- AmeriHealth Caritas Health Plan (Washington, DC)
- …to efficiently document and assess patient cases Strong understanding of utilization review processes, including medical necessity criteria, care coordination, ... compliance Demonstrated ability to meet productivity standards in a fast-paced, high-volume utilization review environment The range displayed in this job… more
- Ascension (Wichita, KS)
- …Provide health care services regarding admissions, case management, discharge planning and utilization review . Review admissions and service requests within ... Details Department: Utilization Management Schedule: Full-time, Day Shift, 40...with healthcare team members. May prepare statistical analysis and utilization review reports as necessary. Oversee and… more
- BRISTOL HOSPITAL GROUP (Bristol, CT)
- …also understand and follow CMS guidelines and implement processes as outlined in CFR 482.30 ( Utilization Review ) Finally, the UM nurse is expected to lead a ... Year Degree Job Shift 1st Shift (Days) Description Registered Nurse Utilization Reviewer At Bristol Health, we...management, the appeal process, and the Peer to Peer review process.. Successful implementation occurs when dialogue between the… more
- Zenex Partners (Santa Rosa, CA)
- Description Job Opportunity: Registered Nurse - Utilization Review Facility: Providence Santa Rosa Memorial Hospital - Case Management Location: Santa Rosa, ... 13 weeks Compensation: Rate Type: Hourly Over Time: 8 regular hours in a day OR 40 regular hours in 1 week: 1.3% Double Time: None On-Call: 15$ Call Back: 1.3%… more
- Network Health WI (Menasha, WI)
- … Nurse (RN) required Experience in insurance, managed care, and utilization management preferred Current Registered Nurse (RN) licensure in Wisconsin ... The RN Coordinator Utilization Management reviews submitted authorization requests for medical...the position, including on first day. Hours: 1.0 FTE, 40 hours per week, 8am-5pm Monday through Friday Check… more
- George Mason University (Fairfax, VA)
- …administration ordered by providers. Additionally, the nurse participates in peer review , CQI, risk management and utilization review , and provides ... Staff Job Type: Full-Time Work Schedule: Full-time (1.0 FTE, 40 hrs/wk) Location: Fairfax, VA Workplace Type: On Site...and orderly flow of patients through the clinic. The nurse participates in student immunization review and… more
- Planned Parenthood of Wisconsin, Inc. (Milwaukee, WI)
- …This is an excellent opportunity for a Nurse Practitioner or Certified Nurse Midwife ( 40 hours/week) at our Northwest Family Planning Health Center! As ... a valuable member of our team, Nurse Practitioners and Certified Nurse Midwifes are provided paid training to learn how to deliver clinical care and how to… more
- Healthcare Staffing Plus (Boston, MA)
- The registered nurse , adheres to the rules and regulations of the Massachusetts Board of Registration in Nursing. is primarily responsible for professional ... patients and their families across the health care continuum. The registered nurse is accountable for clinical, educational, quality and fiscal patient care outcomes… more
- Oncology Consultants (Corpus Christi, TX)
- …been a premier adult medical oncology & hematology practice in Houston, TX for over 40 years. Our healthcare team is committed to provide state of the art cancer ... actions and demonstrates personal professional accountability. The TTN is a Registered Professional Nurse or Licensed Vocational Nurse who is expected to deliver… more
- Advocate Aurora Health (Mundelein, IL)
- …Operations Status: Full time Benefits Eligible: Yes Hou rs Per Week: 40 Schedule Details/Additional Information: Schedule is Monday through Friday, roughly 8-5 ... Maintains an effective process for inventory control and medication supply utilization . Proactively manages staff schedules to minimize use of overtime, temporary… more
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