. Category:Healthcare, Keywords: Utilization Review Nurse , Location:Tumwater, ... Description The Utilization Review (UR) Nurse ...Description The Utilization Review (UR) Nurse has a strong...Degree Or Associate's Degree in Nursing 3 years of Utilization Review , Care Management , Quality… more
- Commonwealth Care Alliance (Boston, MA)
- …clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring ... the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer...**Essential Duties & Responsibilities:** + Conducts timely clinical decision review for services requiring prior authorization in a variety… more
- Alameda Health System (Oakland, CA)
- …plans Role Overview: Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight, strategic ... hoc duties as needed. In essence, they orchestrate efficient utilization management to deliver high-quality patient care....in the classification. Lead and manage a team of utilization review professionals providing guidance, training, and… more
- Bluestone Child & Adolescent Psychiatric Hospital (University Heights, OH)
- …as a psychiatric nurse . 1-2 years-experience in behavioral health utilization review preferred. AGENCY SUMMARY: Bluestone is seeking dynamic healthcare ... Psychiatric Intake Nurse - FT Nights, 5-8 hour shifts- Sunday through...timely response to emails and other communications relating to utilization review . Prepare and submit appeals utilizing… more
- Houston Methodist Hospital (Houston, TX)
- …and timely removal from the waitlist. Participates in recipient waitlist management review forums and monitors appropriate communications affecting recipient's ... At Houston Methodist, the Transplant Recovery Nurse position leads organ procurement services required for...teams, and recipient candidate and family to ensure proper management of the organ recovery and transplant events. PEOPLE… more
- University Health (San Antonio, TX)
- …(as a Staff nurse II or above). Work experience in case management , utilization review or hospital quality is preferred. LICENSURE/ CERTIFICATIONS ... Nurse with the Texas State Board of Nurse Examiners is required. An approved case management certification (ACM, CCM or ANCC) is preferred and must… more
- Aveanna Healthcare (Birmingham, AL)
- …the plan of care and patient needs. Participates in quality improvement, utilization review , and infection control activities as requested. Attends appropriate ... Position Overview: The Hospice Registered Nurse is responsible for pain management ,...coordination. Collaborates with the interdisciplinary team in the development, review and revision of the clinical component of patient/family… more
