- Actalent (Des Moines, IA)
- Job Title: Post Review Nurse - Utilization Management Job Description We are seeking a dedicated Post Review Nurse to join our Utilization Management team. In ... cross-functional collaboration across divisions. + Provide backup support to other UM teams, including precertification and continued stay reviews. + Facilitate… more
- Humana (Tallahassee, FL)
- …caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and ... medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation… more
- Dignity Health (Bakersfield, CA)
- …criteria used for decision-making. - Ensures that there is evidence that the UM nurse reviewer documented communications with the requesting provider to validate ... denial notice for determination. - Escalates non-compliant cases to UM compliance and consistently reports on denial activities. -...LVN Program. - Clear and current CA Licensed Vocational Nurse (LVN). - Knowledge of nursing theory and ability… more
- Humana (Atlanta, GA)
- …and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and ... and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work assignments are varied and frequently require interpretation… more
- Integra Partners (Troy, MI)
- …manager for frontline staff. Salary: $75,000.00/Annually JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES The UM Nurse Team Lead's responsibilities include but are ... The Utilization Management ( UM ) Nurse Supervisor is responsible for providing direct leadership and oversight to the UM nursing team. This role ensures team… more
- University of Washington (Seattle, WA)
- …medical necessity and financial liability for patients all hospitalized patients. The UM Nurse communicates this information with the interdisciplinary team to ... procedures, and quality patient care for the duration of the hospitalization. The UM Nurse is responsible for maintaining the knowledge and skill set related to… more
- Humana (Richmond, VA)
- …communication of long-term supports and services and/or benefit administration determinations. The UM Nurse work assignments are varied and frequently require ... and independent determination of the appropriate courses of action. The UM Nurse 2 work assignments involve moderately complex to complex issues where… more
- CVS Health (Lansing, MI)
- …may include weekends, holidays, and evening hours._ _Weekends: F/S/S/M 10 hour shifts_ ** UM Nurse Consultant** Fully Remote- WFH **Position Summary** UM ... Nurse Consultant Position Summary: UM Nurse Consultant Utilizes clinical experience and skills in a collaborative process to assess, plan, implement,… more
- CVS Health (Carson City, NV)
- …high-quality healthcare for members. We are seeking a dedicated Utilization Management ( UM ) Nurse Consultant to join our remote team. **Key Responsibilities** ... of a computer. + Flexibility to provide coverage for other Utilization Management ( UM ) Nurses across various UM specialty teams as needed, ensuring continuity… more
- CVS Health (Santa Fe, NM)
- …healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management ( UM ) Nurse to join our remote team. In this role, you'll ... + Flexibility to provide coverage for other Utilization Management ( UM ) Nurses across various UM specialty teams as needed, ensuring continuity of care and… more
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