- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and… more
- Cleveland Clinic (Cleveland, OH)
- …career with one of the most respected healthcare organizations in the world. As a Utilization Management Specialist , you will perform UM activities, such as ... a minimum of 85% on IRR quarterly. + Complete Utilization Management for assigned patients with a...of Nursing + Current state licensure as a Registered Nurse (RN) + Basic Life Support (BLS) Certification through… more
- Penn State Health (Hershey, PA)
- …status, and family medical or genetic information._ **Union:** SEIU Healthcare Pennsylvania **Position** Utilization Management Specialist - Utilization ... responsible for maintaining compliance with the CMS Conditions of Participation for Utilization Management . MINIMUM QUALIFICATIONS: * Bachelors Degree in Nursing… more
- Penn State Health (Hershey, PA)
- …SEIU Healthcare Pennsylvania **Position** Specialist (Part-time) - VARIED SHIFTS - Utilization Management **Location** US:PA: Hershey | Nursing | Part Time ... for maintaining compliance with the CMS Conditions of Participation for Utilization Management . **MINIMUM QUALIFICATION(S):** + Bachelor's Degree in Nursing… more
- Sanford Health (Sioux Falls, SD)
- …Conduct level of care medical necessity reviews within patient's medical records. Performs utilization management (UM) activities in accordance with UM plan to ... utilization and potentially, prior authorization. Assists the department in monitoring the utilization of resources, risk management and quality of care for… more
- HonorHealth (Scottsdale, AZ)
- …here -- because it does. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization of ... in an acute care setting Required 1 year experience in UR/UM or Case Management Required Licenses and Certifications Registered Nurse (RN) State And/Or Compact… more
- Ascension Health (Baltimore, MD)
- **Details** + **Department:** Utilization Management + **Schedule:** On-site, Monday-Friday, 8:00AM-4:30PM. + **Hospital:** Ascension St. Agnes Hospital + ... at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient...assists with the budgeting process. + Serve as content specialist for staff in the areas of utilization… more
- Great River Health (West Burlington, IA)
- …responsible for maintaining compliance with the CMS Conditions of Participation for Utilization Management .What you will do + Review inpatient encounters for ... all state and Federal regulations for all UM reviews.-Practice utilization management activities within the scope of...and understand the speech of another person. + Registered Nurse Iowa Board of Nursing (IBON) (United States of… more
- Veterans Affairs, Veterans Health Administration (Albany, NY)
- …and knowledge of quality management practices. The duties of the Registered Nurse - Accreditation Quality Specialist include but are not limited too - ... The Albany VAMC is looking to fill (1) Registered Nurse - ACCREDITATION QUALITY SPECIALIST This job...Veteran healthcare Provides guidance and oversight of national program management to ensure proper resource utilization Participates… more
- MyFlorida (Macclenny, FL)
- REGISTERED NURSE SPECIALIST (I/C) - 60043244 Date: Apr 17, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... No: 851275 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST (I/C) - 60043244 Pay Plan:...Ability to analyze complex reports and determine the service utilization habits of clients and to evaluate the appropriateness… more