- University Health (Pleasanton, TX)
- …(as a Staff nurse II or above). Work experience in case management , utilization review or hospital quality is preferred. LICENSURE/ CERTIFICATIONS Current ... Nurse with the Texas State Board of Nurse Examiners is required. An approved case management certification (ACM, CCM or ANCC) is preferred and must… more
- Mercy (Dexter, MO)
- …. Experience: Minimum three years nursing experience. Previous leadership/ management experience preferred. Certifications: BLS, ACLS, PALS Certification required ... staff members in the Med Surg and Outpatient Departments. Insures efficient utilization of available resources and meets productivity and/or financial goals. Meets… more
- University Health (Hondo, TX)
- …minimum three years of clinical nursing experience is required. Data entry, referral management , utilization management experience is required. Case ... Management experience preferred. Experience in a similar setting and working with OB patients preferred. Experience working with EPIC EMR desirable. LICENSURE/CERTIFICATION Current licensure in the State of Texas as an RN or LVN is required. more
- University Health (Boerne, TX)
- …years recent, full time hospital experience preferred. Work experience in case management , utilization review, or hospital quality assurance experience is ... and clinicians in the Ambulatory setting by gathering information, coordinating utilization efforts, and reviewing HCC quality indicators, and RAF scores to… more
- University Health (Pleasanton, TX)
- …Three years recent, full-time hospital experience preferred. Work experience in case management , utilization review or hospital quality assurance experience is ... hire date. LICENSURE/CERTIFICATION Current license from the Board of Nurse Examiners of the State of Texas to practice...the State of Texas to practice as a registered nurse is required. National certification in related field is… more
- Whidbey General Hospital (Coupeville, WA)
- …care culture and provide caring and decisive leadership to their management team. Responsibilities include developing departmental policies and procedures consistent ... policies. The Director will also be responsible and accountable for overall management , planning, coordinating and directing of the Surgery and Post Anesthesia Care… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests ... coverage while working remotely. Primary Responsibilities * Performs clinical utilization reviews using evidenced based guidelines, policies and nationally… more
- CVS Health (Raleigh, NC)
- …holidays and evening hours._ **Must reside in CST or EST zone.** As a Utilization Management Nurse Consultant you will utilizes clinical experience and ... Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN...Requirement to reside in EST or CST zone. + Utilization Management is a 24/7 operation and… more
- CVS Health (Raleigh, NC)
- …all with heart, each and every day. **Position Summary** Medicare Precertification Utilization Management Nurse Consultant position: _Utilization ... with occasional holiday rotation.** **Preferred Qualifications** + Prior Authorization or Utilization Management experience + Managed care experience +… more
- Actalent (Minnetonka, MN)
- Utilization Management Nurse Job Description As a Utilization Management Nurse for Post Acute care, you will be responsible for reviewing and ... the medical necessity of post-acute stays. Essential Skills + Expertise in utilization management and utilization review. + Experience in acute care and… more
