- Elevance Health (FL)
- …outpatient professional treatment health benefits through telephonic or written review. The BH Care Manager ( UM ) job progression is primarily a ... **JR169828 Behavioral Health Care Manager II** Responsible for managing...behavioral healthcare in a cost-effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to… more
- Healthfirst (NY)
- …authorization, concurrent review, and service requests** **Lead, coach, and develop UM managers overseeing interdisciplinary teams of registered nurses, social ... from an accredited institution or equivalent work experience** **NYS RN ** **Demonstrated understanding of UM regulatory requirements,...Care Plan (MLTCP)** **Experience working as a case manager for a long-term care programs such… more
- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management ( UM ) Reviewer is responsible for day-to-day timely ... Ensures accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying...applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance… more
- Elevance Health (Washington, DC)
- …management specialists. + Manages resource utilization to ensure appropriate delivery of care to members, adequate coverage for all tasks and job responsibilities. + ... a must for this position. + A current unrestricted RN license issued by the Commonwealth of Virginia is...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Veterans Affairs, Veterans Health Administration (Hines, IL)
- …utilization of resources and care coordination. Responsibilities The Utilization Management ( UM ) Consultant Registered Nurse ( RN ) demonstrates ... ( UM ) RN reports to the UM Manager RN . The ...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- ERP International (Hurlburt Field, FL)
- **Overview** ERP International is seeking a full time ** Registered Nurse ( RN ) Case Manager ** in support of the 1st Special Operations Medical Group at ... Counselor (CRC) American Nurses Credentialing Center Nurse Case Manager ( RN -NCM) National Academy of Certified Care Managers: Care Manager… more
- ERP International (Twentynine Palms, CA)
- …Counselor (CRC) o American Nurses Credentialing Center Nurse Case Manager ( RN -NCM) o National Academy of Certified Care Managers: Care Manager ... **Overview** ERP International is seeking ** Registered Nurse ( RN ) Case...**Be the Best!** Join our team of exceptional health care professionals across the nation. Come discover the immense… 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 ... **Be the Best!** Join our team of exceptional health care professionals across the nation. Come discover the immense...or pending adverse actions) to practice nursing as a registered nurse in any US state/jurisdiction. Security**… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …varied clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, ... All Levels + Associates degree required. Bachelor's degree preferred. + Active NYS RN or Registered Dietician or Physical Therapist licensure required. + Minimum… more
- Vanderbilt University Medical Center (Nashville, TN)
- …negative elements. **Position Qualifications:** **Responsibilities:** **Certifications:** LIC- Registered Nurse - Licensure-OthersLicensure-Others **Work ... mission is to advance health and wellness through preeminent programs in patient care , education, and research. **Organization:** TMO/ UM Team E **Job Summary:**… more
- Cedars-Sinai (Beverly Hills, CA)
- …the Los Angeles Fair Chance Initiative for Hiring. **Req ID** : 12949 **Working Title** : Registered Nurse - ISP Care Coordinator - PER_DIEM 8 Hour Days ... are transitioning to the Skilled Nursing Facilities, refers to nurse practitioner and case manager assigned to...nursing (Medical Surgical/Tele/ICU) with 2 or more year of care management experience ( UM or DC Planning).… more
- University of Michigan (Ann Arbor, MI)
- REGISTERED NURSE / FLIGHT NURSE SPECIALIST :...pediatric ICU (does not include Neonatal ICU) experience as a RN in a referral center / tertiary care ... Curriculum is to prepare the proficient emergency / critical care nurse for clinical practice as a...employer. **Job Detail** **Job Opening ID** 270230 **Working Title** REGISTERED NURSE / FLIGHT NURSE SPECIALIST… more
- ERP International (Luke AFB, AZ)
- …full, active, and unrestricted license to practice as a Registered Nurse , any state. Clinical Certification:** Certified Case Manager by Commission for ... **Overview** ERP International is seeking a full time ** Registered Nurse - Case Management** in...**Be the Best!** Join our team of exceptional health care professionals across the nation. Come discover the immense… more
- University of Miami (Miami, FL)
- …worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Registered Nurse works as a part of ... a team to provide quality care to designated patients. The RN works...effectively and cooperatively in groups/teams to ensure quality patient care . Communicates effectively with directors and/or manager … more
- University of Miami (Miami, FL)
- …not require direct physician involvement as per physician orders and within the scope of RN licensure 7. Renders dire ct patient care by assisting providers with ... any abnormal results (non - critical values) to the nurse who in turn will contact the physician accordingly...and cooperativel y in groups/teams to ensure quality patient care . 21. Communicates effective with manager and… more
- Veterans Affairs, Veterans Health Administration (Middleton, WI)
- Summary The Revenue Utilization Review (RUR) nurse is under the supervision of the Nurse Manager and ANM. The RUR nurse is an active member of the ... Services, Compliance, Providers, Health Information Management (HIM), Utilization Management ( UM ), and Community Care . Completes 4-6 month...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Corewell Health (Grand Rapids, MI)
- …clinical nursing and or case management/managed care or related field Preferred + Registered Nurse ( RN ) - State of Michigan Upon Hire required + ... (4 hours), mostly remote, occasional on-site About the Department: RN UM - Supporting the insurance coordination...prior authorizations, initial reviews, continuous stay reviews and appeals. Nurse Care Manager - Plans… more
- OhioHealth (Columbus, OH)
- …State of Ohio Board of Nursing, BLS - Basic Life Support - American Heart Association, RN - Registered Nurse - Ohio Board of Nursing **Additional Job ... careers and in our communities. **Job Description Summary:** The Care Manager works in partnership with patients,...**Work Shift:** Day **Scheduled Weekly Hours :** 40 **Department** UM Care Coord-South Central Hu Join us!… more
- Providence (Santa Rosa, CA)
- …daily operations oversight of the RN Case Managers in the Care Management Department. The Manager role models proactive, collaborative working relationships ... **Description** RN Manager - Case Management unit...Manager (ACM) upon hire + For Case Management/ UM Review: Strong operations experience. **Why Join Providence?** Our… more
- University of Southern California (Alhambra, CA)
- …InterQual guidelines, and Medicaid/Medicare contracts and benefit systems. Required Licenses/Certifications: + Req Registered Nurse - RN (CA DCA) + Req Basic ... daily assigned caseload, as assigned by the Lead Ambulatory Care Manager . 3. Assess physical and biopsychosocial...the status and processing of requests received from ambulatory care management nurse . 8. Assesses ongoing discharge… more