clinical expertise against HMSA medical and reimbursement policies, plan benefits, and nationally-accepted clinical guidelines... clinical care experience or case management; or related experience. Knowledge of the appropriate protocol to be followed...
Hawaii Medical Service AssociationPURPOSE OF POSITION: The primary purpose of the Utilization Management LPN in the Care Coordination process... and directed to assure that treatment requests of the Utilization Management Department/Case Management Department are handled...
Aultman Health Foundation. The Utilization Review Nurse will use appropriate governmental policies as well as specified clinical guidelines/ criteria... as a "Great Place to Work" since 2015. Position Summary Job Description The Utilization Review Nurse works as a member...
Martin’s Point Health CareUnder general direction: The Utilization Management RN serves as a leader resource in the Utilization Management... compliance. The UM RN conducts initial concurrent and retrospective medical necessity reviews. All Utilization Management...
University of VirginiaRN- Utilization Review Nurse LTSS/DME *Full Time 100% Remote Opportunity* COME WORK FOR THE LEADING, LOCAL... MANAGED CARE COMPANY - VILLAGECARE! VillageCare is looking for a self-motivated and passionate RN as Utilization Review...
VillageCareRN- Utilization Review Nurse LTSS/DME *Full Time 100% Remote Opportunity* COME WORK FOR THE LEADING, LOCAL... MANAGED CARE COMPANY - VILLAGECARE! VillageCare is looking for a self-motivated and passionate RN as Utilization Review...
VillageCareBe a Patient Advocate, Drive Quality Care: Utilization Review Nurse Do you have a passion for patient well-being... the most appropriate and cost-effective treatment. We're looking for a dedicated Utilization Review Nurse to join our team...
Ethos Risk ServicesJob Description: The Utilization Management Nurse Reviewer plays a crucial role in healthcare systems by ensuring... to determine the necessity and appropriateness of medical procedures, tests, and treatments. Utilization Management Nurse...
Sane StreetCornerStone Medical is looking for a Registered Nurse Utilization Review for a state of the art hospital system in... RN Utilization Review is responsible for determining the clinical appropriateness of care provided to patients...
Cornerstone MedicalThe Utilization Management Nurse Reviewer plays a crucial role in healthcare systems by ensuring that medical services... necessity and appropriateness of medical procedures, tests, and treatments. Utilization Management Nurse Reviewers collaborate...
Dane Street, LLCsatisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. The Utilization... Review Nurse, reporting to the Revenue Cycle Director, provides the professional assessment and reporting of complex acute...
Yukon-Kuskokwim Health CorporationBe a Patient Advocate, Drive Quality Care: Utilization Review Nurse Do you have a passion for patient well-being... the most appropriate and cost-effective treatment. We're looking for a dedicated Utilization Review Nurse to join our team...
Ethos Risk ServicesThis position will manage activities and staff of the Utilization Review and Clinical Documentation Improvement.... Analyze and report data related to case management activities, payer activities, resource utilization, and clinical denials...
Childrens National Medical CenterAbout The Role BHPS provides Utilization Management services to its clients. The Utilization Review Appeals Nurse... within managed care setting. 3+ years’ experience in clinical nurse setting preferred. Grievance experience preferred. TPA...
Brighton Health Plan Solutions, LLCUnder minimal supervision and using clinical knowledge, the RN Utilization Review completes utilization review... of hospitalization and subsequent payment. Acts as a clinical resource for the Coordinator Utilization Review. Position Highlights...
Edward-Elmhurst HealthAbout The Role BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs...’ experience in a UM team within managed care setting. 3+ years experience in clinical nurse setting preferred. TPA Experience...
Brighton Health Plan Solutions, LLCor email and we will be happy to assist you. REGISTERED NURSE - UTILIZATION MANAGEMENT REGISTERED NURSE - UTILIZATION MANAGEMENT Req #: 228720... Department: HARBORVIEW - UTILIZATION MANAGEMENT Job Location: Harborview Medical Center Posting Date: 05/03/2024 Closing Info...
University of Washington