- Veterans Affairs, Veterans Health Administration (Providence, RI)
- …education programs/degrees are not creditable as related degrees. Preferred Experience: 1-3 years Utilization Management, Nurse Case Manager . 3-5 years of ... Summary This Utilization Management Nurse position is located...and/or critical care healthcare settings. Certification in Certified Case Manager or Certified Professional in Healthcare Quality preferred. Knowledge… more
- Beth Israel Lahey Health (Burlington, MA)
- …a job, you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient Registered ... Nurse (RN) Case Manager for Hospital at Home Care Transitions coordinates utilization review, discharge planning and monitors quality assurance for Lahey… more
- AdventHealth (Mansfield, TX)
- …care and services of selected patient populations across the continuum of illness. The Nurse Manager promotes effective utilization of health care resources, ... all ages, and a growing business community. **The role you'll contribute:** The Nurse Manager is a specialized health care professional who adheres to the goals,… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) 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
- 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 - ... class as needed. Responsibilities include concurrent (as needed) and retrospective reviews. The Utilization Management Nurse will act as a resource on denial… more
- Monroe County, NY (Rochester, NY)
- …The employee reports directly to, and works under the general supervision of a Nurse Manager , or other higher-level staff member. General supervision may be ... Full Jobs List Full Exams List Registered Nurse (RN) - Utilization Review Unit, Per Diem Location: Rochester, NY Title: Registered Nurse (RN) - … more
- US Tech Solutions (Columbia, SC)
- …to hire) **Job Description:** + NICE TO HAVE skill sets/qualities: Utilization management experience and /or Appeals experience /strong clinical skills Behavioral ... experience and /or UR experience/Process Appeals requests/can have experience in either Utilization management or Appeals. + Team: Fast paced, Interactive team works… more
- CenterWell (Denver, CO)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare +… more
- CenterWell (Augusta, ME)
- …Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare/Medicaid… more
- Beth Israel Lahey Health (Plymouth, MA)
- …the denial management, documentation, and appeals process. + Collaborates with UR Manager and/or physician advisor regarding cases that do not meet established ... years recent, broad clinical experience in the hospital setting + Experience with utilization management within the last 3 years required + An understanding of the… more
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