- The Cigna Group (Bloomfield, CT)
- …nursing license required. **Hiring Requirements** **Job Details** + Job ProfileJob Profile + UM Clinical Reviewer Senior Analyst + Job Families for ... Other duties as required and related to this role. **Minimum requirements:** + Active unrestricted Registered Nurse ( RN ) license in state or territory of the… more
- Centers Plan for Healthy Living (Margate, FL)
- UM Clinical Reviewer 5297 W Copans Rd, Margate, FL 33063, USA Req #664 Monday, December 2, 2024 Centers Plan for Healthy Living's goal is to create the ... currently accepting applications for Full Time Registered Nurse without experience. The Utilization Management Clinical ... Nurse without experience. The Utilization Management Clinical Reviewer works within a multidisciplinary team… more
- Sutter Health (Sacramento, CA)
- …**EDUCATION:** Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** RN - Registered Nurse of California Upon Hire **TYPICAL EXPERIENCE:** ... years of recent relevant experience. 2 years experience in Utilization Management ( UM ) and Clinical Denial Management Preferred **SKILLS AND KNOWLEDGE:**… more
- Elevance Health (Norfolk, VA)
- …necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to Peer Reviewers ... PulsePoint office. This utilization management role is responsible for utilization management review for Behavior Analysis services. **How you will make an impact:**… more
- Healthfirst (CO)
- …+ Associates degree from an accredited institution + Licensed Practical Nurse (LPN), Registered Nurse ( RN ), or Licensed Social Worker (LCSW or LMSW) + ... key governance committee members. + Review the appropriate UM or related clinical and medical policies, job aids/procedures, and correspondence and make… more
- Fallon Health (Worcester, MA)
- … Nurse in Massachusetts. **Experience** + A minimum of three to five years clinical experience as a Registered Nurse in a clinical setting ... Facebook, Twitter and LinkedIn. **Brief summary of purpose:** The UM Nurse uses a multidisciplinary approach to...information from medical care providers as needed for the clinical review process + Conducts clinical… more
- Apex Health Solutions (Houston, TX)
- …Solutions' members for the utilization review (UR) of healthcare services. The UM Reviewer will be responsible for complying with utilization review ... Summary: The UM Reviewer serves as a contact...as carrying out day today pre-authorization functions. The Utilization Review Nurse will also be responsible for… more
- Point32Health (MA)
- …day in service to our members, partners, colleagues and communities. **Job Summary** The Clinical Reviewer , Inpatient RN , is a licensed professional that is ... acute, subacute, acute rehabilitation, LTAC, CORF and others. The Clinical Reviewer , Inpatient RN is...You Need To Perform The Job **EDUCATION** : * Registered Nurse with current, unrestricted MA license… more
- University of Miami (Coral Gables, FL)
- …or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . NURSE ... for full- time positions at the Assistant/Associate/Full Professor of Clinical rank. UM is one of the...Conduct didactic, simulation, and clinical teaching and academic/ clinical advising of students in the doctoral nurse… more
- Point32Health (MA)
- …service to our members, partners, colleagues and communities. **Job Summary** The Clinical Reviewer is a licensed Registered Nurse that is expected to ... clinically complex caseload of varied requests for services. The Clinical Reviewer is responsible for making the...the job** + Bachelor's degree in Nursing preferred + Registered Nurse with a current and unrestricted… more