- ERP International (Vandenberg AFB, CA)
- **Overview** ERP International is seeking a full-time ** Registered Nurse (RN) Utilization Management ** for a temporary contract position in support of ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- Katmai (Fort Carson, CO)
- …Red Cross. + Three (3) years within the last four (4) years as a registered nurse in utilization management . + One (1) year of experience in UR/UM and ... Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE...full, active, and unrestricted license to practice as a registered nurse . + Must be a graduate… more
- McLaren Health Care (Port Huron, MI)
- …as Assigned:** 1. Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure that appropriate ... for timeliness, appropriateness and completeness as pertains to the utilization management process including level of care,...and directed. **Qualifications:** Required ⦁ State licensure as a registered nurse (RN) ⦁ Bachelor's degree in… more
- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day ... clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA… more
- Trinity Health (Troy, NY)
- …often lead to innovative solutions. ** Registered Nurse Professional Utilization Management Nurse - St. Peter's Hospital--Full-TIme Days** If ... to accommodate all schedules **What you will do:** + Perform utilization management , both concurrent and retroactive for inpatient and outpatient services in… more
- Saint Francis Health System (OK)
- …in various levels of care and receipt of necessary services. The Utilization Management (UM) Registered Nurse will communicate with providers the details ... Nursing. Licensure, Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License. Work Experience: Minimum 2 years of… more
- CDPHP (Latham, NY)
- …Minimum two (2) years of acute care experience is required as a Registered Nurse . + Minimum of two (2) years Utilization Management experience is ... you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for...recognized criteria and CDPHP policies, and procedures. QUALIFICATIONS: + Registered Nurse with a current New York… more
- UNC Health Care (Kinston, NC)
- …clinical experience as a Registered Nurse required. + 2 years utilization review, care management , or compliance experience preferred. + Minimum 1 year ... management preferred. + **LICENSURE/REGISTRATION/CERTIFICATION** + Licensed to practice as a Registered Nurse in the state of North Carolina. **Job Details**… more
- Ascension Health (St. Charles, IL)
- …and coordinate compliance to federally mandated and third party payer utilization management rules and regulations. **Requirements** Licensure / Certification ... offer._ **Responsibilities** Provide health care services regarding admissions, case management , discharge planning, and utilization review. +.../ Registration: + Registered Nurse credentialed from the Illinois Board… more
- Beth Israel Lahey Health (Burlington, MA)
- …weekends. This position is on-site at Lahey Hospital and Medical Center. The Utilization Analyst works with physicians, the payers and inpatient case management ... medical necessity of the hospital care. Using the concepts of utilization review, clinical documentation improvement and revenue integrity, these specialized case… more