of designated healthcare services, continuity or care, and access to care clinical review determinations. The Manager, Utilization... and Medical Review will report to the Director, Utilization and Medical Review. In this role you will be managing a high...
dedicated to promoting customer-focused services for case management, discharge planning, utilization review, and social work...An incredible opportunity is open for a driven Resource Management Nurse Manager with an awarded hospital in the...
Manager of Behavioral Health Utilization Management (BH UM). In this role you will conduct clinical review of mental health...Your Role The Behavioral Health Utilization Management team performs prospective, concurrent, retrospective...
healthcare services, continuity or care, and access to care clinical review determinations. The Utilization Management Nurse..., Senior will report to the Manager, Utilization and Medical Review. In this role you will be performing first level...
coordination of care with specialists, community resources. Care Managers perform a blended function of utilization management... member care review with medical groups or individual providers for continuity of care, out of area/out of network...
coordination of care with specialists, community resources. Care Managers perform a blended function of utilization management... member care review with medical groups or individual providers for continuity of care, out of area/out of network...
candidate is hired below midpoint of the range. Introduction Do you have the career opportunities as an Operating Room Nurse... with our Nurses at Los Robles Surgery Center! Job Summary and Qualifications We are seeking an Operating Room Nurse...
a healthier, more engaged future. Responsibilities: Who are you? We are seeking a Utilization Review Nurse to join our dynamic... following: Under the supervision of a registered nurse (RN), provide professional assessment and review for the medical...
, and evaluate medical services; provide nursing case management, discharge planning and utilization review services to patients; act... as department resource for medical inquiries, claim file reviews and utilization review. Coordinate and monitor patients through...
. We are in search of a highly motivated candidate to join our talented Team. Job Title: Utilization Review Nurse Location... members. Conducting utilization management (UM) activities in accordance with health plan policies and regulatory guidelines...
Description As the Utilization Management & Quality Review Nurse, you will be responsible for: Ensuring appropriate..., cost-effective, and high-quality care for New Century Health Plan members Conducting utilization management...
Regional office in Temecula, CA is seeking a Full-Time RN Central Utilization Review Nurse who will be responsible for carrying.... Ensures compliance of utilization review practices as required by payers, external regulatory agencies, and organization...
Regional office in Temecula, CA is seeking a Full-Time RN Central Utilization Review Nurse who will be responsible for carrying.... Ensures compliance of utilization review practices as required by payers, external regulatory agencies, and organization...
Regional office in Temecula, CA is seeking a Per-Diem RN Central Utilization Review Nurses who will be responsible for carrying.... Ensures compliance of utilization review practices as required by payers, external regulatory agencies, and organization...
Regional office in Temecula, CA is seeking a Per-Diem RN Central Utilization Review Nurses who will be responsible for carrying.... Ensures compliance of utilization review practices as required by payers, external regulatory agencies, and organization...
of patients for discharge planning and utilization review. This includes those who may have Medicare, Medicaid, HMO or private... and significant others who have an ongoing caring relationship with the patient. Utilization review procedures include those stated...
of patients for discharge planning and utilization review. This includes those who may have Medicare, Medicaid, HMO or private... and significant others who have an ongoing caring relationship with the patient. Utilization review procedures include those stated...
Ensuring appropriate, cost-effective, and high-quality care for New Century Health Plan members Conducting utilization..., required Current valid California RN license, required Two or more years of experience in utilization management, preferably...
the Utilization Review Nurse facilitates quality care by screening the admission and continued stay of patients utilizing... Intensity of Service/Severity of Illness criteria. The Utilization Nurse complies with regulatory requirements and supports...
Management and Utilization Review to join our UR Case Management Department located in Moreno Valley. The most competitive... management and utilization review in a hospital is preferred. Schedule: 9/80 after 90 days (negotiable) Meet the Team...