with the cost effective utilization of resources. You will perform concurrent clinical review to determine appropriateness... in the acute care setting. Prior utilization/quality/discharge planning/and/or case management experience highly...
North Suburban Medical CenterDescription Summary: The Utilization Management Nurse III is responsible for determining the clinical... approved certification for services. The Utilization Management Nurse collaborates as necessary with other members of the...
Christus Healthapproved certification for services. The RN Utilization Review Nurse collaborates as necessary with other members of the health... from an accredited nursing program or proven success as Registered Nurse Utilization Review I role Familiarity with criteria sets...
Christus HealthAbout The Role BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs..., or new ones may be assigned at any time with or without notice. Primary Responsibilities Performs concurrent utilization...
Brighton Health Plan Solutions, LLCto apply concurrent review determinations as described in the Medical Management UM work plan. This detailed clinical judgment... clinical care experience or case management; or related experience. Knowledge of the appropriate protocol to be followed...
Hawaii Medical Service AssociationReporting to the Manager of Clinical Operations, the Concurrent Review & Care Transition Nurse is a registered nurse..., resource management, utilization review, discharge planning or post-acute placements. Experience with NCQA, Medi-Cal, DHCS...
San Francisco Health PlanUtilization Management Nurse for Medical Management Pharmacy is responsible for utilization review and the coordination of members... will perform Utilization Reviews of specialty drugs appropriateness as applicable to Medicare Part B benefit. Primary...
UnitedHealth GroupUtilization Management Nurse for Medical Management Pharmacy is responsible for utilization review and the coordination of members... will perform Utilization Reviews of specialty drugs appropriateness as applicable to Medicare Part B benefit. Primary...
UnitedHealth GroupUtilization Management Nurse for Medical Management Pharmacy is responsible for utilization review and the coordination of members... will perform Utilization Reviews of specialty drugs appropriateness as applicable to Medicare Part B benefit. Primary...
UnitedHealth GroupUtilization Management Nurse for Medical Management Pharmacy is responsible for utilization review and the coordination of members... will perform Utilization Reviews of specialty drugs appropriateness as applicable to Medicare Part B benefit. Primary...
UnitedHealth Groupand correctly applies the guidelines for nationally recognized levels of care. The Utilization Management Nurse will report to the... Utilization Management Nurse Manager. In this role you will be assigned a list of inpatient facilities and then review clinical...
Blue Shield of Californiastandards. The Utilization Management Nurse Consultant will report to the Utilization Management Manager. In this role... management activities. Your Work In this role, you will: Perform prospective, concurrent and retrospective utilization...
Blue Shield of CaliforniaNurse McKesson Certified Professional in Utilization Management AAMCN Utilization Review Professionals RNCB Certified... Rehabilitation Registered Nurse ACMA ACM Certification Registered Nurse ANCC Nursing Case Management Additional Qualifications: RNs...
Baptist Health South FloridaThe Utilization Management Nurse Specialist LVN II will facilitate, coordinate and approve medically necessary referrals... a patient care setting and/or combination in utilization management, appeals and grievances, delegation oversight, and/or CNA...
L.A. Care Health Planand correctly applies the guidelines for nationally recognized levels of care. The Utilization Management Nurse will report to the... Utilization Management Nurse Manager. In this role you will be assigned a list of inpatient facilities and then review clinical...
Blue Shield of CaliforniaUtilization Management Nurse Work from home within Oregon, Washington, Idaho or Utah Build a career with purpose... Services team, our Utilization Management Nurses provide utilization management (such as prospective concurrent...
Cambia Health SolutionsJob Description: Utilization Management Nurse Work Location: Remote based. Candidates can be located anywhere in the... Management Nurse will work with the Utilization Management team primarily responsible for inpatient medical necessity/utilization...
Morgan Stephens