- AdventHealth (Altamonte Springs, FL)
- …role you will contribute:** The role of the Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by analyzing patient ... including concurrent payer communications to resolve status disputes. The Utilization Management Nurse is accountable.... Current and valid license to practice as a Registered Nurse (ADN or BSN) required. .… more
- CVS Health (Frankfort, KY)
- …Health clinician with Kentucky state licensure (LCSW, LPCC, LMFT, LPAT, LP) or a Registered Nurse ( RN ) with active current and unrestricted Kentucky state ... convenient and affordable. **Position Summary** This is a fully remote Utilization Review Clinical Consultant. **MUST RESIDE...Health licensure (LCSW, LPCC, LMFT, LPAT, LP) or a Registered Nurse ( RN ) with unrestricted… more
- Centene Corporation (Oklahoma City, OK)
- …Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact ... flexibility. **Must reside in the State of Oklahoma!** **Now Hiring: Remote Supervisor, Utilization Management ** **Centene is looking for a dynamic leader… more
- Ochsner Health (New Orleans, LA)
- …a difference at Ochsner Health and discover your future today!** This job is a registered Nurse with a diverse medical background, who is able to determine the ... Contents are subject to change at Ochsner's discretion. **Education** Required - Registered Nurse Diploma or equivalent **Work Experience** Required - 1… more
- Veterans Affairs, Veterans Health Administration (Seattle, WA)
- …not limited to: The Nurse Utilization Management (UM) Registered Nurse ( RN ) is responsible for providing competent, evidence-based practices ... Summary Registered Nurse ( RN ) Utilization Management (UM)...medical, religious or pregnancy). VHA HCPs do not include remote workers who only infrequently enter VHA locations. If… more
- Veterans Affairs, Veterans Health Administration (Salt Lake City, UT)
- Summary The Utilization Management (UM) Registered Nurse ( RN ) executes position responsibilities that demonstrate leadership, experience, and ... related degrees. Preferred Experience: Master's prepared Registered Nurse 3 years of Utilization Management...medical, religious or pregnancy). VHA HCPs do not include remote workers who only infrequently enter VHA locations. If… more
- Veterans Affairs, Veterans Health Administration (Tucson, AZ)
- Summary The Utilization Management Registered Nurse makes decisions that reflect distinct and contributory supporting roles of nursing; is responsible ... not meeting InterQual criteria to the physicians and Physician Utilization Management Advisors (PUMAs). Communicates and supports...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Banner Health (CO)
- …risk adjustable chronic conditions by utilizing thorough chart reviews and problem list management . The RN works in collaboration with the primary care provider ... workflows and other scheduling allow.** Location: This is a remote position. Due to the nature of this of...in primary care, community nursing, critical care (ICU/ED) or utilization /prior authorization review would be helpful but not required.… more
- Ochsner Health (New Orleans, LA)
- …discharge plans based on patient's individualized needs. Registered Nurse ( RN ) Case Manager - Case Management OMC Jefferson Highway PRN To perform ... experience in discharge planning, case management or utilization review. **Certifications** Required - Current registered ...or utilization review. **Certifications** Required - Current registered nurse license in state of practice.… more
- Ochsner Health (New Orleans, LA)
- …plan. + Under the direction of a RN Case Manger performs utilization review functions for the Case Management Department. + Demonstrates participation in ... discover your future today!** This job plans, organizes and implements utilization management programs based upon individualized patient biopsychosocial… more