External Utilization Management Nurse Reviewer

Description Workers' compensation utilization management activities include the review of clinical information to determine medical necessity at all levels of care. You will utilize criteria, or evidence-based guidelines, coordinate of care across the continuum, and interact with physicians, providers, claimants and peer reviewers as part of the utilization...

Job SummaryAs a Clinical Review Nurse - Utilization Management, you will play a critical role in ensuring the medical necessity of care at all levels. You will utilize evidence-based guidelines to coordinate care across the continuum, interacting with physicians, providers, claimants, and peer reviewers. This position requires a current and unrestricted RN...

Job SummaryAs a Clinical Review Nurse - Utilization Management, you will play a crucial role in ensuring the medical necessity of care provided to claimants. This involves reviewing clinical information, utilizing evidence-based guidelines, and coordinating care across the continuum. You will interact with physicians, providers, claimants, and peer reviewers...

UM Nurse Qualifications Bachelor's degree in Nursing Compact RN License 2+ years experience in medical review or utilization management. Knowledge of utilization review, Medicare, utilization management, and EMR systems. Certification in managed care (preferred). Job Description We are seeking a dedicated and detail-oriented Utilization Management...

Job Title: Utilization Management NurseJob Description We are seeking a dedicated and detail-oriented Utilization Management Nurse to join our team. The ideal candidate will be responsible for meeting all State and Federal regulations, as well as internal mandates related to claims and preauthorization processing. This role involves accurate and timely...

Job Title: Utilization Management NurseJob DescriptionWe are seeking a dedicated and detail-oriented Utilization Management Nurse to join our team. The ideal candidate will be responsible for meeting all State and Federal regulations, as well as internal mandates related to claims and preauthorization processing. This role involves accurate and timely...

Job Title: Utilization Management Nurse Job Description We are seeking a dedicated and detail-oriented Utilization Management Nurse to join our team. The ideal candidate will be responsible for meeting all State and Federal regulations, as well as internal mandates related to claims and preauthorization processing. This role involves accurate and timely...

Job Title: Utilization Management NurseJob DescriptionWe are seeking a dedicated and detail-oriented Utilization Management Nurse to join our team. The ideal candidate will be responsible for meeting all State and Federal regulations, as well as internal mandates related to claims and preauthorization processing. This role involves accurate and timely...

Job Title: Utilization Management NurseWe are seeking a dedicated and detail-oriented Utilization Management Nurse to fill this role. The ideal candidate will be responsible for ensuring compliance with State and Federal regulations, as well as internal mandates related to claims and preauthorization processing.This role involves accurate and timely medical...

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Performs a clinical review and assesses care related to...

Description: - Responsible for meeting all State and Federal regulations as well as mandates related to claims and preauthorization processing - Responsible for accurate and timely medical review of claims and preauthorization's - Responsible for accurate and timely medical review of customer service inquirers about claims and preauthorization's -...

Position Summary Perform as a skilled electrician in all phases of utility equipment electrical maintenance, construction, repair, and other activities related to the trade. Position is responsible for utility electrical system compliance and electrical distribution operation for the Utility Plant that serves the UNMC/NE Med Campus Electrical...

As the Tax Manager, you will be responsible for the overall tax planning, reporting, and tax compliance for The Mutual Group and its Member institutions. Responsibilities:Tax Compliance: Utilize tax expertise in the preparation and supervision of federal/state tax, benefit plans, premium taxes, municipal taxes, assessment and surcharge management for TMG...

Job DescriptionInSearch Recruiting and Staffing is seeking a detail-oriented Contract Reviewer Specialist to join their team. The ideal candidate will have a strong understanding of logistical and supply chain management, as well as excellent communication and problem-solving skills.Responsibilities• Review incoming contracts for new sales orders to verify...

Job SummaryThe Contract Reviewer will be responsible for reviewing purchase orders received from customers, identifying discrepancies, and communicating with the customer to resolve the issues. This role requires excellent communication skills, attention to detail, and the ability to work at a fast pace.Key Responsibilities* Review purchase orders for...

Job DescriptionCasual/PRN - Mon-Fri 8:00-4:00 as needed. No weekends or holidays At Children's, the region's only full-service pediatric healthcare center, our people make us the very best for kids. Come cultivate your passion, purpose and professional development in an environment of excellence and inclusion, where team members are supported and deeply...

Schedule: Mon-Fri, 0730-1600, No weekends or holidays At Children’s, the region’s only full-service pediatric healthcare center, our people make us the very best for kids. Come cultivate your passion, purpose and professional development in an environment of excellence and inclusion, where team members are supported and deeply valued. Opportunities for...

Utility Buffet Server $15 - $17 per hour Resort Lifestyle Communities is accepting applications for a part-time Utility Buffet Server to ensure a first-class dining experience for residents and their guests. You will work collectively with the Culinary and Dining Services team under the direction of our hardworking Executive Chef. Schedule, Benefits...

AVAILABLE BENEFITS & PERKS: Health insurance, dental, vision, life insurance, short term disability, and other supplemental policies available HSA with employer contributions available 401(k) with company match Ten Paid Holidays ESSENTIAL FUNCTIONS & DUTIES: Manages the relationship with the outsourced IT provider and ensures the firms issues/needs are...

AVAILABLE BENEFITS & PERKS: Health insurance, dental, vision, life insurance, short term disability, and other supplemental policies available HSA with employer contributions available 401(k) with company match Ten Paid Holidays ESSENTIAL FUNCTIONS & DUTIES: Manages the relationship with the outsourced IT provider and ensures the firms issues/needs are...