A company is looking for a Utilization Review Nurse Reviewer (Remote, RN Required). ...
Job Title: Denial Review Nurse. We are currently seeking a highly motivated Denial Review Nurse. Possession of an active, unrestricted, and current California Registered Nurse (RN) or Licensed Vocational Nurse (LVN) license. Responsible for managing all deferrals and or denials by conducting a compr...
The position allocated to this class is responsible for directing, through subordinate supervisors, the activities of the Utilization Review Nurses engaged in utilization review activities, in accordance with the Professional Standards Review Organization guidelines and the Joint Commission on Accre...
We’re seeking an exceptionally gifted, self-motivated leader with: * Current CA LVN licensure required * Two or more years of utilization review/utilization management experience in an HMO, MSO, IPA, or health plan environment * Previous clinical experience * Experience drafting and issuing complian...
Utilization review experienceJob Duties: 1. Perform clinical site reviews and/or medical record reviews as directed in support of health plan and/or other regulatory/accreditation/compliance requirements6. Review occurrence reports and the related pertinent medical records to determine opportunities...
We are currently seeking a highly motivated Denial Review Nurse. Possession of an active, unrestricted, and current California Registered Nurse (RN) or Licensed Vocational Nurse (LVN) license. Responsible for managing all deferrals and or denials by conducting a comprehensive review of clinical docu...
This Case Management (Utilization Review) in LPN/LVN (License Practical Nurse) job in Los Angeles, CA could be the next chapter in your story of personal and professional growth. ...
As a Utilization Management Nurse/Social Worker, you'll play a crucial role in our multidisciplinary team, ensuring that patients progress seamlessly through their care journey according to appropriate admission statuses. Proficient in Utilization Review processes, you'll maintain effective procedur...
Licensed as a Registered Nurse (RN) or Advanced Practice Registered Nurse (APRN) in the State of Florida. The Registered Nurse independently plans, implements, and evaluates nursing care in patient care situations using standards of care, policy, and procedure. ...
The role of the UM Nurse is to promote quality, cost-effective outcomes for a population by facilitating collaboration and coordination across settings, identifying member needs, planning for care, monitoring the efficacy of interventions, and advocating to ensure member's receive services and resou...
A company is looking for an RN Case Manager for Transitions of Care. ...
A company is looking for an Enterprise Manager Utilization Review. ...
Key Responsibilities:Telephonically manage cases on a long or short term basis per established guidelinesContact patients for thorough assessments and develop treatment plansMaintain detailed documentation, perform Utilization Review, and provide mentorshipRequired Qualifications:Graduation from an ...
A company is looking for a Remote Utilization Management Registered Nurse. ...
A company is looking for a Utilization Management RN Case Manager Per Diem Remote. ...
A company is looking for a Utilization Review RN. ...
A company is looking for a Utilization Management & Review Specialist. ...
A company is looking for a Utilization Review Specialist in Healthcare. ...
A company is looking for a Utilization Review Nurse Reviewer (Remote, RN Required). ...
A healthcare organization is seeking a Registered Nurse Case Manager for a remote contract position. Key Responsibilities:Lead coordination of multidisciplinary team to provide holistic care managementAssess, develop, implement, and monitor care plans to optimize member healthCoordinate care deliver...
A company is looking for a Clinical Review Manager in Utilization Review. ...
RN Case Manager - Loan Forgiveness & $20,000 Sign-on Bonus - Full Time, Days (Hollywood). The RN Case Manager is responsible for performing a high level clinical assessment and reassessment of acute care Inpatients for the purpose of performing utilization review, resource management and safe discha...
Supervise licensed and non-licensed denial unit staff, managing daily tasks, performance reviews, and disciplinary actions. Collaborate effectively with physician reviewers, medical directors, and other departments. Review performance reports, identify deficiencies, and implement corrective action p...
Acts as Case Manager when assigned by Clinical Supervisor and assumes responsibility to coordinate patient care for assigned caseload. Glendale, California (Office), Specifically servicing the following areas: West LA, San Fernando Valley, South Bay, Central LA, and Orange County. You are always lea...
RN (Registered Nurse) ED/ER and O. Valid Registered Nurse (RN) license. RN experience for the last 3 years. ...