- Mindlance (Syracuse, NY)
- Job Title: Travel Nurse / Registered Nurse Job Location: Syracuse, NY Zip Code: 13201 Top 3/5 Skills: RN, UAS Assessments, NYS License Summary Description: ... and health care services for members; The SN UAS Nurse may also perform other technical and administrative tasks...understanding of multiple areas, including but not limited to UM and CM , Fair Hearings and Appeals/Grievances,… more
- Ventura County (Ventura, CA)
- Medical Management Nurse Senior- UM , CM /DM, &/or QA (Updated) Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4280743) Apply Medical ... Management Nurse Senior- UM , CM /DM, &/or QA...to County employees and their covered dependents. The Senior Registered Nurse -Ambulatory Care series is distinguished from… more
- ERP International (Camp Pendleton, CA)
- **Overview** ERP International, LLC is seeking a ** Registered Nurse - Case Manager** for a full-time position supporting **Branch Health Clinic Port Hueneme, ... software, and databases for community resources. * Integrate CM and utilization management ( UM ) and integrating...Licensure:** Current, full, active and unrestricted license as a Registered Nurse Security** : Must possess ability… more
- The Arora Group (Mayport, FL)
- Registered Nurse Case Manager Nurse... software, databases for community resources, etc. + Integrate CM and utilization management ( UM ) and integrate ... Medical Home Port at Naval Branch Health Clinic Mayport. Registered Nurse Case Manager is full-time position,...and ensure that the CMP meets established case management ( CM ) standards of care. Assist in coordinating a multidisciplinary… more
- The Arora Group (Goose Creek, SC)
- Registered Nurse Case Manager - Lead... software, and databases for community resources. + Integrate CM and utilization management ( UM ) and integrating ... Nurse Currently recruiting a Registered Nurse Case Manager - Lead to...and ensure that the CMP meets established case management ( CM ) standards of care. + Provide nursing expertise about… more
- The Arora Group (Coronado, CA)
- Registered Nurse Case Manager Nurse Currently recruiting a Registered Nurse (RN) Case Manager in Coronado, California, to work at Coronado Naval ... - Fri between 7:30AM - 8:00PM. DUTIES OF THE REGISTERED NURSE CASE MANAGER (RN): + Perform... software, and databases for community resources. + Integrate CM and utilization management ( UM ) and integrating… more
- The Arora Group (Twentynine Palms, CA)
- Registered Nurse Case Manager Nurse Currently recruiting a Registered Nurse (RN) Case Manager near Palm Springs, California, to provide care to ... - Fri between 7AM - 6PM. DUTIES OF THE REGISTERED NURSE CASE MANAGER (RN): + P...planning, implementation, coordination, and monitoring. + Integrate case management ( CM ) with utilization management ( UM ) and disease… more
- ERP International (Little Rock AFB, AR)
- **Overview** ERP International is seeking a ** Registered Nurse - Case Management** for a full-time position supporting **Little Rock AFB, Arkansas** . Apply ... software, and databases for community resources. * Integrate CM and utilization management ( UM ) and integrating...Licensure:** Current, full, active and unrestricted license as a Registered Nurse Security** : Must possess ability… more
- The Arora Group (Bethesda, MD)
- Registered Nurse Case Manager Nurse...as necessary. + Document as directed, the Case Management ( CM ) workload and patient care plans, MEPRS, EOM reports, ... for each two-week period will be provided one month in advance. DUTIES OF THE REGISTERED NURSE CASE MANAGER (RN): The contracted RN shall provide the following… more
- ERP International (Tinker AFB, OK)
- **Overview** ERP International, LLC is seeking a ** Registered Nurse - Utilization Managment** for a full-time position supporting **Medical Managment** in ... software, and databases for community resources. * Integrate CM and utilization management ( UM ) and integrating...or pending adverse actions) to practice nursing as a registered nurse in any US state/jurisdiction. Security**… more
- ERP International (Tinker AFB, OK)
- **Overview** ERP International, LLC is seeking a ** Registered Nurse - Case Manager** for a full-time position supporting **SHG Clinic** in support of **Tinker ... software, and databases for community resources. * Integrate CM and utilization management ( UM ) and integrating...or pending adverse actions) to practice nursing as a registered nurse in any US state/jurisdiction. Security**… more
- LA Care Health Plan (Los Angeles, CA)
- …Medicaid Services(CMS) requirements for health plan compliance with UM or CM . Licenses/Certifications Required Registered Nurse (RN) - Active, current ... Utilization Management Nurse Specialist RN II Job Category: Clinical Department:...or HMO setting . Preferred: Managed Care experience performing UM and CM at a medical group… more
- Blue KC (MO)
- …of URAC and NCQA(R) guidelines and state and federal regulations. + Valid and active Registered nurse (RN) in Missouri and Kansas. + Valid and active ... Registered nurse (RN) licensure in all 50...Registered nurse (RN) licensure in all 50 states and the...level keyboarding skills + Intermediate level knowledge of FACETS UM , CM and claims applications. + Experience… more
- Actalent (Santa Barbara, CA)
- …@actalentservices.com** Description: The Health Plan Nurse Coordinator (HPNC) is a Registered Nurse who is assigned to one of several Health Services' ... services. These sub-specialized programs require the RN to perform UM or CM activities for a specific...Qualifications: General Duties and Responsibilities of the Health Plan Nurse Coordinator (HPNC): * Comply with HIPAA, Privacy, and… more
- Guthrie (Sayre, PA)
- Summary The Registered Nurse (RN) Utilization Management ( UM ) in collaboration with Care Coordination, Guthrie Clinic offices, other physician offices, ... Office, is responsible for developing, coordinating, and maintenance of UM processes based on regulatory and reimbursement requirements of...of patient status. + Collaborate and set standards with registered nurse (RN) case managers (CMs) and… more
- LA Care Health Plan (Los Angeles, CA)
- …team player. Must be able to work independently. Licenses/Certifications Required Registered Nurse (RN) - Active, current and unrestricted California ... is responsible for executing the day-to-day operations of the UM department, and monitoring the Care Management ( CM... UM department, and monitoring the Care Management ( CM ) staff's responsibilities and activities. This includes, but not… more
- LA Care Health Plan (Los Angeles, CA)
- …Medicaid Services(CMS) requirements for health plan compliance with UM or CM . Licenses/Certifications Required Registered Nurse (RN) - Active, current ... net required to achieve that purpose. Job Summary The Utilization Management ( UM ) Admissions Liaison RN II is primarily responsible for receiving/reviewing admission… more
- LA Care Health Plan (Los Angeles, CA)
- …accreditation guidelines and standards preferred. Licenses/Certifications Required Licenses/Certifications Preferred Registered Nurse (RN) - Active, current and ... for operational and administrative management of the Utilization Management ( UM ), Case Management ( CM ), and Managed Long...of the Utilization Management ( UM ), Case Management ( CM ), and Managed Long Term Supportive Services (MLTSS) teams… more
- Sutter Health (Salt Lake City, UT)
- …+ Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** + RN- Registered Nurse of California Upon Hire **TYPICAL EXPERIENCE:** + 2 years ... KNOWLEDGE:** + Demonstrates basic knowledge of the role of UM , Care Transition and/or CM for patients...to race, color, creed, religion, marital status, sexual orientation, registered domestic partner status, sex, gender, gender identity or… more
- Billings Clinic (Billings, MT)
- …Licenses * Healthcare Provider CPR Certification At hire * Current Montana license as a Registered Nurse At hire * Current working knowledge of payer and managed ... by respective payers and communicate any issues/denials to attending physician, CM , and department leadership *Conducts UR until all tasks are completed;… more
