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Utilization Review/Appeals Clinician - ABA
Sunshine State Health Plan
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Tallahassee, FL, 32313
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management ... Analyzes BH member data to improve quality and appropriate utilization of services Interacts with BH healthcare providers as ... - May 09
Travel Nurse RN - Case Manager, Utilization Review - per week
Sharp Medical Staffing
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White Plains, NY, 10606
... Posted job title: RN (Registered Nurse) - CARE MANAGEMENT, 220.7920 type:Case Management (Utilization Review) About Sharp Medical Staffing At Sharp Medical Staffing, we set the bar for excellence by providing an elite experience for traveling ... - May 04
System Utilization Management SUM Utilization Review RN
Alameda Health System
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Oakland, CA, 94612
Summary SUMMARY: The System Utilization Management [SUM] Utilization Review RN is responsible for ensuring the appropriate use of healthcare resources while maintaining high- standards of patient care. This role involves evaluating medical necessity ... - May 03
System Utilization Management SUM Utilization Review RN
Alameda Health System
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Oakland, CA, 94612
Summary SUMMARY: The System Utilization Management [SUM] Utilization Review RN is responsible for ensuring the appropriate use of healthcare resources while maintaining high- standards of patient care. This role involves evaluating medical necessity ... - May 03
RN- Admissions Coordinator/ Utilization Management
Carle Health
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Normal, IL, 61761
... Nursing, Work Experience: Nursing >2yr Inpatient or Case Management Responsibilities Collaborates with charge nurse daily ... Monitors utilization and keeps clinical team apprised of length of stay relative to the patient's CMG.Assists in identifying ... - May 07
Utilization Review Coordinator
Neuropsychiatric Hospitals LLC
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South Bend, IN, 46506
About Us HEALING THE BODY AND MIND Founded fifteen (15) years ago, NeuroPsychiatric Hospital is the largest hospital system ... 5 years of utilization review experience in a hospital setting required. Minimum of 5 years of case management experience, ... - Apr 21
Utilization Management Nurse III - Case Management
Christus Health
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San Antonio, TX, 78251
... • Resource/Utilization Management appropriateness: Assess assigned patient population for medical necessity, level of care, and appropriateness of setting and services. Utilizes MCG/InterQual Care Guidelines and/or health system-approved tools to ... - May 07
Travel Case Manager - Utilization Review - per week
Anders Group
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Port Angeles, WA, 98362
Anders Group is seeking a travel nurse RN Case Management for a travel nursing job in Port Angeles, Washington. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: ASAP Duration: 13 weeks 40 hours per week Shift: 8 ... - May 06
Travel Utilization Review Case Manager - per week
Host Healthcare
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Milford, MA, 01757
75.75 per hour
Host Healthcare is seeking a travel nurse RN Case Management for a travel nursing job in Milford, Massachusetts. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: 05/09/2025 Duration: 13 weeks 40 hours per week ... - Apr 28
Utilization Management Nurse
Actalent
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Des Moines, IA, 50381
... + Accurately document review processes and decisions within the documentation system. + Meet quality assurance and production metrics established for the utilization management unit. + Communicate approval and denial decisions to members and ... - May 08