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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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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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Utilization RN - Utilization Review RN - Travel Utilization Review RN, Part-Time, Contract, Travel, Temporary, 13 Weeks, Temp. Tier5, Travel Utilization Review RN Registered Nurse.
$10,500 a monthExpandApply NowActive JobUpdated Yesterday - 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. Posted job title: Rn Utilization Review, Clinical.
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Partners with the UM Chief and KFH/TPMG local medical center leadership, to engage the following areas in the development and implementation of a comprehensive utilization management work plan to meet or exceed medical center targets: Physicians, managers across the continuum, and TPMG/KFH service leaders and managers.
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Position Purpose The Utilization Review Nurse I provides first level clinical review for all outpatient and ancillary services requiring authorization. This is a fully remote position that requires NYS RN licensure and experience with Medicaid and Medicare and their covered benefits as well as Care Management, Intake or Home Health Care.
$25.97 - $46.68 an hourFull-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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The Case Management process facilitates communication and care coordination along a continuum through effective transitional care management and utilization management. 2 years of experience in Case Management (Care Coordination or Utilization Management) or successful completion of the Transitions in Practice (TIP) program for Care Manager.
$52.46 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Key Words: RN Travel, Travel Nurse, Contract Nurse, Agency Nurse, Travel Contract, Travel Nursing, Case Manager, Case Management, Utilization Review, Case Manager RN.
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UTILIZATION REVIEW / CASE MANAGEMENT RN - Part Time, Weekends. Position Summary: Conducts concurrent and retrospective chart review for clinical, financial and resource utilization information.
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Ensures compliance with principles of utilization review, hospital policies and external regulatory agencies, Peer Review Organization (PRO), Joint Commission, and payer defined criteria for eligibility.
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The IMM RN Care Manager blends the mission of AHF with Care Management across the Managed Care, Department of Medicine and Pharmacy Divisions. Completing a Health Risk Assessment, Care Plans, resources and support will directly contribute to AHF’s success in meeting the deliverables of the IMM program and URAC (Utilization Review Accreditation Commission) certification.
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The Contractor shall frequently collaborate with managers of the UBO, Utilization Review Registered Nurse (RN) and pre-certification clerk. Experience: Requires a minimum of 2 years of clinical and utilization review experience or any combination of education and experiences which would provide an equivalent background.
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The Utilization Management (UM) Coordinator (CIDD) supports the comprehensive coordination of medical services including intake, screening, and referrals to Florida Community Care (FCC) care management and promotes/supports quality effectiveness of healthcare services.
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The Utilization Management (UM) RN performs utilization review activities, including, but not limited to, precertification, ensures appropriate level of care and status (Inpatient, Outpatient, and Observation) throughout admission and performs concurrent reviews/retrospective reviews according to guidelines.
$40.28 - $66.78 an hourFull-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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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. Three to Five years experience in case management or utilization review or proven success as Registered Nurse Utilization Review I role.
$31.7 - $42.35 an hourExpandApply NowActive JobUpdated Today
management utilization review rn continuing education jobs Title: travel rn Company: Medical Solutions in AZ, Australia
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