- Humana (Providence, RI)
- **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 (Providence, RI)
- **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 (Providence, RI)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse within the Clinical Access Grievance Team utilizes ... care management and utilization management skills...are available as needed. The Clinical Access Grievance Team Nurse uses clinical knowledge, communication skills, and independent critical… more
- Humana (Providence, RI)
- …Work hours will be an 8.5-hour shift between 7:00am - 5:00pm CST. The Utilization Management Nurse 2 uses knowledge, communication, and independent critical ... Qualifications** + Associate's Degree or higher + Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary...a team **Preferred Qualifications** + BSN + Knowledge of Utilization Management + Previous Medicare and Medicaid… more
- Humana (Providence, RI)
- **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 (Providence, RI)
- …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
- Humana (Providence, RI)
- **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 (Providence, RI)
- **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
- CVS Health (Woonsocket, RI)
- …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 (Providence, RI)
- …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
- University Medicine (Providence, RI)
- SUMMARY: Reporting to the Manager of Case Management , the nurse case manager is responsible for providing comprehensive screenings, assessment, care coordination ... services, disease education with the intent of encouraging self- management for patients with chronic conditions. The Nurse...to the right level of care and decrease unnecessary utilization . The nurse case manager is an… more
- Veterans Affairs, Veterans Health Administration (Providence, RI)
- …promotion, health education and coaching on wellness, disease prevention, and chronic care management . The nurse will assist in directing the provision of ... application. Former EDRP participants ineligible to apply. Responsibilities This Registered Nurse -Outpatient(PACT) position is located in Primary Care Service at the… more
- CVS Health (Woonsocket, RI)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Pediatrics, **Oncology** or Specialty Pharmacy. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or … more
- Atrius Health (Dedham, MA)
- …value-based care system in the country. *_SUMMARY_*__ Physician Assistant/ Nurse Practitioner (MNA) position supporting our Orthopedics department. The Physician ... Assistant/ Nurse Practitioner will work collaboratively on a team to...urgent care, a range of wellness visits, chronic disease management and acute care. We offer superior staffing resources… more
- Prime Healthcare (Woonsocket, RI)
- …alignment with clinical standards and regulatory requirements. + Facilitate utilization management , including prior authorizations, discharge planning, and ... Overview Department: Utilization ManagementShift: Per Diem, Day Shift (8:00 AM...Manager is responsible for overseeing the quality and resource management of patients admitted to the facility, from the… more
- Highmark Health (Providence, RI)
- …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
- Atrius Health (Easton, MA)
- …Growing together.* *SUMMARY * Under the direction of the Department Chief, Nurse Leader or designee, this registered professional nurse provides practice ... across the lifespan. This position is responsible for effective care delivery and management of patient care within a specialty, utilizing the nursing process and… more
- Atrius Health (Dedham, MA)
- …Growing together. *SUMMARY * Under the direction of the Department Chief, Nurse Leader or designee, this registered professional nurse provides practice ... across the lifespan. This position is responsible for effective care delivery and management of patient care within a specialty, utilizing the nursing process and… more
- Atrius Health (Dedham, MA)
- …in the country. *SUMMARY * Under the direction of the Department Chief, Nurse Leader or designee, this registered professional nurse provides practice support ... across the lifespan. This position is responsible for effective care delivery and management of patient care within a specialty, utilizing the nursing process and… more
- Fresenius Medical Center (Providence, RI)
- …procedure, under the direction of the Facility Manager and/or Charge Registered Nurse , utilizing standard nursing techniques to assist the physician in optimum ... acting on adverse events and action thresholds in collaboration with facility management . + Maintains integrity of medical records and other FVC administrative and… more