- Humana (Montgomery, AL)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the… more
- CVS Health (Montgomery, AL)
- …administration of the utilization /benefit management function. Required Qualifications + Registered Nurse in state of residence. + 3+ years of Nursing ... experience. Preferred Qualifications + Prior authorization utilization management /review experience preferred Outpatient Clinical experience. + Knowledge of… more
- CVS Health (Montgomery, AL)
- …active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include weekends, ... **Required Qualifications** + 2+ years of experience as a Registered Nurse in adult acute care/critical care...or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing… more
- Community Health Systems (Gadsden, AL)
- **Job Summary** The Registered Nurse ( RN ), Charge Nights, oversees the operations of a nursing unit during assigned shifts, ensuring effective and efficient ... Monitors patient flow, manages bed assignments, and optimizes resource utilization within the unit. + Conducts employee and patient...addressing unit challenges and emergencies. **Licenses and Certifications** + RN - Registered Nurse -… more
- Aveanna Healthcare (Montgomery, AL)
- Hospice Registered Nurse RN Full Time 7500 Sign On Bonus ApplyRefer a FriendBack Job Details Requisition #: 204144 Location: Montgomery, AL 36117 Category: ... - $39.00 per hour Position Details Position Overview: TheHopsice Registered Nurseis responsible for pain management , symptom...and Paid Holidays Qualifications: + Current license as a Registered Nurse in the State of Alabama… more
- Fresenius Medical Center (Montgomery, AL)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Fresenius Medical Center (Huntsville, AL)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... of education and experience. + Graduate of an accredited School of Nursing ( RN ). + Current appropriate state licensure. **EXPERIENCE AND SKILLS:** + Required: + 6+… more
- Sharecare (Montgomery, AL)
- …cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification of those ... according to the disease management program intervention guidelines. A Clinical Registered Nurse is supervised by an Operations Manager (OM). All Sharecare… more
- CVS Health (Montgomery, AL)
- …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... is URAC accredited in Case Management , Disease Management and Utilization Management . AHH...in a hospital setting. + A Registered Nurse that holds an active, unrestricted… more
- CVS Health (Montgomery, AL)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... reviews **Required Qualifications** - 5+ years' experience as a Registered Nurse with at least 1 year...using a keyboard **Preferred Qualifications** - 1+ years' Case Management experience or discharge planning, nurse navigator… more
- YesCare Corp (Springville, AL)
- **Experience & Requirements** + RN Active license for Alabama required. + Minimum of 3 to 4 years of Management & Supervisory experience managing a team in a ... and annual orientation and training activities. + Ensures site utilization and compliance with all Corizon and applicable client...PREA, ACA, NCCHC, etc.) at a time specified by management for the Facility. Ensure site compliance with correctional… more
- Highmark Health (Montgomery, AL)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... required depending on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field + Certification in Case … more
- Humana (Montgomery, AL)
- …+ Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management + Exceptional attention to detail. + Demonstrated excellent time ... + Expertise on NCQA accreditation standards, especially related to Utilization Management and/or Behavioral Health; MED-Deeming accreditation standards… more
- Southeast Health (Dothan, AL)
- …three (2-3) years practice management experience Minimum Education Required + Current Registered Nurse ( RN ) in state of Alabama Minimum Education ... + One (1) year of supervisory experience in practice management + Or, demonstrated ability of complex problem solving,...appropriate utilization of the skills of the Registered Nurse as approved by the Alabama… more
- Southeast Health (Dothan, AL)
- …on these needs. + Demonstrates appropriate utilization of the skills of the Registered Nurse as approved by the Alabama Board of Nursing + Demonstrates the ... supplies. + Provides moderate sedation and aids in pain management during and post procedure. + Reports promptly any...one (1) or more years of experience as a Registered Nurse ; + For Behavioral Medicine Unit,… more
- Community Health Systems (Dothan, AL)
- … skills to prioritize tasks in a dynamic environment. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact State ... to ensure appropriate discharge goals are met. The Care Manager - RN is responsible for coordinating and overseeing discharge planning, transitions of care,… more
- Evolent (Montgomery, AL)
- …As a Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... are supported by Field Medical Directors (MDs) in the utilization management determination process. + Reviews charts...and Preferred:** + Current, unrestricted state licensure as a Registered Nurse - **Required** + Associate or Bachelors… more
- Community Health Systems (Birmingham, AL)
- … skills to prioritize tasks in a dynamic environment. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact State ... **Job Summary** The Care Manager - RN is responsible for coordinating and overseeing discharge...and overseeing discharge planning, transitions of care, and case management activities to ensure optimal patient outcomes. This role… more
- CVS Health (Montgomery, AL)
- …5+ years of clinical experience required 2+ years of experience as a Registered Nurse with current unrestricted state licensure required in state of ... residence **Preferred Qualifications** Utilization Management review Managed Care experience Client... review Managed Care experience Client processing experience **Education** Registered Nurse **Anticipated Weekly Hours** 40 **Time… more
- Intermountain Health (Montgomery, AL)
- …/Professional Nursing program. + Required Licensure/Certification: State licensure as a Registered Nurse ( RN ). Preferred Qualifications + Bachelor's ... cost-effective outcomes. Provides focused support to various areas such as utilization management , emergency department, acute, ambulatory and specialty care.… more