- Veterans Affairs, Veterans Health Administration (Portland, OR)
- …Referral System (VIRS) Transfer Coordinator practices as an RN in the Utilization Management Unit within Inpatient & Emergency Services Division (IESD). ... is responsible for assessing and documenting the requests for transfer of Veterans from community hospitals, outside clinics, and other VA facilities and maintaining… more
- CareOregon (Portland, OR)
- …Level Manager Direct Reports Registered Nurse - Clinical Quality Assurance, Registered Nurse - Utilization Management II Manager Title Director, Quality ... oversight in the correct and effective use of decision tools used for utilization management activities including staff training. The position is responsible for… more
- Veterans Affairs, Veterans Health Administration (White City, OR)
- …knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ... options, provide scheduling guidance, and be a resource within the service to provide Veteran with soonest and best care. Guide Veterans through their full range… more
- Sharecare (Salem, OR)
- …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
- CVS Health (Salem, OR)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... or Specialty Pharmacy Advocacy** **.** **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- Fresenius Medical Center (Albany, OR)
- …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 (St. Helens, OR)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... + Preferred but not required: + 3+ years supervisory or project/program management experience. + Med/surg or ICU/CCU experience. **PHYSICAL DEMANDS AND WORKING… more
- United Therapeutics (Salem, OR)
- …for which transplant is not currently an option. Who you are You are experienced nurse and an expert in all things PAH. You love providing mentorship, coaching and ... make a difference. The Regional Field Director, RNS Program Management serves as a director of all clinical field...+ Plan, collaborate, create and produce the yearly Clinical Nurse Summit meeting for HCPS across the United States… more
- Highmark Health (Salem, OR)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... Care **LICENSES or CERTIFICATIONS** **Required** + United States Registered Nurse (RN) license + Delaware RN license must be...is part of the compact **Preferred** + Certification in Utilization Management or a related field **SKILLS**… more
- Providence (Medford, OR)
- …**Full-Time/ Day Shift** The RN Case Manager is an expert professional registered nurse who is responsible for developing and managing patient care outcomes for an ... based on population focus. Duties also include complex discharge planning and utilization review. Providence caregivers are not simply valued - they're invaluable.… more
- Sharecare (Salem, OR)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more
- Praxis Health (Eugene, OR)
- …Suite(Word, Outlook, Teams, Excel). + Expertise in chronic disease management , case management , utilization management , and adult acute care. + Hands-on ... Job Description Join Our Team as a Transitional Care Management (TCM) Coordinator! Location:Remote (Oregon residents only) Schedule:Full-time, Monday - Friday… more
- Fresenius Medical Center (Hillsboro, OR)
- …dialysis clinic. You will collaborate with the Medical Director and the Charge Nurse regarding the provision of quality patient care in the dialysis clinic. ... data collections and auditing activities. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. +… more
- Praxis Health (Eugene, OR)
- …with a strong background in care coordination and population health management . The ideal candidate is detail-oriented, collaborative, and passionate about improving ... performance in: + HEDIS metric tracking + Transitional Care Management (TCM) + Annual Wellness Visit (AWV) completion rates...Team (IDT) agenda for review 3. High Emergency Room Utilization Oversight + Monitor and manage patients identified on… more