A company is looking for a System Director - RN, Utilization Management.Key ResponsibilitiesOversees department leaders and staff in managing fiscal resources for the utilization management programDevelops and maintains statistical information to demonstrate fiscal responsibility and monitors vendor service levelsCollaborates with stakeholders to address performance issues and participates in system quality initiativesRequired Qualifications, Training, and EducationGraduate of an accredited school of nursing with an RN license requiredSeven years of experience, with five years in a leadership roleRegistered Nurse (RN) license in Illinois, Missouri, Wisconsin, or OklahomaExperience in utilization management policies and practicesKnowledge of regulatory requirements and accreditation processes
Market Medical Director, Utilization Management - WellMed - Remote
The Market Medical Director for Utilization Management will support WellMed Medical Management, Inc. WellMed, part of the Optum family of businesses, is seeking a Market Medical Director, Utilization Management to join our team in Dallas, Austin, San Antonio, El Paso, Tampa, Orlando, Miami, Atlanta,...
Obstetrics Utilization Management RN
A company is looking for an Obstetrics Utilization Management RN - Remote. ...
RN Director - Palliative Care Advanced Illness Management
RN Director of Advanced Illness Management (AIM). Registered Nurse Director / RN Director Requirements:. Registered Nurse Director / RN Director,. Our clinical teams serve as an extension of physicians’ care, partnering with them and other specialists to offer advanced illness management, a speciali...
Utilization Management RN
A company is looking for a Utilization Management RN to oversee utilization management activities in a healthcare setting. ...
RN Director Specialist - Advanced Illness Management
RN Director Specialist for Advanced Illness Management. The RN Director Specialist will establish, implement, and evaluate goals and objectives for Advanced Illness Management that meet and promote high standards of quality clinical care and sound financial success. Advanced Illness Management Progr...
Medical Director Utilization Management
A company is looking for a Medical Director for their Clinical Review Team. ...
Utilization Management RN
Job Title & Specialty Area: Utilization Management RN. Analyzes patient records to determine legitimacy of admission, treatment, and length of stay in health-care facility to comply with government and insurance company reimbursement policies: Analyzes insurance, governmental, and accrediting agency...
Utilization Management Director
Utilization Management Director. Oversite of granting authorizations and conducting utilization reviews for behavioral health services per clinical information given by providers and internal criteria for medical necessity and appropriateness of care. Licensed Practitioner of the Healing Arts (LPHA)...
Utilization Management RN
Job Title & Specialty Area: Utilization Management RN. Analyzes patient records to determine legitimacy of admission, treatment, and length of stay in health-care facility to comply with government and insurance company reimbursement policies: Analyzes insurance, governmental, and accrediting agency...
Case Management Utilization Review RN - REMOTE
Assists in the development of physician profiles to identify over/under utilization patterns. RN license required; Certification in Case Management (CCM) strongly preferred. Collaborates with the multidisciplinary team to assist patient with benefits management. Identifies and plans strategies to op...