• DaVita Medical Group (Las Vegas, NV)
    …in the development of policies and procedures.MINIMUM JOB QUALIFICATIONS AND REQUIREMENTSEducation: Registered Nurse ( RN or LPN) with current, unrestricted ... to investigate member history and eligibility as appropriate, contact case managers and UM Clinical Support Staff to gather...excellent customer service to internal and external customers.The UM Nurse reports to the UM Manager .OTHER JOB… more
    DaVita Medical Group (05/16/18)
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  • Veterans In Healthcare (Columbus, OH)
    …trains, evaluates and supervises a staff of HEDIS Coordinators and Quality RN 's. Prepares presentations, training materials, manuals, audit tools and reports ... Job Description Manager , Quality & HEDIS - MediGold - Corporate...variety of professional roles including information technology, financial analysis, audit , provider relations and more. Job Description Details: The… more
    Veterans In Healthcare (04/30/18)
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  • CareGivers of America (Lauderhill, FL)
    …those deserving the ultimate care in the privacy of their home. As a Home Health RN Case Manager , you will: Review all Medicare episodic clinical records at ... by the Field RN while in the patient home Qualifications: Current FL Registered Nurse Minimum of three years clinical home care experience Minimum of one… more
    ZipRecruiter (05/18/18)
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  • Highmark Health (Los Angeles, CA)
    Job Description Description JOB SUMMARY This job supervises a team of Case Manager Supervisors who are charged with promoting quality member outcomes, to ... to LTSS Case Management services. ESSENTIAL RESPONSIBILITIES Manage a team of Case Manager Supervisors. Oversee the development of and updates to policies… more
    ZipRecruiter (05/17/18)
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  • Healthcare Source (Biddeford, ME)
    …and navigate the appeals process through the use of work queues and an audit manager database. The selected candidate will analyze and monitor trends, present ... This position offers a unique opportunity for a qualified RN to work with leadership and providers to reach...practices. Required Minimum Knowledge, Skills, and Abilities (KSAs) Current Registered Nurse Licensure from the Maine State… more
    Lensa (05/14/18)
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  • Regal Medical Group (Northridge, CA)
    …utilization management staff, home health care agencies, Employer home-visit physicians and nurse practitioners. 13. Provide regular audit reports on Program and ... Job Description Responsible for management and oversight of Case Management operations and related programs related to...current CA driver’s license and car insurance 11. Requires RN license, CCM certification preferred. We offer a full… more
    ZipRecruiter (04/29/18)
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  • Banner Health (Greeley, CO)
    …experience directly related to care management in health plan/mgmt./quality. Requires current Registered Nurse (R. N.) license in state worked. Requires ... societies. Oversees and is responsible for the quality of RN assessments. Assists with payer audit process surrounding NCQA, URAC, or any other regulatory agency… more
    Lensa (05/14/18)
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  • Sutter Health (San Francisco, CA)
    …Incumbent must also have the ability to schedule RN Case Manager training sessions, conduct and present audit findings, trends and program results to ... The incumbent serves as the Bay Area Operating Unit Case Manager (CM) Subject Matter Expert (SME)...and one-on-one training sessions with peers and new hire RN case managers, provide constructive feedback, and… more
    Jobs2Careers (04/16/18)
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  • Dependable Health Services (Tucson, AZ)
    Responsibilities:Position: RN ( Registered Nurse )Dual Role...in caring for their loved one.You will act as Case Manager for each client when assigned ... teach, train, evaluate, and supervise others. If you have case management and supervisory experience, that would be very...care.A Day in the life of our Dual Role RN ( Registered Nurse ) Patient Care… more
    Lensa (05/14/18)
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  • Florida Hospital (Kissimmee, FL)
    Case Manager RN - ...or Registration Required: Clear/Active Florida State license as a Registered Nurse Case Management certification highly ... in collaboration with the patient/family, social workers, physicians and interdisciplinary team, the RN Case Manager ensures patient progression through the… more
    Lensa (05/14/18)
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  • Florida Hospital (Orlando, FL)
