- Humana (Salem, OR)
- **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 (Salem, OR)
- **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 (Salem, OR)
- **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 (Salem, OR)
- …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
- Humana (Salem, OR)
- **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
- CVS Health (Salem, OR)
- …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 (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 ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- Catholic Health Initiatives (Pendleton, OR)
- …and Responsibilities** **Relocation Assistance Available!** **Job Summary** The Registered Nurse provides leadership and co-ordination to the health care team ... based on ability/competence and scope of practice. + Is aware and demonstrates utilization of proper infection control standards and practices. + Is aware and… more
- Lincoln County (Newport, OR)
- Community Health Nurse Print (https://www.governmentjobs.com/careers/lincoln/jobs/newprint/5041377) Apply Community Health Nurse Salary $40.19 - $54.02 Hourly ... Lincoln City Kite Festival Coastal Healthcare is looking for a Community Health Nurse to assist in providing direct patient care and treatment in our primary… more
- Highmark Health (Salem, OR)
- …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
- Providence (OR)
- …+ Dual RN License: Oregon and Washington + 1 year Quality management /quality improvement/ utilization review auditing experience, including experience in auditing ... them. **Required Qualifications:** + Degree in Nursing + Oregon Registered Nurse License + 5+ years clinical experience (Nursing) **Preferred Qualifications:** +… more
- Fresenius Medical Center (Albany, OR)
- …staff training, equipment, physician and patient relations, cost containment, supply management , medical records, patient billing, OSHA and all company, state and ... quality of patient care, as defined by the quality goals, by working with management to ensure that policies and procedures are followed. + Assists with implementing… more
- Fresenius Medical Center (Portland, 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
- CVS Health (Salem, OR)
- …Tuesday 6:30am to 5pm in their respective time zone.** As a Care Management Associate you will be supporting comprehensive coordination of medical services including ... supporting the implementation of care plans to promote effective utilization of healthcare services. Promotes/supports quality effectiveness of Healthcare Services.… more
- CenterWell (Lake Oswego, OR)
- …driver's license, auto insurance and reliable transportation. + Two years as a Registered Nurse with at least one-year of management experience in a home care, ... review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts… more
- Providence (Beaverton, OR)
- …of Care Planning, Discharge Planning, Coordination of Outpatient Care) + Utilization Management Experience (EX. Concurrent Review, Prior Authorization, Medical ... who are terminal and nearing end of life + Care management services include: nurse education, care coordination and general assistance with managing day to… more
- Providence (Medford, OR)
- …some weekends as needed.** 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
- Datavant (Salem, OR)
- …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
- PeaceHealth (Springfield, OR)
- …as we continue through the episode of care. May also be responsible for management of referrals; working closely with team members to ensure optimum utilization ... two years college And + Preferred: Medical Assistant, Licensed Practical nurse , or Registered Nurse + Minimum of 3 years Required: Experience working in… more