Registered Nurse - Utilization Management The John D. Dingell VA Medical Center in Detroit, MI is recruiting for a Registered Nurse - Utilization Management that will function in Quality and Patient ...
Registered Nurse - Utilization Management The John D. Dingell VA Medical Center in Detroit, MI is recruiting for a Registered Nurse - Utilization Management that will function in Quality and Patient ...
The Utilization Management (UM) Registered Nurse (RN) executes position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex utilization ...
The Utilization Management (UM) Registered Nurse (RN) executes position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex utilization ...
Registered Nurse - Utilization Management (Um) The John D. Dingell VA Medical Center is recruiting for a Registered Nurse - Utilization Management (UM) that will function in Quality and Patient ...
Registered Nurse - Utilization Management (Um) The John D. Dingell VA Medical Center is recruiting for a Registered Nurse - Utilization Management (UM) that will function in Quality and Patient ...
The Utilization Management (UM) Registered Nurse (RN) executes position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex utilization ...
The Utilization Management (UM) Registered Nurse (RN) executes position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex utilization ...
RN Utilization Management
Detroit, MI · On-site
Detroit, Michigan Registered Nurse (RN) Contract We are seeing a Michigan RN Utilization Manager. This is a 100% remote position in Michigan. Perform prospective, concurrent and retrospective review ...
RN Utilization Management
Detroit, MI · On-site
Detroit, Michigan Registered Nurse (RN) Contract We are seeing a Michigan RN Utilization Manager. This is a 100% remote position in Michigan. Perform prospective, concurrent and retrospective review ...
RN Utilization Management
Detroit, MI · On-site
Detroit, Michigan Registered Nurse (RN) Contract We are seeing a Michigan RN Utilization Manager. This is a 100% remote position in Michigan. Perform prospective, concurrent and retrospective review ...
RN Utilization Management
Detroit, MI · On-site
Detroit, Michigan Registered Nurse (RN) Contract We are seeing a Michigan RN Utilization Manager. This is a 100% remote position in Michigan. Perform prospective, concurrent and retrospective review ...
Registered Nurse Looking for Utilization Management AND Education experience. Scope of work: In conjunction with Medical Management leadership, coordinates the educational plan for the Behavioral ...
Registered Nurse Looking for Utilization Management AND Education experience. Scope of work: In conjunction with Medical Management leadership, coordinates the educational plan for the Behavioral ...
Hybrid Grand Rapids, MI Full time R217886 Registered Nurse Looking for Utilization Management AND Education experience. Scope of work: In conjunction with Medical Management leadership, coordinates ...
Hybrid Grand Rapids, MI Full time R217886 Registered Nurse Looking for Utilization Management AND Education experience. Scope of work: In conjunction with Medical Management leadership, coordinates ...
Registered Nurse Looking for Utilization Management AND Education experience. Scope of work: In conjunction with Medical Management leadership, coordinates the educational plan for the Behavioral ...
Registered Nurse Looking for Utilization Management AND Education experience. Scope of work: In conjunction with Medical Management leadership, coordinates the educational plan for the Behavioral ...
Director of Utilization Management
Troy, MI · On-site +1
$160K - $160K/yr
Integra's Utilization Management (UM) division is looking for an experienced individual to direct the clinical and non-clinical utilization management teams for a managed care organization. This ...
Director of Utilization Management
Troy, MI · On-site +1
$160K - $160K/yr
Integra's Utilization Management (UM) division is looking for an experienced individual to direct the clinical and non-clinical utilization management teams for a managed care organization. This ...
Works with the Utilization Management team primarily responsible for inpatient medical necessity ... Must be an RN Utilization Review background in either Managed Care of Provider environment (at ...
Works with the Utilization Management team primarily responsible for inpatient medical necessity ... Must be an RN Utilization Review background in either Managed Care of Provider environment (at ...
RN Utilization Review Nurse
$33 - $37/hr
Primarily inpatient, skilled nurses facilities, rehab, behavioral health, and home healthcare. * Works with the Utilization Management team primarily responsible for inpatient medical necessity ...
RN Utilization Review Nurse
$33 - $37/hr
Primarily inpatient, skilled nurses facilities, rehab, behavioral health, and home healthcare. * Works with the Utilization Management team primarily responsible for inpatient medical necessity ...
Works with the Utilization Management team primarily responsible for inpatient medical necessity ... Qualifications Must be an RN Utilization Review background in either Managed Care of Provider ...
Works with the Utilization Management team primarily responsible for inpatient medical necessity ... Qualifications Must be an RN Utilization Review background in either Managed Care of Provider ...
Utilization Management Clinical Analyst - Substance Use Disorder (SUD) The Utilization Management ... (RN) CADC, CAADC, or development plan for the CADC/CAADC credentials. Experience Requirements:
Utilization Management Clinical Analyst - Substance Use Disorder (SUD) The Utilization Management ... (RN) CADC, CAADC, or development plan for the CADC/CAADC credentials. Experience Requirements:
Works collaboratively with physicians, nursing, members of the multidisciplinary team (such as Home ... Experience in utilization management/case management, critical care, or patient outcomes/quality ...
