- The Cigna Group (Bloomfield, CT)
- …health care related field with current licensure. **Job Description** This position, the Nurse Case Manager Senior Analyst , through the case management process, ... with client (plan participant/member), family, physician(s), and other providers to determine medical history and current status and to assess the options for… more
- The Cigna Group (Harlingen, TX)
- …possible case management intervention. * Interfaces with providers of medical services and equipment to facilitate effective communication, referrals, development ... or document trends. * Understands and follows administrative guidelines ( policy and procedure) of the unit. * Attends and...* None **Experience:** * Current Licensure as a Registered Nurse , in the state of Texas in good standing.… more
- The Cigna Group (Hattiesburg, MS)
- …possible case management intervention. + Interfaces with providers of medical services and equipment to facilitate effective communication, referrals, development ... to resolve issues or document trends. + Understands and follows administrative guidelines ( policy and procedure) of the unit. + Attends and actively participates in… more
- Healthfirst (NY)
- Duties/Responsibilities: Support the Medical Policy and Clinical Utilization Management (UM) Governance Committee Chairs, committee members, and related ... and preparing/maintaining related reports and documentation. Facilitate the Healthfirst medical and clinical policy processes, including developing new… more
- The County of Los Angeles (Los Angeles, CA)
- SENIOR INFORMATION SYSTEMS ANALYST (Electronic Health Record) Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3124187) Apply SENIOR ... INFORMATION SYSTEMS ANALYST (Electronic Health Record) Salary $102,729.84 - $138,443.04 Annually Location Los Angeles County, CA Job Type Full time Job Number… more
- RWJBarnabas Health (New Brunswick, NJ)
- Clinical Data Analyst , Trauma ServicesReq #:0000149986 Category:Nursing Status:Full-Time Shift:Day Facility:RWJ New Brunswick Department:Trauma Services Location: ... 08901 RWJBH is seeking a highly dedicated Clinical Data Analyst for our Trauma Services. The clinical data ...BLS and ACLS Certification + Active New Jersey Registered Nurse License + Association for the Advancement of Automotive… more
- Milton Hershey School (Hershey, PA)
- System Analyst , Student Health Services - ( 24000035 ) **Description** Milton Hershey School (MHS) is a top-notch home and school where 2,000 pre-K through 12th ... serve more students! MHS is currently seeking a Student Health Services Systems Analyst to provide support to the Director, Student Health Systems, working closely… more
- Cedars-Sinai (CA)
- …Best Hospitals. **What Will I be Doing in this Role?** The Credentials Evaluation Analyst provides guidance and support to medical staff leadership in the ... fuels innovation. **Req ID** : 361 **Working Title** : Credentials Evaluation Analyst **Department** : Medical Staff Administration **Business Entity** :… more
- Motion Recruitment Partners (Durham, NC)
- …+ Coordinate all aspects of the appeals process to ensure compliance with medical necessity criteria, Corporate Medical Policy (CMP), contract provisions, ... Clinical Appeals Analyst Durham, NC **100% Remote** Contract $35/hr -...Duration: 6+ Months **Required Skills & Experience** + Registered Nurse in the state of North Carolina with 3… more
- ManpowerGroup (Durham, NC)
- …+ Coordinate all aspects of the appeals process to ensure compliance with medical necessity criteria, Corporate Medical Policy (CMP), contract provisions, ... **Title:** **Clinical Appeals Analyst ** **Location: 4613 University Drive Durham NC 27707...requested. **Hiring Requirements:** + **Licensure:** Must be a Registered Nurse (RN) licensed in the state of North Carolina… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …thought possible. **Description** We're seeking a **Registry Utilization Management Analyst ** responsible for reviewing each hospital admission in accordance with ... nationally recognized criteria and department policies to determine the medical necessity of admission and appropriate LOS. This individual will: + Complies with… more
- The Cigna Group (Bloomfield, CT)
- …and technical aspects of their roles. The ideal candidate is a nurse experienced in adult education, demonstrates self-driven initiative, and strong problem-solving ... skills. This nurse trainer will utilize multiple modalities of education delivery...and existing Evernorth Care Group staff and clinicians. Incorporating policy , process and procedure changes as identified. + Administers… more
- Hackensack Meridian Health (Hackensack, NJ)
- …Assists with pre-authorizations of hospital admissions, procedures, medications and medical equipment. + Maintains ongoing communication with insurance companies to ... number. Works with departmental supervisor and/or clinician to determine medical necessity and if the appointment can be rescheduled....& timely. + Prioritizes bed assignment in accordance with policy . + Ensures patients are assigned to the proper… more
- Travelers Insurance Company (Tampa, FL)
- …settlement, discontinuation of benefits through litigation). Collaborate with our internal nurse resources ( Medical Case Manager) in order to integrate ... moderate supervision, manage Workers' Compensation Claims with: Stable Lifetime Indemnity and/or Medical Benefits where the medical expenditures are not expected… more
- The Cigna Group (Bloomfield, CT)
- …risk members. Interfaces with providers of behavioral health services, medical services and equipment to facilitate effective communication, referrals, development ... care planning process. **Minimum Requirements:** Current licensure as a Registered Nurse (RN), or Licensed Social Worker (LCSW or LMSW) in applicable… more
- The County of Los Angeles (Los Angeles, CA)
- MEDICAL SERVICE COORDINATOR, CCS (Registered Nurse , Pediatrics - Case Management) Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4145908) ... Apply MEDICAL SERVICE COORDINATOR, CCS (Registered Nurse , Pediatrics...to be disclosed. Equal Employment Opportunity: It is the policy of the County of Los Angeles to provide… more
- The County of Los Angeles (Los Angeles, CA)
- NURSE MANAGER Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/1272528) Apply NURSE MANAGER Salary $143,536.32 - $214,855.92 Annually ... APPLIED NEED NOT REAPPLY, BUT MAY CONTACT THE EXAM ANALYST IF THEY WOULD LIKE TO SUBMIT ADDITIONAL INFORMATION....hospitals are training sites for physicians completing their Graduate Medical Education in nearly every medical specialty… more
- The County of Los Angeles (Los Angeles, CA)
- SUPERVISING CLINIC NURSE II/ SUPERVISING STAFF NURSE II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/1321172) Apply SUPERVISING CLINIC ... NURSE II/ SUPERVISING STAFF NURSE II Salary $113,309.04 - $169,609.20 Annually Location Los...APPLIED NEED NOT REAPPLY, BUT MAY CONTACT THE EXAM ANALYST IF THEY WOULD LIKE TO SUBMIT ADDITIONAL INFORMATION.… more
- The County of Los Angeles (Los Angeles, CA)
- …of patient condition and reports these observations to the designated registered nurse . Obtains and documents computerized medical histories, observing patients ... Reception Center under close supervision of the designated registered nurse . Reviews orders by medical or psychiatric...the time of filing or email it to exam analyst at ###@dhs.lacounty.gov within fifteen (15) calendar days of… more
- The County of Los Angeles (Los Angeles, CA)
- LICENSED VOCATIONAL NURSE II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3408806) Apply LICENSED VOCATIONAL NURSE II Salary $51,756.00 ... (CDU), DHS hospitals are training sites for physicians completing their Graduate Medical Education in nearly every medical specialty and subspecialty. In… more
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