- Baptist Memorial (Memphis, TN)
- Summary The Utilization Review Nurse is...Summary: Position: 19738 - RN - Utilization Review Facility: BMHCC Corporate Office Department: HS ... appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse...Case Mgmt Administration Corporate Category: Nurse RN Type: Clinical Work Type: Full Time Work Schedule:… more
- Elevance Health (Miami, FL)
- …plans for people enrolled in Medicaid and/or Medicare programs in Florida. **Licensed Utilization Review I** **Location:** This is a remote position. The ... on operational needs (holiday and weekend rotation). The **Licensed Utilization Review I** is responsible for working...regulatory requirements and standards. **Minimum Requirements:** + Requires a HS diploma or equivalent and a minimum of 2… more
- ChenMed (St. Petersburg, FL)
- …care and cost effectiveness through the integrating and functions of case management, utilization review and discharge planning. The incumbent in this role ... time. + Spoken and written fluency in English. EDUCATION AND EXPERIENCE CRITERIA: + High school diploma or equivalent required + Bachelor's degree in a… more
- Access Dubuque (Dubuque, IA)
- …Effectively manages length of stay and cost avoidance. Discuss cases with Utilization Review Committee and/or Executive Health Resources (EHR) when cases ... of stay and/or discharge standards. Attends meetings of the Utilization Review Committee and submits reports as...we say we are. MINIMUM QUALIFICATIONS Must be a registered nurse and must hold an active… more
- Marshfield Clinic (Marshfield, WI)
- …weekend. **JOB QUALIFICATIONS** **EDUCATION** _For positions requiring education beyond a high school diploma or equivalent, educational qualifications must be ... Three years' experience in a medical facility. **Preferred/Optional:** Discharge Planning, Utilization Review or Case Management experience in a clinic/hospital… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …identify the most appropriate resources to promote quality, cost effective outcomes. Utilization Review staff are responsible for providing clinical service ... other insurance carriers, and healthcare vendors. **QUALIFICATIONS** **Education** + High School Diploma or equivalent required **Work...Health Care Management 2 years required + Certification in Utilization Review or Managed Care 2 years… more
- Northern Light Health (Pittsfield, ME)
- …direction and manages workflow and time. Credentials + Required Registered Nurse Education + Required High School Diploma/General Educational Development ... on bonus that is paid out incrementally.** Summary: The Registered Nurse II is a fully competent...care. * Resource Management o Identifies opportunities to improve utilization of resources. * Professional Development o Takes responsibility… more
- Northern Light Health (Pittsfield, ME)
- …direction and manages workflow and time. Credentials:Essential:* Registered Nurse Education:Essential:* High School Diploma/General Educational ... a $10,000 (minus tax) sign on bonus that is paid out incrementally. Summary:The Registered Nurse II is a fully competent practitioner of nursing. The incumbent… more
- Northern Light Health (Pittsfield, ME)
- …direction and manages workflow and time. Credentials + Required Registered Nurse Education + Required High School Diploma/General Educational Development ... Per Week: Variable Hours Work Schedule: Variable Summary: The Registered Nurse II is a fully competent...+ Resource Management + + Identifies opportunities to improve utilization of resources. + Professional Development + + Takes… more
- The Cigna Group (Bloomfield, CT)
- …Therapeutic Resource Centers. **QUALIFICATIONS** + Active, unencumbered Registered Nurse ( RN ) license in Pennsylvania + High School Diploma or GED, ... Nurse Clinician - Accredo Job Description Summary The Nurse Clinician - RN is responsible for...years of experience is preferred in prior authorization or utilization review and appeals + Demonstrated proficiency… more