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Three to Five years experience in case management or utilization review or proven success as Registered Nurse Utilization Review I role. The RN Utilization Review Nurse collaborates as necessary with other members of the health care team to ensure the above according to the mission of CHRISTUS.
$31.7 - $42.35 an hourExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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VNS Health is seeking a Registered Nurse (RN) Clinic Utilization Review for a nursing job in Hoboken, New Jersey. Minimum three years progressive professional experience in health care, including a minimum of two years in a grievance and appeals or related area such as medical or utilization management required.
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VNS Health is seeking a Registered Nurse (RN) Clinic Utilization Review for a nursing job in Manhattan, New York. Specialty: Utilization Review. Collaborates with professionals, health plan departments such as Claims and Medical Management, and the third party administrator staff and legal, as necessary, to investigate and facilitate resolution of individual grievances and appeals.
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Under the direction of the VP of Case Management & Continuing Care, the Sr. Director of Utilization Review (UR) is responsible for overseeing the development, implementation, and performance management of Utilization Review services performed across the Tenet enterprise.
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Qualifications Must possess knowledge of case management or utilization review as normally obtained through the completion of a bachelor's degree in case management or health care.
$36.42 - $60.33Full-timeExpandApply NowActive JobUpdated 30 days ago - UpvoteDownvoteShare Job
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The MDS Coordinator supervises the Care Management Nurse, MDS Nurse. Is prepared to conduct PPS meetings maintaining MDS assessments per Medicare schedule and maintains PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management Coordinator.
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Posted job title: Rn Coordinator - Utilization Review Atrium Health Clinical Care Management Remote Prn Days. Atrium Health Charlotte is seeking a Registered Nurse (RN) Clinical Coordinator, Utilization Review for a nursing job in Charlotte, North Carolina.
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The Utilization Review Specialist manages daily operations, which include supervising the staff performing benefit enrollments and utilization management activities. The Utilization Review Specialist review functions as the internal resource on issues related to the appropriate utilization of resources & services, coordination of care across agency and utilization review and management.
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Current Licensed Registered Nurse (RN), with a bachelor's degree and 2 years of related care management, disease management experience and/or training required; equivalent combination of education and experience at the discretion of the Director of Value Based Care. Utilization Review/Management experience preferred.
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Manage professional and clerical associates who work with a range of functions, including but not limited to: Access Authorization and pre-certification, utilization review and denial management, Care.
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Case management to include assessment, screening, orientation, referral, counseling, crisis response, patient education, reportinq and record keepinq and consultation with other professionals.
$20.79 - $23.1Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Psychiatric Nurse practitioners may participate in utilization review activities as needed to ensure patients are able to access necessary careThe Psychiatric Nurse Practitioner will fulfill all duties in compliance with Pioneer Rural Health procedures including 42 CFR, Part 2 (privacy regulations.
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Utilization Review RN Case Management. As a Utilization Review Nurse/Integrated Care Manager RN with Sentara, you work together intensely with the patients, families, and members of the medical team to provide patients with the resources they need and help prevent them from being readmitted to the hospital.
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The Psychiatric Nurse Practitioner will participate in 24/7 call for emergency, evening or weekend coverageComplete peer to peer reviews as necessary with payor sources Maintain a positive, respectful, and professional working relationship with Pioneer Rural Health’s staff and consumers alike.
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Consult and advise on the development of protocol, procedures, oversight and training in the following areas: Pharmacy Pre-admission authorization Prospective, concurrent (inpatient) and retrospective review Long Term Care Services and Support including Skilled Nursing and Subacute care Inpatient claims review Utilization/Medical Management review reporting and evaluation SFHP led Member Case Management Potential Clinical Quality Issues Grievance resolution.
$312,000 - $346,000 a yearFull-timeExpandApply NowActive JobUpdated Yesterday
management utilization review nurse continuing jobs Company: Medical Solutions in AZ, Australia
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