- Humana (Jackson, MS)
- **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
- UCLA Health (Los Angeles, CA)
- Description The ED and SNF ICM Coordinator supports Medicare Advantage patients with frequent emergency department and skilled nursing facility utilization who ... to a case manager. Under the direction of the RN Assistant Director, this role provides non-clinical care coordination,...for identified high-risk and ICM-enrolled patients across ED, inpatient, SNF , and post-acute settings + Monitor hospital and … more
- Cedars-Sinai (CA)
- …as a condition of continued employment. **Req ID** : 13443 **Working Title** : Registered Nurse Care Coordinator- Inpatient Specialty Program - 8 Hour Days $5K ... nurse practitioner and case manager assigned to the SNF 's for continued review and follow up. + Authorizes...TPL carrier of all injured worker cases receiving case management services. + Ensures appropriate utilization of… more
- AmeriHealth Caritas (Washington, DC)
- **$5,000.00 SIGN ON BONUS** **Role Overview** Our Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient services, ensuring ... in the least restrictive and most effective manner. The Utilization Management Reviewer must maintain a strong...of 3 years of diverse clinical experience as a Registered Nurse in an Intensive Care Unit… 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
- 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
- ChenMed (Richmond, VA)
- …We're rapidly expanding and we need great people to join our team. The Nurse Case Manager 1 ( RN ) is responsible for achieving positive patient outcomes ... post-acute facilities, as well as, their home environments. The Nurse Case Manager 1 ( RN ) role also...preferred providers. + Coordinates the integration of social services/case management functions in the pre-acute, ER, acute and post-acute… 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. * ... degree in nursing required **License/Certifications:** Active and unrestricted licensure as a Registered Nurse in Massachusetts. **Experience:** * A minimum of… more
- Accura Healthcare (Shell Rock, IA)
- …to ensure complete, current, and accurate medical records. QUALIFICATIONS: + Hold current Registered Nurse ( RN ) license with applicable state, without ... to welcome an Assistant Director of Nursing (ADON) - RN to join our team! We're seeking a skilled...join our team! We're seeking a skilled and compassionate registered nurse to manage and oversee the… more
- Catholic Health Initiatives (Lisbon, ND)
- …+ Graduate of an accredited nursing program. + Bachelor's in Nursing (BSN) + Registered Nurse License in the state of North Dakota (ND) **Preferred** + ... obtaining referrals, prior authorization for Home Health Care, DME, SNF , etc. + Acts as a patient advocate and...clinical experience in acute care settings + Prior Case Management / Utilization Review **Where You'll Work** CHI Lisbon… 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
- ChenMed (Columbus, OH)
- …We're rapidly expanding and we need great people to join our team. The Nurse Case Manager 1 ( RN ) is responsible for achieving positive patient outcomes ... post-acute facilities, as well as, their home environments. The Nurse Case Manager 1 ( RN ) role also...preferred providers. + Coordinates the integration of social services/case management functions in the pre-acute, ER, acute and post-acute… more
- Washington County Hospital and Clinics (Washington, IA)
- …Time Job Shift Day Category Health Care Description SUMMARY The Transitional Care Utilization RN coordinates seamless patient transitions across the continuum of ... of patient information during hospitalization with LTC facilities. coordinates WCHC SNF referrals and collaborates with insurance payors as needed. + Serves… more
- Sharp HealthCare (San Diego, CA)
- …3 Years case management , utilization review, care coordination 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
- 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)
- …**Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered ... 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
- Albany Medical Center (Albany, NY)
- …the field of Clinical Social Work or Nursing with experience in Case Management , Utilization Review and Discharge Planning. * BLS Certification. * Demonstrated ... principles of conflict resolution and promote consensus building.* Represents Case Management /Social Work at organizational committee meetings as directed* Serves as… more
- Atlantic Health System (Morristown, NJ)
- …, ED transfers, and avoidable acute escalations. + Collaborate with ACO and utilization management teams to support appropriate PAC placement, avoid over- ... + Strong background in care coordination, transitions of care, post-acute care, utilization management , and population health preferred. At Atlantic Health… more
- Pine Acres Rehabilitation & Care Center (Nebraska City, NE)
- …accountability to Administrator Reporting to this position: None Job Classification: Registered nurse with administrative duties/ management Position Purpose: ... a current, unencumbered, active license to practice as a registered nurse in Nebraska. Must have 3...primary resource for problem solving in regards to the SNF prospective payment system and quality reporting program. Infection… more
- UCLA Health (Los Angeles, CA)
- Description The ICM Oncology Coordinator supports Oncology RN Case Managers by providing non-clinical care coordination for Medicare Advantage patients with advanced ... cancer and high-acuity needs. Under the direction of the RN Assistant Director, this role focuses on timely referral and authorization processing, care coordination… more