- Humana (Concord, NH)
- **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 (Concord, NH)
- **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 (Concord, NH)
- **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
- Cognizant (Concord, NH)
- …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
- CVS Health (Concord, NH)
- …experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal ... clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult… more
- Sharecare (Concord, NH)
- …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
- Veterans Affairs, Veterans Health Administration (Manchester, NH)
- …EDRP application. Former EDRP participants ineligible to apply. Responsibilities This Registered Nurse - Community Living Center (CLC) is located in the Long Term ... education, orientation, competencies, and providing quality improvement and outcomes utilization consultation. - Demonstrates leadership in delivering and improving… more
- CVS Health (Concord, NH)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- HCA Healthcare (Portsmouth, NH)
- …we support our colleagues in their positions. Join our Team as a(an) Registred Nurse Inpatient Wound Care and access programs to assist with every stage of your ... affordable to gain certifications and job skills. Apply today for our Registered Nurse Inpatient Wound Care opening and continue to learn! **Job Summary and… more
- Lawrence General Hospital (Lawrence, MA)
- …referrals and facilitates appropriate discharge plans. + Works in conjunction with Utilization Review Nurse , Social Worker and Clinical Care Leader to ... experience in an acute care setting with discharge planning, continuing care, care management , and utilization review. + Five years clinical nursing experience… more
- Tufts Medicine (Lowell, MA)
- …productivity and utilization of all resources. The ED Clinical Resource Nurse utilizes the nursing process, leadership skills and current evidence based clinical ... Lowell General Hospital is seeking an **ED Clinical Resource Nurse .** The ED Clinical Resource Nurse is...specific needs of groups or individuals and work with education/ management to address those needs in a timely manner… more
- Beth Israel Lahey Health (Exeter, NH)
- Registered Nurse Case Manager + Full Time + Exeter, NH 03833 ... one weekend per month (may change), alternating holiday rotation The Nurse Case Manager/Discharge Planner collaborates, facilitates and negotiates the delivery of… more
- Highmark Health (Concord, NH)
- …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 (Portsmouth, NH)
- …in their positions. Join our Team as a Patient Safety Coordinator Registered Nurse and access programs to assist with every stage of your career. **Benefits** ... skills. Apply today for our Patient Safety Coordinator Registered Nurse opening and continue to learn! **Job Summary and...to achieve the goals of case review, data abstraction, management and reporting. The Patient Safety Coord will actively… more
- Beth Israel Lahey Health (Exeter, NH)
- Clinical Resource Nurse + Part Time + Exeter, NH 03833 (https://maps.google.com/maps?q=Exeter%2C%20NH%20%2003833&zoom=14&size=512x512&maptype=roadmap&sensor=false) + ... 18 months of hire **Major Responsibilities:** 1. Assumes responsibility for clinical management functions on the assigned shift. 2. Models excellence in nursing… more
- Evolent (Concord, NH)
- …responsible for support and assistance for all cardiology administrative and clinical utilization management and quality improvement functions under the auspices ... is 11:30-8:00 eastern** **OTHER SKILLS and ABILITIES:** Strong clinical, management , communication, and organizational skills. Demonstrated leadership skills Analytic… more
- Fresenius Medical Center (Lowell, MA)
- …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
- Tufts Medicine (Lowell, MA)
- …Reporting to the Vice President of Patient Care Services and Chief Nurse Executive, this position has oversight of all clinical and administrative functions ... of the case management and social work departments in a four-time designated...programs of care. 11. Monitors and critically analyzes resource utilization of the unit. 12. Collaborates with physicians, hospital… more
- Datavant (Concord, NH)
- …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
- HCA Healthcare (Portsmouth, NH)
- …throughput while supporting a balance of optimal care and appropriate resource utilization . Provides case management services for both inpatient and observation ... **Job Summary and Qualifications** **Job Summary and Qualifications** The Registered Nurse (RN) CM is responsible for promoting patient-centered care by coordinating… more