- Corvel (Tallahassee, FL)
- …orthopedics, neurology, or rehabilitation preferred Strong cost containment background, such as utilization review or managed care helpful Certification as a ... The Telephonic Case Manager coordinates resources and creates flexible,...BSN desirable Graduate of accredited school of nursing Current RN Licensure in FL 3 or more years' of… more
- Cedars Sinai (Marina Del Rey, CA)
- …the established/communicated timeframe Documents appropriate reviews for assigned patients using utilization review tool. Provides telephonic review ... us one of America's Best Hospitals! What You Will Do in This Role: A Registered Nurse Case Manager plans and coordinates care of the patient from… more
- Pyramid Consulting, Inc. (Wolfforth, TX)
- Immediate need for a talented Senior LTSS Service Care Manager ( RN ) . This is a 06+months contract opportunity with long-term potential and is located in Lubbock TX ... (Remote) . Please review the job description below and contact me ASAP...in the field or you may be working on telephonic follow ups from your home office. We carry… more
- UnitedHealth Group (Durham, NC)
- …Experience in discharge planning Experience in utilization review , concurrent review or risk management Experience in a telephonic role Experience in ... for other roles you may be interested in. Required Qualifications: Current, unrestricted RN license in the state of North Carolina Certified in Basic Life Support… more
- Albany Med (Albany, NY)
- …(United States of America) Salary Range: $60,028.00 - $99,023.00 Salary range: $33/hr. - $47.60/hr. Registered Nurse ( RN ) - Full Time HIV Medicine Clinic - ... advanced practice provider (APP) and the supervision of the Nurse Manager ( RN ) and/or Nurse ...Nursing program is required *Current NYS license as a Registered Nurse is required *Minimum of 1-2… more
- Nuvance Health (Poughkeepsie, NY)
- …preferred. Must have current RN license. Preferred experience in Utilization Review /Management. Location: Vassar Brothers Medical Center Work Type: Full-Time ... affiliates, Position Summary: Under the general supervision of the Director, The Nurse Case Manager role provide clinically-based case management to support the… more
- AdventHealth (Altamonte Springs, FL)
- …Remote **The role you'll contribute:** A Workers Comp Support Registered Nurse is responsible for providing telephonic medical case management for Workers ... injuries and rehabilitation is essential **LICENSURE, CERTIFICATION, OR REGISTRATION REQUIRED:** + Active Registered Nurse ( RN ) license in the state of… more
- Option Care Health (Austin, TX)
- …and/or Experience Requirements:** + Graduate of an accredited school of nursing + Current Registered Nurse ( RN ) licensure in the state of practice + ... telephonic nursing support and management. + Provide excellent communication to nurse colleagues regarding patients on service with review of current status,… more
- CVS Health (Austin, TX)
- …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... in a hospital setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- Humana (Hallandale Beach, FL)
- …+ Bachelor's degree in social work or behavioral health-related field + Active licensed Registered Nurse , RN in the state of Florida without disciplinary ... ensure interaction between the company and members are optimized. The Telephonic Behavioral Health Care Manager Internship provides transitioning service members… more
- Access Dubuque (Dubuque, IA)
- …office and is also available remotely within Iowa. **Key Responsibilities:** + Provide telephonic case management and utilization review for assigned ... Bilingual RN Case Manager **Cottingham & Butler/ SISCO** 1...Minimum 2 years of clinical practice. Case management or utilization review experience strongly preferred. + **Skills:**… more
- ICW Group (Lisle, IL)
- …Discharge Planning, or Home Health preferred. **CERTIFICATES, LICENSES, REGISTRATIONS** Current unrestricted Registered Nurse ( RN ) or Licensed Vocational ... evaluate needs for treatment in worker's compensation claims. The Telephonic Nurse Case Manager will negotiate and...+ Interfaces with external agencies in relation to the utilization review process including, Third-Party Payers, Insurance… more
- US Tech Solutions (Columbia, SC)
- **Duration: 3+ Months Contract (Possible Extension)** **Job Description:** + Must be an RN in SC and have an active and unrestricted SC RN license. + ... promote quality, cost effective outcomes. + Performs medical or behavioral review /authorization process. Ensures coverage for appropriate services within benefit and… more
- LA Care Health Plan (Los Angeles, CA)
- …requirements for health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... Utilization Management Nurse Specialist RN...Actively monitors for admissions in any inpatient setting. Performs telephonic and/or onsite admission and concurrent review ,… more
- Commonwealth Care Alliance (Boston, MA)
- …CCA-Auth & Utilization Mgmt **Position Summary:** The Sr Clinician, Behavioral Health Utilization Review will review behavioral health and substance use ... in behavioral health managed care preferred + Experience in behavioral health utilization review or medical necessity evaluation preferred **Required Knowledge,… more
- Cedars-Sinai (Marina Del Rey, CA)
- …the established/communicated timeframe + Documents appropriate reviews for assigned patients using utilization review tool. + Provides telephonic review ... Hospitals! **What You Will Do in This Role:** A Registered Nurse Case Manager plans and coordinates...in Nursing (preferred). **Certifications/Licenses:** + Current and valid California RN License (required). + Certified Case Manager (CCM) or… more
- Centene Corporation (Springfield, IL)
- …**Candidates must reside within 30 miles of Peoria.** **What We're Looking For:** + ** Registered Nurse ( RN ) with active Illinois license** + **Experience in ... case management and/or utilization review ** + **Previous work in an...4 - 6 years of related experience. **License/Certification:** + RN - Registered Nurse -… more
- Albany Medical Center (Albany, NY)
- …States of America) Salary Range: $60,028.00 - $99,023.00 Salary range: $33/hr. - $47.60/hr. Registered Nurse ( RN ) - Full TimeHIV Medicine Clinic - Albany, ... advanced practice provider (APP) and the supervision of the Nurse Manager ( RN ) and/or Nurse ...Nursing program is required* Current NYS license as a Registered Nurse is required* Minimum of 1-2… more
- Albany Medical Center (Albany, NY)
- …Work Shift: Day (United States of America) Salary Range: $60,028.00 - $99,023.00 Registered Nurse ( RN ) - Full Time Pediatric Endocrine Department ... advanced practice provider (APP) and the supervision of the Nurse Manager ( RN ) and/or Nurse ...may provide direct patient care, patient triage (in-person and telephonic ), assessment, planning, directing and evaluating of a patient's… more
- UPMC (Pittsburgh, PA)
- …Support (BLS) OR Cardiopulmonary Resuscitation (CPR) + Certified Case Manager (CCM) + Driver's License + Registered Nurse ( RN ) + Act 33 with renewal + Act 34 ... will support Shadyside Family Practice onsite in Shadyside and may provide telephonic support to other practices. The position will work standard daylight hours,… more
