- Christus Health (San Antonio, TX)
- …Medicare GMLOS by managing per Milliman/Interqual Care Guidelines. Resource/ Utilization Management/appropriateness: Assess assigned patient population for medical ... Proactively refers cases to physician adviser for P2P, medical necessity review , and denail avoidance. Demonstrates and maintains current knowledge of regulatory… more
- Christus Health (Irving, TX)
- …in CHRISTUS RN Care Manager I position. Case management and Utilization Review experience preferred. Licenses, Registrations, or Certifications RN ... patient need, manage length of stay and promote efficient utilization of resources to include the facilitation of patient...Case Management or demonstrated success in CHRISTUS RN Care Manager I Position preferred. Work Type: Full … more
- Providence (Irvine, CA)
- **Description** ** RN Utilization Review at Irvine, CA. This position is Full - time and will work Remote 8-hour, Day shifts.** Provide prospective, ... empower them. **Required Qualifications:** + Associate's Degree Nursing. + Upon hire: California Registered Nurse License + 2 years experience working in a… more
- Georgetown Behavioral Health Institute (Georgetown, TX)
- …Institute is a 118 bed inpatient behavioral health hospital and seeking a full -time Outpatient Utilization Review Coordinator. This position is responsible ... full range of their benefits through the utilization review process. Requirements + Education: Master's...LMFT or LMFT-A Preferred but not required. LVN or RN licensure also considered for this position. + Experience:… more
- Providence (Mission Hills, CA)
- …must empower them. **Required Qualifications:** + Associate's Degree in Nursing. + California Registered Nurse License upon hire. + 2 years of experience working ... Utilization Management, medical necessity, and patient status determination. The Utilization Management RN must effectively and efficiently manage a diverse… more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical ... using indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical necessity… more
- Beth Israel Lahey Health (Plymouth, MA)
- …you're not just taking a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management ... Our Team of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager, you will:** + Directs staff performance… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Registered Nurse I Department: Utilization Management Location: Rochester General Hospital Hours Per Week: 40 hours ( Full -Time) Schedule: ... with minimum direction. + Act as a resource for utilization review stakeholders and assists team members...Support - American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse -… more
- Catholic Health (Kenmore, NY)
- …Days with Weekend and Holiday Rotation Hours: 8 am- 4 pm Summary: The Registered Nurse ( RN ), Utilization Review , as an active member of the Middle ... in the hospital setting. Utilizing foundational nursing clinical skills Utilization Review nurse collaborates with...facilitate movement of the patient through the continuum. The Utilization Review RN identifies and… more
- Katmai (Fort Carson, CO)
- …or American Red Cross. + Three (3) years within the last four (4) years as a registered nurse in utilization management. + One (1) year of experience in ... **SUMMARY** Provide a comprehensive utilization review (UR) and utilization..., active, and unrestricted license to practice as a registered nurse . + Must be a graduate… more
