RN Utilization Management Nurse

Amida Care, the largest Medicaid HIV Special Needs Plan in NY, delivers a uniquely effective care model that has become a true benchmark for innovation, engagement and member health outcomes. Our mission is to provide access to comprehensive care and coordinated services that facilitate positive health outcomes and general well-being for our members. This...

Position OverviewDepartment: Utilization ManagementWork Schedule: Monday to Friday, 7:30 AM - 4:00 PM (40 hours per week)Unit Details: ICU - 8 beds, Medical - 25 beds, Surgical - 25 beds. Familiarity with Meditech is preferred.Key Responsibilities:Conduct ongoing evaluations of patient clinical data to ensure efficiency in care delivery.Review...

Summary Department: Utilization Mgmt Shift timings: 7:3016:00 Monday to friday (5 Days/ 8 Hours) Per Week: 40 Hours ICU8beds Medical25 Surgical25 Meditech Preferred work in all above areas Use of MCG criteria Use of Interqual criteriaRoles & Responsibilities Concurrent review of patients clinical information for efficiencyOngoing review of precertification...

Job SummaryWe are seeking a highly skilled RN Utilization Review Specialist to join our team at Confident Staff Solutions. As a key member of our Utilization Management team, you will play a critical role in ensuring the efficient use of healthcare resources.Key ResponsibilitiesConduct concurrent reviews of patients' clinical information to identify...

Position Overview The Care Manager under the direction of the Vice President of Clinical Services, is primarily responsible for managing both simple and complex medical cases to achieve high-quality patient care outcomes and minimize unnecessary medical expenses, through the coordination of services, both outpatient and inpatient. The Care Manager will...

Prestigious Non-Profit Managed Care Organization Seeking Head of Utilization Management This position is hosted by Jobot. Salary: $130,000 - $150,000 per annum. About Us: We are a non-profit managed care organization based in New York City, dedicated to providing exceptional healthcare services to our community. Our mission is to connect our members...

Job SummaryPlanet Healthcare is seeking a skilled Travel Nurse RN to fill a Utilization Review position in a dynamic healthcare setting.Key ResponsibilitiesConduct thorough reviews of patient cases to ensure optimal healthcare utilizationCollaborate with healthcare teams to develop and implement effective care plansAnalyze data to identify trends and areas...

Job SummaryMetroPlus Health Plan Inc is seeking a skilled RN Care Manager to join our team. As a RN Care Manager, you will be responsible for developing, facilitating, and monitoring care plans for our members. You will work closely with members, their families, primary care physicians, and other healthcare providers to ensure that our members receive the...

## Job OverviewWe are seeking a dedicated Utilization Review Nurse to join our healthcare team. The ideal candidate will be responsible for reviewing medical records to ensure that patients receive necessary care and treatment while optimizing healthcare resources.-*Job Description**Initial and concurrent Status Reviews, MDR's, Denial work.*Requirements**RN...

A fantastic acute care hospital near New York City is looking to add an experienced RN Manager Nursing Operations to their team! This 500+ bed, Level 1 Trauma Center has been providing their community with top-notch medical care for decades. As one of the top non-profit, teaching facilities near Brooklyn, NY, this facility prides themselves on continually...

Job Description:Summary:This position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ensuring compliance with internal and external standards set by regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review. Refer to and...

Prominent Non-Profit Managed Care Organization Seeking a Director of Utilization ManagementAbout Us:We are a well-respected non-profit managed care organization dedicated to serving our community. Our mission is to provide a wide range of healthcare services that cater to the unique needs of our members and their families.Position Overview:We are in search...

Job SummaryWe are seeking a highly skilled Senior Utility Manager to join our team at Upward On. As a key member of our operations team, you will be responsible for managing our utility operations, ensuring accurate and timely billing, and providing exceptional customer service to our tenants.Key ResponsibilitiesUtility Operations ManagementOversee the...

Utilization Management Nurse (RN) - Pop Health - Day (Temporary) Location: WellSpan Health, York, PA Schedule: Full Time Schedule and Location Temporary Role thru January 2025 Full Time: 40 Hours/Week Hours: Monday - Friday 8am - 4:30pm This is a remote position where the ideal candidate would be located in South Central Pennsylvania or in Northern Maryland,...

Job DescriptionJob DescriptionPOSITION OVERVIEW: The Utilization Manager is responsible for the day to day functions of collaborative communication with external case managers at referring provider facilities and/or managed care organizations (MCO) for data collection, interpretation and certification/recertification from third party payers at pre-admission...

Job DescriptionJob DescriptionPOSITION OVERVIEW: The Utilization Manager is responsible for the day to day functions of collaborative communication with external case managers at referring provider facilities and/or managed care organizations (MCO) for data collection, interpretation and certification/recertification from third party payers at pre-admission...

Position OverviewEsteemed Non-Profit Managed Care Organization Seeking a Head of Utilization ManagementAbout Us:We are a non-profit managed care organization dedicated to providing exceptional healthcare services to our community. Our mission is to connect our members with the most suitable healthcare solutions tailored to their needs.Why Consider This...

Job DescriptionAbout CarolinaEast Medical Center CarolinaEast Health System is dedicated to quality and compassionate care across the Coastal Carolina region. The flagship of the health system is a 350 bed full service medical center housing a complete complement of inpatient and outpatient services with the latest technology. CarolinaEast Health System...

Are you passionate about leading a skilled team in a cutting-edge semiconductor manufacturing environment?Our client is seeking an experienced Utilities Manager for their facility in New York. In this pivotal role, you’ll drive operational excellence, safety, and quality while collaborating with other facilities leaders to shape our strategic vision.What...

Job DetailsTotalMed Case Management Staffing is seeking a skilled Registered Nurse to fill a Case Management position.Job RequirementsSpecialty: Case ManagementDiscipline: RNEmployment Type: TravelWe are looking for a dedicated and experienced Registered Nurse to join our team as a Case Manager.About the PositionThis is a 13-week assignment with a 40-hour...