- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring… more
- Prime Healthcare (Weslaco, TX)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/233537/ registered - nurse -case- manager ... Overview KNAPP MEDICAL CENTER IS LOOKING FOR A PRN REGISTERED NURSE CASE MANAGER TO WORK WEEKENDS. WE OFFER: + Competitive PRN Compensation + Medical… more
- Beth Israel Lahey Health (Plymouth, MA)
- …the denial management, documentation, and appeals process. + Collaborates with UR Manager and/or physician advisor regarding cases that do not meet established ... years recent, broad clinical experience in the hospital setting + Experience with utilization management within the last 3 years required + An understanding of the… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of ... this position is able to cover a multitude of utilization review functions through point of entry, observation progression...management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure --… more
- Corewell Health (Grand Rapids, MI)
- …experience clinical nursing and or case management/managed care or related field Preferred + Registered Nurse (RN) - State of Michigan Upon Hire required + Basic ... prior authorizations, initial reviews, continuous stay reviews and appeals. Nurse Care Manager - Plans and prioritizes care for individuals and population… more
- University of Utah Health (Salt Lake City, UT)
- …Review or Case Management experience. **Licenses Required** + Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 ... advancement, and overall patient outcomes. **Responsibilities** + Applies approved utilization criteria to monitor appropriateness of admissions with associated… more
- Saint Francis Health System (Tulsa, OK)
- …their placement in various levels of care and receipt of necessary services. The Utilization Management (UM) Registered Nurse will communicate with providers ... Nursing. Licensure, Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License. Work Experience: Minimum 2 years of… more
- WellSpan Health (Lebanon, PA)
- … Management, Case Management, or Clinical Nursing Specialty. Preferred **Licenses:** + Licensed Registered Nurse Upon Hire Required or + Registered ... Weekend rotation **General Summary** Performs a variety of duties and applies utilization and case management techniques to determine the most efficient use of… more
- CVS Health (Austin, TX)
- …And we do it all with heart, each and every day. **Position Summary** This Case Manager - Registered Nurse (RN) position is with Aetna's National Medical ... is a blended role doing both Case Management and Utilization Management. The RN Case Manager is...the member to facilitate the member's overall wellness. Case Manager - Registered Nurse +… more
- Tenet Healthcare (Detroit, MI)
- Registered Nurse Case Manager (RN) - 2506003132 Description : DMC Detroit Receiving Hospital , Michigan's first Level I Trauma Center, helped pioneer the ... Geriatric Center of Excellence. Job Summary The RN Case Manager is responsible to facilitate care along a continuum...management experience preferred. 3. License to practice as a Registered Nurse in the State of Michigan.… more