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The RN Float Case Manager and Utilization Review Nurse provides coverage for an RN Case Manager or RN Utilization Review Nurse. The RN Float Case Manager and Utilization Review Nurse is assigned to function in the role of either a RN Case Manager or RN Utilization Review Nurse, as provided below.
Full-timeExpandUpdated 7 days ago - UpvoteDownvoteShare Job
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License, Certification, RegistrationRegistered Nurse License (California)Basic Life SupportAdditional Requirements:Demonstrated ability to utilize/apply the general and specialized principles, practices, techniques and methods of utilization review/management, care coordination, transfer coordination, discharge planning or case management.
ExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Utilization Review Specialist. Incumbents review client health records to ensure proper utilization of treatment resources. Two (2) years of full-time, paid, post-licensure work experience providing direct behavioral health care services as a Licensed Clinical Social Worker, Licensed Professional Clinical Counselor, Licensed Marriage and Family Therapist, or Registered Nurse.
ExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Coordinates with other departments, i.e.: Pre-Admissions, Admissions, Patient Accounts, Utilization Review, PPS Coordinator, etc., to assure positive fiscal management outcomes for the patient.
Full-timeExpandApply NowActive JobUpdated 13 days ago - UpvoteDownvoteShare Job
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Performs prior authorization, precertification, and retrospective reviews and prepares decision letters as needed in support of the utilization review contract Assists management with training new Nurse Reviewers to include daily monitoring, mentoring, feedback and education.
$49,200 - $70,300 a yearWork from homeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Nurses and allied healthcare professionals are in high demand nationwide, and our team of industry-leading, traveler-favorite recruiters can get you where you want to go — personally and professionally.
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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.
$2,480ExpandUpdated 9 days ago - UpvoteDownvoteShare Job
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Enhances the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integration of functions of case management, utilization review and management, and discharge planning.
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Follows Medicare guidelines regarding utilization review. Contracted Medical Facility's onsite Nurse Manager/Supervisor, Physicians. May work under the supervision of a registered nurse.
ExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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When functioning in the role of a RN Utilization Review Nurse: The RN Utilization Management Specialist coordinates communication with admitting financial counselors, case management team, providers, patient financial services, and payers to ensure all services provided by the hospital are authorized by appropriate payer.
Full-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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The LVN Utilization Management Nurse (UM Nurse) will provide routine review of authorization requests from all lines of business using respective national/state, health plan, nationally recognized guidelines.
Part-timeExpandApply NowActive JobUpdated 16 days ago - UpvoteDownvoteShare Job
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Assist in the maintenance of Medicare log, Medi-cal log, department statistics, and utilization review documents according to department policy and procedures and existing laws of the State and Federal Government.
ExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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Job Summary The Clinical Education Consultant provides customers with clinical, functional, and operational expertise in the following areas: educational and systems development consulting, product line utilization management and services, and clinical sales-related support to the Account Executives and Sales Management.
ExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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Prepares denial letters for review by Medical Director or Nurse Reviewer(s) and distributes letters to appropriate recipients. Prior experience in utilization management processing authorization referrals also required.
$24 - $26 an hourFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Applies clinical knowledge and experience to evaluate information regarding prospective care management members referred by health risk assessment (HRA), risk stratification, predictive modeling, provider's utilization review vendors, members, Call Center, claims staff, Health Homes Program (HHP) eligibility or other data sources to determine whether care management intervention is necessary to meet the member's needs.
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utilization review nurse jobs in Los Angeles, CA
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