- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring… more
- Commonwealth Care Alliance (Boston, MA)
- …procedures, and facilities under the provisions of CCA's benefits plan. The Manager , Utilization Management is responsible for overseeing and managing the ... daily operation of the Utilization Management Review Nurse and Specialist staff...decisions and organizational determinations. Essential Duties & Responsibilities: The Manager , Utilization Management reports to the Director… more
- Commonwealth Care Alliance (Springfield, MA)
- …(must have): - Meaningful clinical experience including: - 3+ years' experience as a Registered Nurse in a high-touch clinical environment or home care, OR - ... by providing best-in-class disability competent primary care. Within Care Delivery, the Manager , Clinical Nursing is responsible for the oversight of clinical care… more
- Stanford Health Care (Palo Alto, CA)
- …affect the processes and outcomes of patient health care **Licenses and Certifications** + Nursing\ RN - Registered Nurse - State Licensure And/Or Compact ... If you're ready to be part of our legacy of hope and innovation,...include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient charts for… more
- Commonwealth Care Alliance (Boston, MA)
- …(must have): - Meaningful clinical experience including: - 3+ years' experience as a Registered Nurse in a high-touch clinical environment or home care, OR - ... member of Care Delivery Leadership, the Primary Care Nursing Manager is the nursing leader of the practice. Responsible...the highest quality care, supporting vulnerable populations, and being part of a larger organizational ethos, you would be… more
- Commonwealth Care Alliance (Boston, MA)
- 011150 CCA-Network Contracting **Position Summary:** The LTSS Program Manager is responsible for overseeing relationships and performance with community-based ... alignment with CCA's model of care and strategic objectives. The Manager fosters effective clinical and programmatic collaboration with provider partners,… more
- Commonwealth Care Alliance (Boston, MA)
- …Position Summary: The Behavioral Health (BH) Provider Engagement Program Manager is responsible for cultivating strong, collaborative relationships with behavioral ... mission and supporting high-quality, coordinated care for members. In this role, the Program Manager acts as an account manager , relationship manager , and… more
- Commonwealth Care Alliance (Boston, MA)
- …CA-Provider Engagement & Performance Position Summary: The Provider Delegation Performance Manager is responsible for overseeing and improving the performance of ... programs, working with clinical community partners responsible for care management and utilization management across CCA's One Care and SCO products. This role… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …home opportunity! Please note this position aligns to PST business hours.** The ** Manager , Case Management** Team is a Supervisor for Case Managers. This position is ... and direction of work processes to support cost and utilization variations. + Participate in the development, implementation, and...deficits with improvement plans and consistent follow-up. + As part of this role, you may be assigned internal… more
- Commonwealth Care Alliance (Springfield, MA)
- …medical and behavioral health patients. The SBHC functions within and is an integral part of a highly skilled interprofessional team model. The SBHC ensures that a ... influence the clinical outcomes of assigned patients by impacting acute care utilization , ensuring optimal treatment for behavioral health needs, and closing quality… more
- Commonwealth Care Alliance (Boston, MA)
- …Lead ongoing communication efforts, working closely with Provider Communications Manager , to keep providers informed of organizational objectives, regulatory ... Results-oriented and self-motivated, with the ability to work independently and as part of a team to meet departmental goals. - Demonstrates empathy, self-awareness,… more
- UNC Health Care (Smithfield, NC)
- …care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management ... and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and...date. **Licensure/Certification Requirements:** * Licensed to practice as a Registered Nurse in the state of North… more
- HCA Healthcare (Richmond, VA)
- …our nurses set us apart from any other healthcare provider. We are seeking a(an) Case Manager Registered Nurse RN PRN to join our healthcare family. ... At Henrico Doctors' Hospital, our nurses play a vital part . We know that every nurse 's path...passion for patient care. Apply today for our Case Manager Registered Nurse RN… more
- St. Luke's University Health Network (Allentown, PA)
- …regardless of a patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager is responsible for coordinating the complex ... the continuum of care. Also works with the providers, registered nurse care managers, social workers, and...members of care management, including but not limited to: RN care managers, assistants, coordinators, utilization management… more
- Tenet Healthcare (Detroit, MI)
- Registered Nurse ( RN ) - Case Manager ...growth and work-life balance. Ready to be a vital part of our mission? Apply today and bring your passion ... dedicated healthcare team where compassion meets innovation! As a Registered Nurse with us, you'll have the...and is determined by employment status Job Description: The RN Case Manager is responsible to facilitate… more
- AdventHealth (Mansfield, TX)
- …Required + 2 years Registered Nurse Work Experience Required + Registered Nurse ( RN ) License Required **Preferred qualifications:** + Certified Case ... **Our promise to you:** Joining AdventHealth is about being part of something bigger. Its about belonging to a...a growing business community. **The role you'll contribute:** The RN Care Manager in collaboration with the… more
- HCA Healthcare (Tomball, TX)
- **Description** **Introduction** Do you have the career opportunities as a Registered Nurse RN Case Manager PRN you want in your current role? We invest ... utilization ** **What qualifications you will need:** + **Current Registered Nurse License in the State of...encourage you to apply for our Registered Nurse RN Case Manager PRN… more
- AdventHealth (Orlando, FL)
- …nursing experience [Required] + Registered Nurse ( RN ) [Required] **Preferred qualifications:** + Prior Care Management/ Utilization Management ... **Our promise to you:** Joining AdventHealth is about being part of something bigger. Its about belonging to a...ROLLINS STREET, Orlando, 32803 **The role you'll contribute:** The RN Care Manager in collaboration with the… more
- Texas Health Resources (Arlington, TX)
- Registered Nurse ( RN ) Care Transition Manager - Full Time Work location: Texas Health Arlington 800 W. Randol Mill Road TX 76012 Work hours: Full Time - ... discharge planning. Assesses and interviews patient and caregivers as part of this evaluation and as needed. Reviews the...acute care case management experience preferred. Licenses and Certifications RN - Registered Nurse Upon… more
- AdventHealth (Ormond Beach, FL)
- ** Registered Nurse RN Care Manager ** **-** **AdventHealth Hospice** **All the benefits and perks you need for you and your family:** + Up to $5,000 Sign ... **Our promise to you:** Joining AdventHealth is about being part of something bigger. Its about belonging to a...role you'll contribute:** The Home Health Registered Nurse ( RN ) Care Manager is… more
