- Omaha Children's Hospital (Omaha, NE)
- …equal opportunity employer including veterans and people with disabilities. **A Brief Overview** Utilization Management (UM) is a specialty area of Nursing Case ... settings. + Skills in negotiation and problem solving with utilization management . + Should be a creative,...Compact State Licensure Required and + RN-BC - Case Management Nurse Preferred Children's is the very… more
- Crouse Hospital (Syracuse, NY)
- …health education and outreach programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse (RN) to track and manage ... with occasional weekends (typically requires 6 weekends a year). Utilization Management Registered Nurse (RN)...+ Certification in a specialty area preferred. + Three ( 3 ) - Five (5) years acute hospital experience. +… more
- CVS Health (Tallahassee, FL)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + UMNC meets set productivity and ... every day. **Position Summary** This is a fulltime remote Utilization Review opportunity. Working hours are four 10hr days...their Leader. **Required Qualifications** + Active and unrestricted Registered Nurse in state of residence + 3 +… more
- AmeriHealth Caritas (Dover, DE)
- …Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... in a fast-paced environment. ;The Clinical Care Reviewer - Utilization Management will also be counted upon...preferred. + An active OH or compact state Registered Nurse (RN) license in good standing is required. +… more
- Geisinger (Danville, PA)
- … 3 years-Nursing (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE & VALUES: Everything ... and a union role. Some weekends required. At least ( 3 ) years of RN work experience is required. +...alternatives and assists in ensuring documentation integrity. + Enters utilization review data into database for tracking and trending… more
- Ascension Health (Baltimore, MD)
- **Details** + **Department:** Utilization Management + **Schedule:** Hybrid work schedule available. Monday-Friday, 8:00AM-4:30PM. + **Hospital:** Ascension St. ... salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes… more
- US Tech Solutions (Chicago, IL)
- …HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE 1 YEAR OF UTILIZATION ... and implementation of QM Work Plan Activities **Experience:** + 3 + years of experience as an RN + Registered...+ years of experience as an RN + Registered Nurse in state of residence + Must have prior… more
- US Tech Solutions (May, OK)
- …HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review. . MUST HAVE 1 YEAR OF UTILIZATION ... and implementation of QM Work Plan Activities Experience: . 3 + years of experience as an RN . 1+.... 1+ years of inpatient hospital experience . Registered Nurse in state of residence . Must have prior… more
- HCA Healthcare (Nashville, TN)
- …or behavioral health experience required + 1- 3 years relevant case management / utilization review experience preferred + Must hold and maintain current ... you have the career opportunities as a Behavioral Health Utilization Review Specialist you want with your current employer?...wellbeing + 401(k) Plan with a 100% match on 3 % to 9% of pay (based on years of… more
- Beth Israel Lahey Health (Plymouth, MA)
- …+ Three years recent, broad clinical experience in the hospital setting + Experience with utilization management within the last 3 years required + An ... Collaborates with the multidisciplinary team to assess and improve the denial management , documentation, and appeals process. + Collaborates with UR Manager and/or… more