    RN Case Manager - ...or Registration Required: Clear/Active Florida State license as a Registered Nurse Case Management certification highly ... Management - Orlando Florida Hospital Orlando seeks to hire RN Case Manager who will...department policy to support and ensure accurate billings, pro-active audit and denial management. Participates in the development of… more
    Lensa (05/14/18)
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  • UnitedHealth Group (Fort Myers, FL)
    …and help people live healthier lives while doing your life's best work.(sm) The Case Manager II - Inpatient Services performs onsite review or telephonic ... team, and the member and/or family / caregiver. The case manager is responsible for coordinating the...management applications to comply with documentation requirements and achieve audit scores of 90% or better on a monthly… more
    LatPro, Inc. (05/18/18)
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  • Gentiva (Birmingham, AL)
    …in-service programs and outside educational opportunities. Required Skills Qualifications: Licensed Registered Nurse Minimum of two years clinical home care ... my work is my calling. As a Home Health RN Care Manager , you will: Perform...the skills/abilities of the care team assigned to each case . Lead Care Team Conference of assigned team members… more
    Lensa (05/14/18)
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  • Santa Clara Family Health Plan (Campbell, CA)
    …Service Employees International Union (SEIU) Local No. 521. GENERAL DESCRIPTION OF POSITION The RN Case Manager is responsible for providing on-going case ... Plan (SCFHP) members. As a SCFHP member advocate, the RN Case Manager facilitates communication...organized in a manner that adheres to standards for audit requirements. Facilitate involvement of the member and/or family/responsible… more
    Lensa (05/14/18)
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  • Family Home Health Services Family Centered Hospice (Addison, IL)
    …relationships with others in the home care industry. Position Qualifications: 1. Registered nurse with current licensure to practice professional nursing in ... provide. We have an immediate opening for a Clinical Manager , who shares our mission to lead the way...to ensure proper assignment of appropriate clinicians to each case depending on the available patient information and home… more
    ZipRecruiter (04/20/18)
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  • KINDRED AT HOME (NC)
    …part-time and PRN positions.I believe my work is my calling.As a Home Health RN Care Manager , you will:Perform or delegate the initial and ongoing evaluation ... the skills/abilities of the care team assigned to each case .Lead Care Team Conference of assigned team members with...Team Conference of assigned team members with oversight by Manager Clinical Practice and collaborates with all team members… more
    Lensa (05/14/18)
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  • Anthem (Atlanta, GA)
    …WE CONTINUE TO SOURCE FOR TOP TALENT, THIS POSTING IS FOR FUTURE OPPORTUNTIES ONLY. Nurse Case Manager I Responsible for performing care management within ... in problem solving with providers, claims or service issues. Nurse Case Manager II Responsible...preceptor for new care management staff. Participates in department audit activities. Qualifications Requires a BA/BS in a health… more
    Lensa (05/14/18)
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  • United Surgical Partners International (Irving, TX)
    …care hospital. Baylor Surgical Hospital at Las Colinas is seeking an experienced RN Case Manager and Utilization Review nurse . The Case Manager ... Reports all RAC activity to the UR committee and administration. JOB REQUIREMENTS: Registered Nurse Previous case management and Utilization Review… more
    Lensa (05/14/18)
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  • Beacon of Hope Hospice (Davenport, IA)
    …off including 8 paid holidays, and tuition reimbursement. Are you a highly skilled Registered Nurse who is organized, has great assessment skills, good critical ... with our Nursing and hospice staff, the Patient Care Manager will oversee compliance, manage individual case ...a plan of care in a patient’s home. Conducts audit and ensures proper maintenance of medical records, patient… more
    ZipRecruiter (05/15/18)
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  • Detroit Medical Center (Detroit, MI)
    …Nursing, Business Administration or Hospital Administration preferred. 2. Licensed to practice as a Registered Nurse in the State of Michigan; 3. Three to five ... McKesson InterQual® experience preferred. Business planning experience preferred. 4. Accredited Case Manager (ACM) preferred. Category Directors / Managers /… more
    Ivy Exec (03/25/18)
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