Works collaboratively with physicians, nursing, members of the multidisciplinary team (such as Home ... Experience in utilization management/case management, critical care, or patient outcomes/quality ...
Identifies unsigned level of care (LOC) orders; communicates with utilization management nurse and obtains orders from providers. * Reviews current DRG/LOS identified within Cerner to assess ...
Identifies unsigned level of care (LOC) orders; communicates with utilization management nurse and obtains orders from providers. * Reviews current DRG/LOS identified within Cerner to assess ...
Works collaboratively with physicians, nursing, members of the multidisciplinary team (such as Home ... Experience in utilization management/case management, critical care, or patient outcomes/quality ...
Works collaboratively with physicians, nursing, members of the multidisciplinary team (such as Home ... Experience in utilization management/case management, critical care, or patient outcomes/quality ...
Works collaboratively with physicians, nursing, members of the multidisciplinary team (such as Home ... Experience in utilization management/case management, critical care, or patient outcomes/quality ...
Works collaboratively with physicians, nursing, members of the multidisciplinary team (such as Home ... Experience in utilization management/case management, critical care, or patient outcomes/quality ...
Works collaboratively with physicians, nursing, members of the multidisciplinary team (such as Home ... Experience in utilization management/case management, critical care, or patient outcomes/quality ...
Works collaboratively with physicians, nursing, members of the multidisciplinary team (such as Home ... Experience in utilization management/case management, critical care, or patient outcomes/quality ...
Hospital utilization review/utilization management experience. Preferred * Clinical appeals experience. Preferred * Registered Nurse (RN) - State of Michigan Upon Hire required How Corewell Health ...
New
Hospital utilization review/utilization management experience. Preferred * Clinical appeals experience. Preferred * Registered Nurse (RN) - State of Michigan Upon Hire required How Corewell Health ...
New
Apprentice Utilization Management Nurse information
What is an apprentice utilization management nurse?
An Apprentice Utilization Management Nurse is a nursing professional in training who assists with the review and evaluation of healthcare services to ensure they are medically necessary and cost-effective. They work under the supervision of experienced utilization management nurses and follow established guidelines to assess patient care plans, medical records, and insurance policies. Their role is crucial in helping healthcare organizations maintain quality care while managing costs, and they may interact with physicians, patients, and insurance companies to clarify or justify treatment decisions. As apprentices, they are gaining hands-on experience to develop their skills and knowledge in utilization management.
What are the key skills and qualifications needed to thrive as an apprentice utilization management nurse, and why are they important?
To thrive as an Apprentice Utilization Management Nurse, you need a foundational understanding of nursing principles, strong analytical skills, and typically an RN license or progression toward one. Familiarity with utilization management software, electronic health records (EHR), and knowledge of insurance guidelines such as Medicare or Medicaid are often required. Attention to detail, critical thinking, and effective communication are essential soft skills for collaborating with healthcare teams and conveying clinical information. These competencies ensure accurate patient care reviews, compliance with regulations, and effective support in healthcare cost management.
What are some common challenges faced by apprentice utilization management nurses, and how can they be addressed?
Apprentice Utilization Management Nurses often encounter challenges such as learning to interpret complex medical records, understanding insurance policies, and adhering to strict regulatory guidelines. Balancing patient advocacy with cost-effective care decisions can also be demanding. These challenges can be addressed by actively participating in mentorship programs, seeking regular feedback from experienced colleagues, and utilizing ongoing training resources provided by employers. Developing strong communication and organizational skills will also help manage the workload and foster effective collaboration with physicians, case managers, and insurance representatives.
What is the difference between Apprentice Utilization Management Nurse vs Utilization Management Nurse?
| Aspect | Apprentice Utilization Management Nurse | Utilization Management Nurse |
|---|---|---|
| Credentials | Licensed RN, in training or early certification stage | Licensed RN with certification in utilization review |
| Work Environment | Supervised training setting, often in healthcare or insurance companies | Independent review in healthcare or insurance organizations |
| Job Responsibilities | Assisting with case reviews, learning utilization review processes | Conducting case assessments, making coverage decisions |
The Apprentice Utilization Management Nurse is in training, focusing on learning review procedures under supervision, while the Utilization Management Nurse is fully qualified, responsible for independent case evaluations and decision-making. The apprentice role is a stepping stone toward becoming a licensed Utilization Management Nurse.
What are the most commonly searched types of Utilization Management Nurse jobs in Michigan?
The most popular types of Utilization Management Nurse jobs in Michigan are:
Other
Posted 9 days ago
Job description
Registered Nurse - Utilization Management
The John D. Dingell VA Medical Center in Detroit, MI is recruiting for a Registered Nurse - Utilization Management that will function in Quality and Patient Safety. The Utilization Management (UM) Registered Nurse (RN) executes position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex utilization processes to include practical experience in the application of UM methods and expertise in medical necessity review criteria.