- Elevance Health (GA)
- ** Telephonic Nurse Case Manager I** **Location: Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... must complete the assessment within 48 hours of receipt and meet the criteria._** The ** Telephonic Nurse Case Manager I** is responsible for telephonic care… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
- ChenMed (New Orleans, LA)
- …assess and record patients' progress and adjust and plan accordingly. + Understanding utilization review and how to leverage with inpatient staff for possible ... we need great people to join our team. The Nurse Case Manager 1 (RN) is responsible for achieving...experience required. + A minimum of 1 year of utilization review and/or case management, home health,… more
- ChenMed (Houston, TX)
- …years' clinical work experience required. + A minimum of 1 year of utilization review and/or case management, home health, discharge planning experience ... we need great people to join our team. The Nurse Case Manager 1 (RN) is responsible for achieving...with patient and family. + Facilitates patient/family conferences to review treatment goals and optimize resource utilization ;… more
- ChenMed (Lakeland, FL)
- …assess and record patients' progress and adjust and plan accordingly. + Understanding utilization review and how to leverage with inpatient staff for possible ... we need great people to join our team. The Nurse Case Manager 2 (RN) is responsible for achieving...experience required. + A minimum of 1 year of utilization review and/or case management, home health,… more
- ChenMed (Philadelphia, PA)
- …engagement with patient and family. + Facilitates patient/family conferences to review treatment goals and optimize resource utilization ; provides family ... people to join our team. The Community Care RN ( Nurse Case Manager) is responsible for achieving positive patient...achieving desired clinical outcomes within specific timeframe. + Conducts review for appropriate utilization of services from… more
- Spectrum Health Services (Philadelphia, PA)
- …from the hospital, specialty care practices, health plan staff, and others, the Nurse Care Manager identifies and proactively manages the needs of patients with high ... health and/or psychosocial problems through practice and home-based visits and telephonic support on a care management or case management basis appropriate… more
- CVS Health (Columbus, OH)
- …with transferring patients to lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred. + ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
- CVS Health (Denver, CO)
- …with transferring patients to lower levels of care - 1+ years' experience in Utilization Review - CCM and/or other URAC recognized accreditation preferred - 1+ ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
- ERP International (Luke AFB, AZ)
- …Case Management Society of America (CMSA); American Accreditation Healthcare Commission/ Utilization Review Accreditation Commission (URAC); CAMH; (AAAHC); Health ... **Overview** ERP International is seeking full time **Registered Nurse - Case Management** in support of the56th Medical Group at Luke AFB, AZ… more
- Baystate Health (Springfield, MA)
- **RN, ACO Nurse Care Manager, Community Health Center** The **ACO Nurse Care Manager i** s responsible for the management of care for a defined group of patients ... face visits, home visits if necessary, as well as telephonic interactions. In addition, they will assist with advance...room, or from a skilled nursing facility. Responsible to review the discharge summaries, follow up on testing that… more
- Nuvance Health (Poughkeepsie, NY)
- …or BSN preferred. Must have current RN license. Preferred experience in Utilization Review /Management.Company: Vassar Brothers Medical Center Org Unit: 1190 ... affiliates, Position Summary: Under the general supervision of the Director, The Nurse Case Manager role provide clinically-based case management to support the… more
- Lowe's (Charlotte, NC)
- …in a clinical position. + 3-5 Years of Experience as a Case Manager or Utilization Review Nurse in worker's compensation + Experience in a clinical ... **Your Impact** The Care Manager is a telephonic medical case management position with emphasis on...Clinical experience + 3-5 Years of Experience required with Nurse Case Management Software, along with Microsoft Office +… more
- Albany Medical Center (Albany, NY)
- …the practice physician and/or advanced practice provider (APP) and the supervision of the Nurse Manager (RN) and/or Nurse Supervisor (RN), the RN may provide ... direct patient care, patient triage (in-person and telephonic ), assessment, planning, directing and evaluating of a patient's...or APP and documents results in EHR + Performs review and triage of incoming test results, patient requests… more
- ERP International (Eglin AFB, FL)
- **Overview** ERP International is seeking a **Registered Nurse (RN)** for a full-time **Case Manager** position in support of the **Eglin Hospital, Eglin AFB, FL ... + Develop and implement local strategies using inpatient, outpatient, onsite and telephonic CM + Develop and implement tools to support case management, such… more
- US Tech Solutions (Columbia, SC)
- …effective outcomes. **Responsibilities:** + Performs medical or behavioral review /authorization process. Ensures coverage for appropriate services within benefit ... and contract benefits. + Utilizes allocated resources to back up review determinations. Identifies and makes referrals to appropriate staff (Medical Director,… more
- CVS Health (Raleigh, NC)
- …Assessment of Members through the use of clinical tools and information/data review , conducts comprehensive evaluation of member's needs and benefit plan eligibility ... while assessing benefits and/or member's needs to enable appropriate utilization of services and/or administration and integration with available internal/external… more
- Albany Medical Center (Albany, NY)
- …Work Shift: Day (United States of America) Salary Range: $60,028.00 - $99,023.00 Registered Nurse (RN) - Part Time HIV Medicine Clinic - Albany, NY We have an ... the practice physician and/or advanced practice provider (APP) and the supervision of the Nurse Manager (RN) and/or Nurse Supervisor (RN), the RN may provide… more
- CVS Health (Columbus, OH)
- …and supporting the implementation of Wellness Plans to promote effective utilization of healthcare services. This position promotes/supports quality effectiveness of ... to accommodate business needs. Position Responsibilities: + Responsible for initial review and triage of members. + Manages population health member enrollment… more
- US Tech Solutions (Columbia, SC)
- …mental health/chemical dependency, orthopedic, general medicine/surgery. Or, 4 years utilization review /case management/clinical/or combination; 2 of the 4 ... **Job Title:** **Registered Nurse UM II** **Location: Columbia SC 29229** **Duration:...and determine medical necessity criteria and contract benefits. Provides telephonic support for members with chronic conditions, high risk… more
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