- Humana (Dover, DE)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...appropriate courses of action. As a Utilization Management RN working on the OneHome/ Home Solutions… more
- Humana (Dover, DE)
- **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 (Dover, DE)
- **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...at a time that is best for your schedule. **Work-At- Home / Internet Information:** To ensure Home … more
- Humana (Dover, DE)
- **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
- Sharecare (Dover, DE)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...minimum. + This position will be based in a home office which must satisfy all HIPAA requirements. Sharecare… more
- CVS Health (Dover, DE)
- …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
- ChenMed (Philadelphia, PA)
- … management programs, clinical meetings and other meetings. The Nurse Practitioner, Specialty incumbent adheres to strict departmental goals/objectives, standards ... we need great people to join our team. The Nurse Practitioner (NP), Specialty acts as part of the...care in nursing homes, skilled nursing facilities (SNF) and home settings, or supporting a Cardiologist practice. The responsibilities… more
- ChenMed (Philadelphia, PA)
- …expanding and we need great people to join our team. The Registered Nurse , Care Line, is responsible for providing telephonic triage directional patient care advice ... client counseling, patient advocacy, health education and referral and resource management to ChenMed patients and their families. Providing on-call coverage, the… more
- Evolent (Dover, DE)
- …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
- CVS Health (Swedesboro, NJ)
- …high-quality, cost-effective care for our members. These strategies encompass utilization management , quality improvement, network coordination, and clinical ... physical, behavioral, and psychosocial services. **Key Responsibilities** + Conduct in- home , face-to-face assessments using comprehensive tools for members enrolled… more
- Fresenius Medical Center (Wilmington, DE)
- …Quality, and Technical Services departments. + Collaborates with or functions as the Home Therapies Program Manager to oversee the facility's Home Therapies ... Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. +… more
- AmeriHealth Caritas (Philadelphia, PA)
- …. **Responsibilities:** Under the supervision of the LTSS Manager/Director for Utilization Management , this position is responsible for providing daily ... oversight of LTSS Review Home Modification Team and staff members within the LTSS...Modification Team and staff members within the LTSS Review Utilization Management Department. Responsibilities include providing technical… more
- ChenMed (Philadelphia, PA)
- …years' clinical work experience required + A minimum of one (1) year of utilization review and/or case management , home health, hospital discharge planning ... plans. The success of this role is determined by management of patients in hospital to ensure patients receive...will provide warm hand off to the Community Care Nurse when patient is discharged to home … more
- University of Pennsylvania (Philadelphia, PA)
- …and wide variety of atmospheres, Philadelphia is the perfect place to call home for work and play. The University offers a competitive benefits package that ... and ultrasound. Job Description Job Responsibilities We are seeking a skilled and dedicated nurse to join our team as an Operating Room and Imaging Nurse .… more
- Penn Medicine (Philadelphia, PA)
- …hospice, community resources, transportation, and quality data collection and risk management referral. Responsibilities: + Utilization management ... community resourcesParticipates and drives accountability in daily interdisciplinary meetings + Utilization Management :Adheres to guidelines to satisfy 3rd party… more
- Penn Medicine (Philadelphia, PA)
- …hospice, community resources, transportation, and quality data collection and risk management referral. Responsibilities: + Utilization management ... your life's work? **The candidate for this position must be a seasoned med/surg nurse with a minimum of 3 to 5 years of nursing experience. Previous experience… more
- Trinity Health (Philadelphia, PA)
- …The Registered Nurse (RN) is responsible for providing oversight and management to the provision of service delivery to participants. Provide skilled nursing ... **Employment Type:** Part time **Shift:** **Description:** **Registered Nurse ** **Location: LIFE Broad Street, Philadelphia PA** **Status:** On-Call **Shift:**… more
- Virtua Health (Pennsauken, NJ)
- …and/or certification from the State of New Jersey as a MSW or Registered Nurse .Case Management Certification (requirement within one year of hire beginning April ... over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques… more
- Insight Global (Elkton, MD)
- …IP phones. Support and provide technical guidance to the Field Staff. Support of the Nurse Call backend systems. This is an ONSITE position based in Elkton, MD. This ... individual can work from home and have flexibility but must be close-by for...request. 2. Analyzes system traffic reports as requested by management , including operator statistics, voice mail, ACD, trunk, and… more