- Humana (Lincoln, NE)
- **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...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Emory Healthcare/Emory University (Duluth, GA)
- …review of medical necessity for all inpatients, concurrent stay documentation per utilization management plan, verification and correction of patient status, ... educational opportunities to enhance health care teams knowledge of case management services; + Participates in and facilitates patient/family education and… more
- HCA Healthcare (Houston, TX)
- …service organizations, agencies and healthcare facilities. **What qualifications you will need:** + ( RN ) Registered Nurse + Associate Degree, or Bachelors ... from any other healthcare provider. We are seeking a(an) Registered Nurse Case Manager to join our...and overall evaluation of individual patient needs. Care coordination, utilization review and management , as well as… more
- Sutter Health (San Francisco, CA)
- …in nursing, case management or related field. **CERTIFICATION & LICENSURE** + RN - Registered Nurse of California (required) + CCM-Certified Case Manager ... Manager is responsible for Care Coordination, Care Transitions, Discharge Planning and Utilization Management throughout the acute care patient experience. The … more
- WMCHealth (Port Jervis, NY)
- Registered Nurse Company: St. Joseph's Place City/State: Port Jervis, NY Category: Nursing/Nursing Management Department: SNF -TCU Union: YES Union Name: ... - $55.73 Apply Now External Applicant link Internal Applicant link Job Details: The Registered Nurse provides professional nursing care in an assigned clinic or… more
- Beth Israel Lahey Health (Exeter, NH)
- Registered Nurse Case Manager + Full Time + Exeter, NH 03833 ... the patient's health care needs following the current phase of illness. **Requirements** + Registered Nurse - NH State or Compact State + BSN Preferred +… more
- Signature Healthcare (Louisville, KY)
- …Care documentation to facility accurate billing. What you Need to make a Difference + Registered Nurse ( RN ) in good standing with required current state ... with leadership, patients, families, internal care givers, and external Utilization Management Nurses. + Coordinate internal and...experience. + Minimum of three (3) years of hospital, SNF or Acute Rehab clinical experience + Certified in… more
- Sharp HealthCare (La Mesa, CA)
- …3 Years Recent acute care nursing experience or case management experience. + California Registered Nurse ( RN ) - CA Board of Registered Nursing ... Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA...and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge… more
- AmeriHealth Caritas (Washington, DC)
- …Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... overtime, and weekends based on business needs. **Responsibilities:** + Conduct utilization management reviews by assessing medical necessity, appropriateness of… more
- ChenMed (Philadelphia, PA)
- …RN with bachelor's degree in a related clinical field preferred + A valid, active Registered Nurse ( RN ) license in State of employment required + Compact ... the remaining hours. The Acute Care Manager, Complex Care ( RN ) is responsible for achieving positive patient outcomes, managing...required + A minimum of one (1) year of utilization review and/or case management , home health,… more
- Centene Corporation (Austin, TX)
- …4-6 years of related experience. Bachelor's degree in Nursing preferred **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact ... required + **Preferred Experience:** + 4+ year of Clinical Registered Nurse with experience in Acute Care...Medicine, LTC, SNF , or Nursing Rehab + RN Case Management or RN … more
- PeaceHealth (Vancouver, WA)
- …of stay consistent with external regulations and standards. + Provide utilization management including facilitating appropriate status assignment per Medicare ... have equivalent combination of education and/or experience) Credentials + Required: WA State Registered Nurse License + Required Upon Hire: Provider Basic Life… more
- Fallon Health (Worcester, MA)
- … Nurse in a clinical setting required. + 2 years' experience as a Utilization Management /Prior Authorization nurse in a managed care payer preferred. + ... in nursing required** **License/Certifications** + Active and unrestricted licensure as a Registered Nurse in Massachusetts. **Experience** + A minimum of three… more
- Billings Clinic (Billings, MT)
- …care. * Maintains respectful and professional communication skills. Insurance and Utilization Management *Maintains working knowledge of CMS requirements and ... * 1 Experience working in Billings Clinic, preferred. License and Certification * Current Registered Nurse license in the state of Montana, at hire Billings… more
- Arnot Health (Bath, NY)
- …of all duties that may be assigned. EDUCATION: Current New York State Registered Nurse Licensure. BSN preferred. Certification in nursing specialty desirable. ... with care team and therapies. + Demonstrates effective time management , flexibility and priority setting. + Promotes and ensures...of the Long Term Care Department. + Ensures the utilization of the nursing process in maintaining quality of… more
- Cedars-Sinai (Beverly Hills, CA)
- …Facilities, refers to nurse practitioner and case manager assigned to the SNF 's for continued review and follow up. + Authorizes all appropriate services based ... TPL carrier of all injured worker cases receiving case management services. + Ensures appropriate utilization of...Science degree in Nursing required **License/Certifications:** + Valid CA RN license required + Certified Case Management … more
- Cedars-Sinai (Beverly Hills, CA)
- …Facilities, refer to nurse practitioner and case manager assigned to the SNF 's for continued review and follow up. + Authorize all appropriate services based ... of acute nursing experience required + 3 years of previous experience in case management , discharge planning, utilization review, and HMO in the acute inpatient… more
- Actalent (Atlanta, GA)
- …+ Active RN license in GA or compact + 3+ years of case management experience + SNF /LTAC/AIR utilization review experience + Knowledge of CMS skilled ... or home. Collaborates with physicians, telephonic care coordinators, inpatient case management /social workers, telephonic to create a safe discharge plan for… more
- Tufts Medicine (Haverhill, MA)
- …our High Pointe House Facility in Haverhill, MA, and Skilled Nursing Facility management and oversight. Hours: Full Time 40 Hours Location: Lowell MA and Haverhill ... **Minimum Qualifications:** 1. Bachelor's degree in Nursing (BSN). 2. Massachusetts RN Licensure. 3. Five (5) years of palliative, hospice, complex care… more
- Sharp HealthCare (San Diego, CA)
- …**Job Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** California Registered Nurse ( RN ) - CA Board of Registered Nursing; ... or equivalent experience in the healthcare setting. + California Registered Nurse ( RN ) - CA...and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge… more