Utilization Management RN - Case Management Pro
St. Joseph's Health
St. Joseph's Health in New Jersey is seeking a Utilization Management Registered Nurse (UM RN) responsible for evaluating the appropriateness and efficiency of healthcare services to ensure optimal patient care delivery. The ideal candidate will have at least a Bachelor of Science in Nursing, with a preference for candidates with 3+ years of Utilization Review or Case Management experience. We offer competitive salary, health benefits, and retirement options. #J-18808-Ljbffr St. Joseph's Health
- ## Clinical Denials Utilization Review RN - FT - Day - Utilization Resource Management Pennington NJApplylocations: RMCtime type: Full timeposted on: Posted Todayjob... ...denials, appeals and clinical audits for inpatient cases. Ensures responsibility for Performance...SuggestedFull timeTemporary workPart timeFlexible hours
$110.35k - $143.1k
NYU Langone Hospitals is seeking a Care Manager RN for a full-time position in New York. This... ...patient care strategies, perform utilization management activities, and ensure optimal... ...Registered Nursing License, and preferably a Case Management certification. The salary...SuggestedFull time- ...should reside in Texas Harbor Health is seeking a dedicated Utilization Management (UM) LVN. The UM LVN supports prior authorization and... ...authorization requests via fax and phone and ensure timely case entry into the designated tracking system and UM platform....SuggestedRemote jobLocal areaMonday to FridayShift work
- A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare... ...review or home health. This contract role offers a chance to manage healthcare quality efficiently while working remotely. #J-1880...SuggestedRemote jobContract work
- A healthcare organization is seeking an experienced Registered Nurse (RN) - Case Management for their New York location. The RN will be responsible for coordinating patient care, managing resources, and ensuring high-quality patient outcomes. Key responsibilities include...Suggested
- ...three years of medical/surgical nursing experience and a bachelor's degree is preferred. The ideal candidate possesses knowledge of managed care regulations and excellent communication skills, and is licensed to practice as a registered nurse in New York. This position...
- Job Description The Utilization Management Registered Nurse (UM RN) is responsible for evaluating the medical necessity, appropriateness, and efficiency of... ...experience. Preferred 3+ years of Utilization Review or Case Management experience. Case Management Society of...Daily paidPart time
- Job Description Job Description Skills: Two years case/resource management and utilization management is required Education: RN License - required AHA BLS - required
- ...provide, ongoing coordination and management of service delivery through an integrated case management approach • Performs... ...quality standards related to Utilization Management • Maintain and submit... ...York State Registered Nurse (RN) required • Minimum three (3)...Permanent employmentFull timeWork at office
- ...NY is seeking a Clinical Care Manager responsible for coordinating and... ...delivery in an integrated case management approach. The ideal... ...a Bachelor’s degree, a valid RN license in New York, and at least... ...essential, alongside proficiency in Utilization Management criteria. This role...
