- Humana (Juneau, AK)
- **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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (Juneau, AK)
- **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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CenterWell (Juneau, AK)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- Cognizant (Juneau, AK)
- …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- CenterWell (Juneau, AK)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... **Required Qualifications** + Must be a licensed Registered Compact Nurse license (RN) with no disciplinary action and ability...volume and fast paced environment + Previous experience in utilization management + Education: BSN or bachelor's… more
- Humana (Juneau, AK)
- **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... and communication of behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work… more
- Sharecare (Juneau, AK)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
- Highmark Health (Juneau, AK)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... within the first 6 months of employment. **Preferred** + Certification in utilization management or a related field + Certification in Case Management … more
- HCA Healthcare (Anchorage, AK)
- …about delivering patient-centered care?** Submit your application for Operating Room Registered Nurse position and spend more time at the bedside with the patient. ... work to deliver clinical excellence behind the scenes in data science, case management or transfer centers. Unlock your potential at Surgery Center of Anchorage!… more
- PeaceHealth (Ketchikan, AK)
- …acute care hospital and + Preferred: Utilization management /quality management experience **Credentials** + Required: Registered Nurse in state of ... is seeking a RN Care Coordinator Inpatient - Care Management for a Part Time, 0.80 FTE, Day position....inpatient populations across the continuum of illness, promote effective utilization and monitoring of health care resources, and assumes… more
- CVS Health (Juneau, AK)
- …with heart, each and every day. **Position Summary** As a Care Management Associate you will be supporting comprehensive coordination of medical services including ... and supporting the implementation of care plans to promote effective utilization of health services service. Promotes/supports quality effectiveness of Healthcare… more
- Community Health Systems (Palmer, AK)
- **Job Summary** The Director, Practice Management is responsible for the operational, financial, and clinical oversight of physician practices within the healthcare ... system. This role ensures optimal resource utilization , efficient service delivery, regulatory compliance, and financial sustainability across all managed practices.… more
- Datavant (Juneau, AK)
- …function as delegated by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and appeal ... of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for...expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in… more
- Highmark Health (Juneau, AK)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
- Community Health Systems (Palmer, AK)
- …huddles. + Monitors patient flow, manages bed assignments, and optimizes resource utilization within the unit. + Conducts employee and patient rounding to evaluate ... are available and properly utilized while maintaining cost-effective resource management . + Facilitates ongoing education and professional development for nursing… more
- HCA Healthcare (Anchorage, AK)
- …quality, patient-centered care by overseeing aspects of the Quality Management /Patient Safety Program(s) and Performance Improvement programs across complex ... organizations (multi-service lines). The Vice President ensures the facilitation and utilization of diverse strategies and communication for quality and performance… more
- HCA Healthcare (Anchorage, AK)
- …Life Support Course (BLS or BCLS) and Certification. + Certification in case management or utilization review preferred. + InterQual experience preferred. HCA ... clinical excellence behind the scenes in data science, case management or transfer centers. Unlock your potential at Alaska...you will need:** + Current licensure as a Registered Nurse in the State of Alaska or RN compact… more
- Community Health Systems (Palmer, AK)
- …huddles. + Monitors patient flow, manages bed assignments, and optimizes resource utilization within the unit. + Conducts employee and patient rounding to evaluate ... are available and properly utilized while maintaining cost-effective resource management . + Facilitates ongoing education and professional development for nursing… more