• Home Health Utilization Management

    Humana (Montgomery, AL)
    …of action. The Utilization Management Nurse 2/Home Health Utilization Management : + Review cases using clinical knowledge, communication skills, ... part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination,… more
    Humana (05/17/24)
    - Save Job - Related Jobs - Block Source
  • Manager, Utilization Management

    Humana (Montgomery, AL)
    …of our caring community and help us put health first** The Manager, Utilization Management Nursing uses clinical knowledge, communication skills, and independent ... the daily management and operations of the department. Oversees utilization management functions which include timely authorizations related to… more
    Humana (05/17/24)
    - Save Job - Related Jobs - Block Source
  • LPN/LVN or RN Value Based Care Nurse

    The Cigna Group (Mobile, AL)
    …skills + Typing and computer knowledge- able to type 35WPM + Knowledge of utilization review requirements and procedures + Knowledge of current health care ... and metrics for customers and communicates to provider + Review STAR summary gap report (daily) by payor +...Five (3-5) years recent experience in an acute-care environment, case- management or utilization management position… more
    The Cigna Group (03/26/24)
    - Save Job - Related Jobs - Block Source
  • Hospice Registered Nurse RN Full Time 10K…

    Aveanna (Pell City, AL)
    …the plan of care and patient needs. + Participates in quality improvement, utilization review , and infection control activities as requested. + Attends ... Hospice Registered Nurse RN Full Time 10K Sign on Bonus...Bonus** Position Overview: TheHospice Registered Nurseis responsible for pain management , symptom control in the delivery of care to… more
    Aveanna (05/18/24)
    - Save Job - Related Jobs - Block Source
  • Dialysis Clinical Manager Registered Nurse

    Fresenius Medical Center (Mobile, 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 (03/23/24)
    - Save Job - Related Jobs - Block Source
  • Staff Professional-Risk Mgmt

    Marriott (Montgomery, AL)
    …with Claims department regarding case management . + Collaborate with UNM on utilization review issues. + Refer catastrophic cases in coordination with claims ... claims most likely to benefit from case management to meet jurisdictional needs. ** Utilization Review ** + Provide initial clinical review in order to… more
    Marriott (05/12/24)
    - Save Job - Related Jobs - Block Source
  • LPN - Unit Coordinator 7a-3p

    NHS Management, LLC (Madison, AL)
    …of subordinate nurses engaged in quality assurance, infection control, and utilization review activities. + Receives physicians' instructions regarding resident ... way. We are in search of a qualified LPN Nurse Unit Coordinator: + Assists in maintaining resident care...nursing observations. Qualifications: + Must be a Licensed Practical Nurse + Working knowledge in medical terminology, and physician… more
    NHS Management, LLC (05/17/24)
    - Save Job - Related Jobs - Block Source
  • RN Every Other Weekend Supervisor

    NHS Management, LLC (Birmingham, AL)
    …of subordinate nurses engaged in quality assurance, infection control, and utilization review activities. + Receives physicians' instructions regarding resident ... along the way. We are in search of a qualified Registered Weekend Nurse Supervisor: + Assists in maintaining resident care standards by supervising and directing… more
    NHS Management, LLC (05/18/24)
    - Save Job - Related Jobs - Block Source