- Summary The Care Ally, Case Manager is a key member of the interdisciplinary care team (ICT). They use a collaborative process of assessment... ...‑person or by phone to provide education and assistance with utilizing Align Senior Care benefits, including but not limited to...Work at officeImmediate startNight shift
$71.1k - $97.8k
A healthcare organization is seeking a Utilization Management Registered Nurse. In this remote role, you will use your clinical nursing skills to... ...ensuring timely responses. Candidates need to hold a Compact RN license and have over a year's experience in relevant clinical...Remote job- ...health, access to care and appropriate utilization of resources, balanced with the patient’... ...based on medical necessity. This position manages medical necessity process for accurate... ...may require negotiation with a payer on a case by case basis. This position integrates...Work at officeRemote work
$71.1k - $97.8k
A leading health organization is seeking a Utilization Management Registered Nurse to support coordination and documentation of medical services. The ideal candidate holds a Compact RN license and has over one year of clinical experience. Responsibilities include interpreting...Remote job$71.1k - $97.8k
A leading health solutions company is seeking a Utilization Management Registered Nurse to join their remote team. This role involves using clinical... ...and manage post-acute care. Candidates must hold a Compact RN license and possess over one year of clinical experience....Remote job- Job Description We are seeking an experienced Utilization Review Nurse to join our team in a hybrid... ...regulatory and compliance standards. Participate in case management and care coordination meetings. Qualifications Active RN license in the state of New York. Minimum of...Work at officeRemote workMonday to FridayFlexible hours
$71.1k - $97.8k
A healthcare organization is seeking a Utilization Management Registered Nurse to utilize nursing skills in coordinating medical services and benefit determination. This remote position requires a Compact RN license and over a year of clinical experience in healthcare...Remote job- A healthcare organization is seeking a Utilization Management Registered Nurse to utilize clinical nursing skills in coordinating medical services. This remote role requires a Compact RN license and over a year of clinical experience. Responsibilities include interpreting...Remote job
- Truman Medical Centers is seeking a Utilization Management RN for a part-time position working from home. The role involves partnering with interdisciplinary teams to optimize patient care and resources, ensuring compliance with regulatory standards. Applicants should have...Remote jobPart timeWork from home
$70k - $100k
Utilization Management RN - Behavioral Health (OR Licensed) Position Responsibilities Specific Determine appropriateness of services through the... ...Medical Director(s) for appropriate referrals, complex cases and adverse determinations to ensure timely access to medically...Minimum wageWork at officeMonday to Friday$115k - $120k
...Full time MLTC Case Manager RN position with 15K New Hire Bonus and Pension This Jobot Job is hosted by: Donna Gawroski-Kusik Are... ...preferred and at least 2 years’ experience in Case Management or Utilization Review. Reporting to the Supervisor of Care Management...Full timeTemporary workLocal areaRelocation packageFlexible hours- ...Job Title: RN - Care Manager - ED Location: Bronx, NY Type: Contract | 14 Weeks Shift... ...optimal patient outcomes. Perform utilization review activities to ensure appropriate... ...policies, regulatory requirements, and case management standards. Maintain accurate...Contract workLocal areaMonday to FridayShift work
- ...Nurse UR Specialist. Key responsibilities include managing insurance notifications, obtaining necessary certifications... ...of 4-5 years in acute care and 1-2 years in utilization review. This position requires a Georgia RN license and a commitment to effective patient advocacy...
$128.25k - $160k
...to join our team as a Supervisor‑Care Management *BSN & RN Required; 3 years of relevant experience... ...successful candidate supervises the utilization management in accordance with the Hospital... ...for the daily operations of the Case Management Department. Job Responsibilities...- Centene Management Company LLC is seeking a Clinical Supervisor to lead the Medical Management team. This fully remote position requires... ...and involves overseeing day-to-day activities of the utilization management team while ensuring compliance with quality and performance...Remote job
$108k
Join to apply for the RN Clinical Manager role at TieTalent 2 days ago Be among the first 25 applicants... ...served by the location. Receives case referrals. Reviews available patient... ...addition to feedback and recommendations by Utilization Review staff. Upon completion of the...Full timeTemporary workApprenticeshipWork at officeImmediate startRelocation packageFlexible hoursNight shiftAfternoon shift$26.01 - $68.55 per hour
4062 Aetna Resources, LLC is seeking a Medicare Precertification Utilization Management Nurse Consultant to work remotely. The role requires an active RN license and a minimum of 3 years of RN experience. Responsibilities include reviewing clinical information, making...Remote jobHourly payFull time- ...motivated Nurse Supervisor who will be responsible for overseeing Utilization Management activities. This full-time position involves leading a... ...quality services. Required qualifications include an active RN license, an Associate's Degree with a preferred BSN, and at least...Full time
- ...Description Position Summary Provides case management as well as routine discharge planning... ...needs in accordance with the utilization/contractual requirements. All questionable... .../Licensure Requirements Current RN license in the state of NJ. Minimum...Contract work
- Appworkshub is seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our remote healthcare team. In this role, you will conduct inpatient and outpatient utilization reviews, support transitions of care, and ensure compliance with...Remote job
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