- Alameda Health System (Oakland, CA)
- System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - ... FTE:1 + Posted:Yesterday **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review RN is responsible for ensuring the… more
- Matrix Providers (Aurora, CO)
- …in a direct patient care clinical setting and 12 months consecutive experience in utilization management , utilization review or case management ... Utilization Review Nurse (RN) Location: Aurora,...Handbook) + 401(k) Plan Minimum Requirements Registered Nurse (RN) Utilization Management : Degree/Education: Bachelor-s degree in nursing.… more
- Intermountain Health (Murray, UT)
- …FEHB, Marketplace Qualified Health Plans, fully funded and self-funded Commercial plans. Utilization Review nurses at Select Health proactively oversee inpatient ... regarding authorizations, approved treatment plan and length of stay. **Skills** + Utilization Management + Clinical Expertise + Independent and autonomous +… more
- Aspen Medical (Aurora, CO)
- …36 months total nursing experience in a direct patient care clinical setting. Must have utilization management , utilization review or case management ... JOB AD: Registered Nurse- Utilization Management Introduction : Aspen Medical... (HCQM) through American Board of Quality Assurance and Utilization Review Physicians (ABQARP), Certified Informatics Nursing,… more
- Wellpath (Lemoyne, PA)
- …care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization review , case management , ... appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners and stakeholders,… more
- Actalent (Sunrise, FL)
- …department activities. Essential Skills + Clinical review + Utilization review + Utilization management + Interqual + Milliman Commercial Guidelines ... education + Valid Florida Driver's License + Knowledge of case management and utilization review concepts + Familiarity with Florida Medicaid Program… more
- Veterans Affairs, Veterans Health Administration (San Francisco, CA)
- Summary The Patient Flow Utilization Management / Utilization Review Consultant RN functions with advanced knowledge and skills to provide clinical ... with a collaborative, inter-disciplinary practice setting. Responsibilities The Patient Flow Utilization Management / Utilization Review Consultant RN… more
- CVS Health (Harrisburg, PA)
- …work Monday through Friday 8:30-5pm EST. No weekends or holidays. - 1+ years of utilization review / utilization management required - 3+ years of ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable… more
- Insight Global (Philadelphia, PA)
- …License or Active LPN License 2-3 years of clinical experience ( Utilization management or utilization review ) Strong computer skills Ability to ... local providers Previous HEDIS review experience or experience with Utilization Review , Quality, Medical Record auditing Bachelors Degree null We are a… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Reviews and makes recommendations and/or decisions on Utilization or Case Management activities. Utilization review activities include: reviews of ... review determinations. + Provides input into the utilization management program policies and procedures. +...Qualifications) + Minimum 2-3 years of experience in medical management , utilization review and case… more