- CoreCivic (Brentwood, TN)
- …and a responsibility to better the public good. CoreCivic is currently seeking a ** Utilization Management / Case Management Nurse** located at our ... onsite and 2 days remote out of our Brentwood, TN office location._ The Utilization Management / Case Management Nurse provides Utilization Review and … more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical ... internal and external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing… more
- Houston Methodist (The Woodlands, TX)
- …and eligibility for state, local, and federal programs + Progressive knowledge of utilization management , case management , performance improvement, and ... At Houston Methodist, the Utilization Review Nurse (URN) PRN position is a...coverage determinations (LCDs & NCDs). This position collaborates with case management in the development and implementation… more
- AdventHealth (Tampa, FL)
- …(RN) license + 3 years of experience of clinical nursing experience + 1 year of utilization management or case management experience This facility is an ... as heart failure, cancer and other diseases. **The role youll contribute:** The Utilization Management RN Supervisor reports directly to the Divisional … more
- Alameda Health System (Oakland, CA)
- …Master's degree in nursing Required Experience: Minimum three (3) years of experience in Utilization Management or Case Management AND proficiency in ... System Utilization Management SUM Utilization ...Nurse in the State of California Preferred Licenses/Certifications: Certified Case Manager (CCM) or Accredited Case Manager… more
- LA Care Health Plan (Los Angeles, CA)
- …in an acute hospital setting. Previous experience to have a strong understanding of Utilization Management / Case Management practices including, but not ... Utilization Management Admissions Liaison RN II...facility, outpatient needs (home health, physical therapy, infusion), and case management referrals (5%) Performs prospective, concurrent,… more
- Intermountain Health (Las Vegas, NV)
- …through an accredited institution. Education is verified. Three years of experience leading Utilization Management case management requiring knowledge of ... Director is responsible for providing leadership and administrative direction for Utilization Management and Review for the Enterprise. The individual works… more
- Alameda Health System (Oakland, CA)
- …Master's degree in nursing Required Experience: Minimum three (3) years of experience in Utilization Management or Case Management AND proficiency in ... System Utilization Management SUM Specialist + Oakland,...Nurse in the State of California Preferred Licenses/Certifications: Certified Case Manager (CCM) or Accredited Case Manager… more
- LA Care Health Plan (Los Angeles, CA)
- …of varied RN clinical experience in an acute hospital setting. At least 2 years of Utilization Management / Case Management experience in a hospital or HMO ... Utilization Management Nurse Specialist RN II...Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, post-service and retrospective claims… more
- Centene Corporation (Jefferson City, MO)
- …Degree in Nursing, related field or equivalent experience required 10+ years of nursing, utilization management , or case management experience in an ... complex and often conflicting requirements. + Oversee the operations of utilization management , reconciliation coordination, concurrent review (telephonic and… more
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