Um nurse jobs in United States

Description · General Summary: UM Nurse focuses on the Gonzaba Medical Group UM Review Process.  · Supervisory Responsibilities: This position has no supervisory responsibilities. · General Requirements: All duties performed will be done accurately and in a timely manner. · Car ...

· Position Overview · This role supports clinical operations by conducting timely and thorough reviews of service authorization requests to determine medical necessity and compliance with health plan benefits and clinical guidelines. The selected candidate will ensure members re ...

· Position Overview · This role supports clinical operations by conducting complex clinical reviews and coordinating care to ensure medical necessity and benefit compliance. The selected candidate will use advanced clinical judgment and collaborate with internal and external sta ...

This position plays a vital role in ensuring the delivery of high-quality, evidence-based care by reviewing and evaluating clinical documentation related to prior authorization requests for medical services. · BSN and/or MSN required · Current California RN license required · ...

Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services Department. · ...

Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist their Health Services Department. · ...

Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services Department. · ...

The Utilization Management Nurse uses clinical knowledge to provide the best treatment and care for members. · Coordinates and communicates with providers and members to facilitate optimal care. · Makes decisions regarding own work methods in ambiguous situations. · ...

We are looking for an experienced CA-licensed Utilization Review Nurse to assist our Health Services Department. The nurse will utilize their clinical judgement to approve or deny outpatient medical services for patients based on Medical Necessity Criteria. · ...

Astrana Health is looking for an experienced CA-licensed Utilization Review Nurse to assist our Health Services Department. · ...

Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services Department. · ...

We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safe ...

· RN UM|LPN UM · Start Date:02/15/22 to 05/17/22 · 14weeks contract · 40 hours guarantee · Shift time:-: :00 AM to 3:30 PM · Location:-Waterville ME 04901 · Facility:- Genesis Mid America & SE Region · Some on-call and early evening admissions from time to time · Registry Person ...

We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. · At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize sa ...

We're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming healthcare. · ...

Conduct pre and post payment review of inpatient admissions, outpatient services, and other procedures to assess the appropriateness and continuity of care. Apply all aspects of the medical review function, including pre-authorization, concurrent review, screening for quality-of- ...

AllMed está buscando a un Utilization Management Reviewer detallado y apasionado. · ...

We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, · support one another, · and grow together.Nurse Licensure Compact (NLC) · ...

· The Utilization Management Nurse uses clinical knowledge to provide the best treatment for members. · ...

At CVS Health we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming healthcare. · ...