- Beth Israel Lahey Health (Burlington, MA)
- …difference in people's lives.** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission ... billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review ...and directed. **Qualifications:** _Required_ + Licensure as a Registered Nurse (RN), Massachusetts + Three years of recent clinical… more
- Beth Israel Lahey Health (Burlington, MA)
- …a job, you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital and Medical Center in ... Nurse (RN) Case Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality assurance for Lahey… more
- Katmai (Fort Carson, CO)
- …need for inpatient/outpatient precertification. **ESSENTIAL DUTIES & RESPONSIBILITIES** + Review precertification requests for medical necessity, referring to the ... Medical Director those that require additional expertise. + Review clinical information for concurrent reviews. + As part...Minimum of two (2) years of prior experience in Utilization Management. + Must possess a current, active, full,… more
- Tenet Healthcare (Detroit, MI)
- …experience in hospital revenue cycle function. Five (5) years in hospital Utilization Review Leadership preferred. Multi- site leadership experience ... Group Utilization Review Director - 2506000536 Description...preferred, Six Sigma Green Belt preferred · Valid Registered Nurse (RN) preferred PHYSICAL DEMANDS: -Lift/position up to 25… more
- Providence (Centralia, WA)
- **Description** The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization ... Nursing **Preferred Qualifications:** + Bachelor's Degree Nursing Or + 3 years Utilization Review , Care Management, Quality Management, and/or Discharge planning… more
- Ochsner Health (Lafayette, LA)
- …or other related MCO departments/functions. **Certifications** Required - Current registered nurse (RN) license in state of practice. *MSW accepted in lieu ... of registered nurse (RN) licensure. Preferred - Certification in Case Management...Determines appropriate staffing levels and the interviewing, hiring, performance review , and termination of employees within practice unit(s); maintains… more
- Ascension Health (Baltimore, MD)
- …the internal Ascension Travel Program, please visit our site (https://about.ascension.org/our-work/associate-travel-program) . **Benefits** Paid time off (PTO) ... date required. American Heart Association or American Red Cross accepted. + Registered Nurse obtained prior to hire date or job transfer date required. Education: +… more
- Ascension Health (Nashville, TN)
- …the internal Ascension Travel Program, please visit our site (https://about.ascension.org/our-work/associate-travel-program) . **Benefits** Paid time off (PTO) ... date required. American Heart Association or American Red Cross accepted. + Registered Nurse obtained prior to hire date or job transfer date required. Education: +… more
- Ellis Medicine (Schenectady, NY)
- Basic Function: The Utilization Management Registered Nurse (UM RN) supports daily coordination of care across healthcare continuum with the healthcare team, ... responsible for preoperative, concurrent and retrospective reviews in accordance with the utilization management program. The UM RN ensures the appropriate level of… more
- Molina Healthcare (Seattle, WA)
- …in good standing Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / ... appropriate and cost-effective based on the severity of illness and the site of service. **KNOWLEDGE/SKILLS/ABILITIES** + Assesses services for members to ensure… more