- The Cigna Group (Hattiesburg, MS)
- …- preferred Spanish both conversational and written **Experience** : + Current Licensure as a LPN/ LVN or RN , in the state of residence in good standing. + ... Five (3-5) years recent experience in an acute-care environment, case -management or utilization management position (experience can... management position (experience can be a combination of LVN / RN licensure) + Previous HEDIS and/or CMS… more
- The Cigna Group (Mobile, AL)
- …- preferred Spanish both conversational and written **Experience** : + Current Licensure as a LPN/ LVN or RN , in the state of residence in good standing. + ... Five (3-5) years recent experience in an acute-care environment, case -management or utilization management position (experience can... management position (experience can be a combination of LVN / RN licensure) + Previous HEDIS and/or CMS… more
- CVS Health (Albany, NY)
- …and escalates quality of care issues under the guidance of a Registered Nurse . Utilizes influencing/motivational interviewing skills to ensure maximum member ... level of intervention. Uses judgment to determine when a case is triaged to the RN for...Evaluation and Documentation of Care. In collaboration with the registered nurse and the member (and, if… more
- Tenet Healthcare (Detroit, MI)
- RN Utilization Review FT Days - 2305004256 Description : The Detroit Medical Center (DMC) is a nationally recognized health care system that serves patients and ... case basis. This position integrates national standards for case management scope of services including: Utilization ...level of care Mentor and monitor work delegated to Utilization Review LVN /LPN and/or Authorization Coordinator as… more
- Tenet Healthcare (Detroit, MI)
- RN Case Manager FT Days Sign on Bonus... management experience preferred. 3. License to practice as a Registered Nurse in the State of Michigan. 4. ... cardiovascular services, hypertension, stroke prevention and heart failure. Job Description: The RN Case Manager is responsible to facilitate care along a… more
- AccentCare, Inc. (Grants Pass, OR)
- … case conference that ensure compliance KPIs (LUPAS, Paraprofessional Utilization , etc.). Perform other clinical coordination duties as assigned. Ensure services ... of AccentCare, Inc. Qualifications Clinical Support Specialist Job Qualifications RN or LVN /LPN with current licensure to practice nursing in the practicing… more
- Pipeline Health System, LLC (Toast, NC)
- Job Title: Case Manager- RN (8hrs.) Base Rate: $46.07 - $64.51 Job Summary: The Case Manager is responsible for managing and coordinating the care of the ... other professional staff to determine appropriate level of care, utilization of resources, length of stay and quality of...health care. Education: + N/A Licensure/Certifications: + Current professional RN , LPN, or LVN license issued and/or… more
- Molina Healthcare (Columbia, SC)
- **JOB DESCRIPTION** For this position we are seeking a ( RN ) Registered Nurse who must be licensed in the state you reside. We are looking for a Clinical ... Nurse Appeals RN to support our SC...Provides training, leadership and mentoring for less experienced appeal LVN , RN and administrative staff. **JOB QUALIFICATIONS**… more
- Elevance Health (Nashville, TN)
- …**LTSS Service Coordinator - RN Clinician** + Job Family: MED > Licensed Nurse + Type: Full time + Date Posted:Mar 26, 2024 + Anticipated End Date:Jun 30, ... case within the scope of licensure; provides supervision and direction to non- RN clinicians participating in the member's case in accordance with applicable… more
- Elevance Health (Morristown, NJ)
- …or ask you for payment as part of consideration for employment. **LTSS Service Coordinator - RN ** + Job Family: MED > Licensed Nurse + Type: + Date Posted:Apr ... **LTSS Service Coordinator- RN ** is responsible for overall management of member's case within the scope of licensure; provides supervision and direction to non-… more
- Elevance Health (Columbus, OH)
- …Clinician Non- RN ** is responsible for working under the direction/supervision of an RN , with overall responsibility for the member's case , as required by ... health care team, to ensure cost effective and efficient utilization of health benefits. + Decision making skills will...LVN , LSW, LCSW, LMSW or license other than RN (as allowed by state law) in applicable state(s)… more
- Universal Health Services (San Antonio, TX)
- …Diploma with 5 or more years of experience in mental health field and utilization review. LICENSURE/CERTIFICATION: LVN , RN , LPC or LMSW preferred. ... Joint Commission, CMS, Tricare standards. Computer skills and knowledge of basic case management/ utilization review principles. EDUCATION: Bachelor's degree in a… more
- Molina Healthcare (Glen Allen, VA)
- **JOB DESCRIPTION** For this position we are seeking a ( RN ) Registered Nurse or LMHP who lives in VIRGINIA and must be licensed for the state of VIRGINIA. ... or equivalent combination of Licensed Vocational Nurse ( LVN ) or Licensed Practical Nurse (LPN) with experience in lieu of RN license. + OR Bachelor's or… more
- Elevance Health (Beech Grove, IN)
- …**LTSS SERVICE COORDINATOR - CLINICIAN** is working under the direction/supervision of an RN , with overall responsibility for the member's case , as required by ... health care team, to ensure cost effective and efficient utilization of health benefits. + Decision making skills will...LVN , LSW, LCSW, LMSW or license other than RN (as allowed by state law) in applicable state(s)… more
- Elevance Health (Memphis, TN)
- …Coordinator - Clinician** this role will be working under the direction/supervision of an RN , with overall responsibility for the member's case , as required by ... health care team, to ensure cost effective and efficient utilization of health benefits. + Decision making skills will...LVN , LSW, LCSW, LMSW or license other than RN (as allowed by state law) in applicable state(s)… more
- Elevance Health (Richmond, VA)
- …The **LTSS Service Coordinator - Clinician** working under the direction/supervision of an RN , with overall responsibility for the member's case , as required by ... health care team, to ensure cost effective and efficient utilization of health benefits. + Decision making skills will...LVN , LSW, LCSW, LMSW or license other than RN (as allowed by state law) in applicable state(s)… more
- Elevance Health (Cary, NC)
- …Current, unrestricted LPN/ LVN , LSW, LCSW, LMSW or license other than RN (as allowed by state law) in applicable state(s) required. **Preferred Skills, ... counties.** **Schedule: Monday-Friday 8:30am-5pm EST** With overall responsibility for the member's case , as required by applicable state law and contract, the **LTS… more
- Universal Health Services (Madera, CA)
- … utilization management experience within a payer organization. License: CA RN , LVN /LPT license Additional Requirements: Knowledgeable in behavioral health ... We are currently seeking a forward thinking and compassionate UTILIZATION MANAGEMENT(UM) COORDINATOR. Facilitates a continuum of service while...JOB MAY BE PERFORMED WILL BE REVIEWED ON A CASE BY CASE BASIS. + Ability to… more
- Western Sierra Medical Clinic Inc (Kings Beach, CA)
- …the position is 4 days a week Monday - Thursday. GENERAL DESCRIPTION Under medical provider, RN , or LVN direction and operating within the scope of practice as a ... and notifying provider as necessary. Follows clinic procedures in case of emergency and is knowledgeable and able to...care could also result in malpractice suits. * Resource Utilization * Appropriate use and knowledge of equipment and… more
- Universal Health Services (Kingwood, TX)
- …Minimum of two (1) years experience in UR or Case Management. + LPC, LMSW, LVN or RN license preferred. + CPR and HWC Crisis Intervention training must be ... for a virtual Facility Tour (https://kingwoodpines.com/about-us/our-campus/) Position Summary The Utilization Review (UR) Coordinator will perform admission and continued-stay… more