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Utilization Manager Rn jobs

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  • Director of Utilization Management

    Boston Medical Center Healthnet Plan - Boston, MA

    quality and other departments on matters related to utilization management. Supervision Exercised: * Directly ... and other departments on matters related to utilization management. Supervision Exercised * Directly supervises 5+...

    10 days ago from Boston Medical Center HealthNet Plan

  • Utilization Manager

    Rex Unc Healthcare US - Raleigh, NC

    Same as for Requistion 12961 Utilization Review/Management or strong cardiovascular/thoracic skill experience highl ... but not required. A minimum of a Bachelor of Nursing degree required NC RN Licensure required Complete...

    1 day ago from Rex UNC Healthcare US

  • Clinical Care Reviewer RN--Utilization Management Medicaid HMO

    AmeriHealth Caritas - Baton Rouge, LA

    NOTE TO APPLICANTS: This position will be physically located in our AmeriHealth Caritas of Louisiana office located in Baton Rouge, LA. Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing...

    2 days ago from AmeriHealth Caritas

  • Utilization Manager (Sign-On Bonus)

    Centene - El Paso, TX

    provide member assistance and participate in special utilization projects. * Authorize, direct and monitor care ... including utilization review. Working knowledge of utilization review procedures, mental health and substance...

    23 days ago from Centene Corporation

  • RN Manager Utilization Review (232492-005)

    Concentra - Fort Lauderdale, FL

    Job Description: RN Quality Manager for HEDIS. The Manager is responsible for coordinating all HEDIS related ... performance improvement studies. The Manager provides ongoing development, maintenance and evaluation of quality...

    30+ days ago from Concentra

  • Utilization Management Nurse RN - Telecommute Work from Home

    UnitedHealth Group - Lisle, IL

    required in state of residence -5+ years of experience as RN -3+ years of Utilization Management/Review and/or ... Assets Preferred: -Pre-authorization experience -Inpatient utilization review -Certified Case Manager...

    1 day ago from UnitedHealth Group

  • HOME HEALTH CARE & DME UTILIZATION MGMT-CASE MANAGER-COAST HEALTHCARE

    Tenet Healthcare - Lakewood, CA

    Health Agency ensuring proper orders, authorization and utilization of benefit. Qualifications : * CA RN or LVN license * Minimum of 2 years case management, utilization or discharge planning experience in an IPA, Medical Group, Health...

    1 day ago from Tenet Healthcare

  • Utilization Management Registered Nurse - PATIENT CARE UTILIZATION (71315)

    Advocate Health Care Network - Barrington, IL

    for patients to insure reimbursement. Insures appropriate utilization of hospital services. Accountabilities: 1. Medical record review for severity of illness and intensity of service. 2. Liaison function with external review agencies to...

    3 days ago from Advocate Health Care

  • Registered Nurse (RN) Utilization Manager

    Healthcare Scouts - New Lenox, IL

    environment Required Skills The ideal Registered Nurse (RN) Utilization Manager will bring enthusiasm and passion ... RN, utilization review, UR, medical necessity, utilization manager, utilization management, InterQual, Milliman For...

    7 days ago from HealthCare Scouts

  • Case Manager Utilization RN-PD(222365)

    Kaiser Permanente - Ventura, CA

    analyses and identifies utilization patterns and trends, problems or inappropriate utilization of resources and ... graduates to take RN license exam. License, Certification, Registration • Current California RN license required. •...

    9 days ago from Kaiser Permanente

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