- Ochsner Health (Gretna, LA)
- …social services, home health, managed care, care management, case management or utilization review .CertificationsRequired - Current registered nurse (RN) ... to change at the company's discretion. EducationRequired - Registered nurse diploma.Preferred - Associate or bachelor's degree in nursing.Work ExperienceRequired… more
- TrackFive (Honolulu, HI)
- …for acute care. Discusses with physicians, the appropriateness of resource utilization , consultations, treatment plan, estimated length of stay and discharge plan. ... Focuses on complex patients, frequent emergency department utilizers, chronic pain and...frequent emergency department visitors by conducting a focus study review of the previous and current admissions. 27217591EXPPLATJob RequirementsSubmission… more
- TrackFive (San Diego, CA)
- …care patient experience. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the timely ... the achievement of optimal health, access to care, and appropriate utilization of resources balanced with the patients' self -determination while coordinating… more
- Sonder Health Plans, Inc. (Atlanta, GA)
- …for you to join us. Sonder Health Plans is looking for a full-time Utilization Management Nurse to make sure our health services are administered efficiently ... quality audits, chart audits and reviews of medical records as needed for either complex high cost cases or cases with quality of care issues *Coordinate case… more
- AmeriHealth Caritas Health Plan (Wilmington, DE)
- …to efficiently document and assess patient cases Strong understanding of utilization review processes, including medical necessity criteria, care coordination, ... compliance Demonstrated ability to meet productivity standards in a fast-paced, high-volume utilization review environment Your career starts now. We are looking… more
- Curative HR LLC (Austin, TX)
- … Nurse Practitioners, Care Coordinators, and Operations, to optimize utilization management processes and improve member outcomes. Contribute to the development, ... years of clinical practice experience. Minimum of 2-3 years of experience in utilization management, medical review , or prior authorizations within an insurance… more
- Team Select Home Care (Salem, NH)
- …Control Plan, EMS Plan and the Compliance Plan Participates in clinical record/ utilization review of medical records and quality assurance and performance ... purpose? Join Team Select Home Care as a Registered Nurse (RN), where you'll bring comfort and confidence to...to families by delivering compassionate one-on-one care to medically complex children and adults in the comfort of their… more
- Texas Health and Human Services Commission (Austin, TX)
- …more. Explore more details on the Benefits of Working at HHS webpage. Functional Title: Nurse III Job Title: Nurse III/ Nurse Manager Agency: Health & Human ... a hub of excellence for forensic mental health and complex psychiatric care, with all facilities accredited by The...position below. Under the direct supervision of the Chief Nurse Executive/ Nurse Administrator/Assistant Chief Nurse … more
- Compu-Vision Consulting, Inc. (Lawrenceville, GA)
- OCCUPATIONAL SUMMARY The Registered Professional Nurse at Northside Hospital independently plans and provides professional nursing care to patients in accordance ... and in accordance with the scope of practice as defined by the Georgia Nurse Practice Act. The American Nurses Association's (ANA) Nursing: Scope and Standards of… more
- Elevance Health (Indianapolis, IN)
- …granted as required by law. The Medical Management Nurse is responsible for review of the most complex or challenging cases that require nursing judgment, ... and/or Provider on select cases, such as cases the nurse deems particularly complex , concerning, or unclear....experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or… more
- State of Colorado (Denver, CO)
- …is to provide the highest quality mental health services to persons with complex , serious, and persistent mental illness within the resources available. Our mission ... with hospital-wide mandatory training, (ie, CPR, infection control, safety, medication review , and seclusion/restraint), attending Code Blue events and drills, fire… more
- Veterans Health Administration (Aurora, CO)
- …accepted on an ongoing basis and will remain on file through 9-30-2025. Initial review will be conducted approximately two weeks from the release date of this ... education, orientation, competencies and providing quality improvement and outcomes utilization consultation. Demonstrates leadership in delivering and improving holistic… more
- Veterans Health Administration (Seattle, WA)
- …and Patient Flow services at the VA hospital in Seattle, Washington. The Nurse Manager directly supervises the RN Utilization Management/Discharge Planners, AMSA ... VA Puget Sound Healthcare System is recruiting for a Nurse Manager to perform supervisory duties with the Patient...patient care delivery, and supporting creative approaches to managing complex client care. The position directly supervises the RN… more
- Inside Higher Ed (Burlington, VT)
- …collaboration and value-driven health care. The Governance Board meets quarterly to review utilization data, discuss finances, and receive updates on all ... Care is affiliated with UVM's Department of Nursing. All nurse practitioners serve dual roles as faculty, mentoring undergraduate...Ability to work well at all levels within a complex academic medical center, fostering a spirit of collaboration… more
- The Emily Program (Atlanta, GA)
- …of all follow-up recommendations and a comprehensive discharge summary. Work with the Utilization Review team to provide psychiatric information to support the ... our clients at all levels of care. Position Overview The Psychiatric Nurse Practitioner is responsible for conducting psychiatric assessments and providing treatment… more
- Veterans Health Administration (Ann Arbor, MI)
- Summary The LTC Charles S. Kettles VA Medical Center is seeking a Registered Nurse (RN) for the Dialysis Clinic, aligned under Medicine Service, located in Ann ... Arbor, Michigan. The Dialysis Registered Nurse (RN) is responsible for providing competent, evidence-based gender-specific dialysis care to patients with oversight… more
- UC Davis Health (Sacramento, CA)
- …the collaborative management of patient care across the continuum, completing utilization review around LOC and authorization concerns, and intervening ... Clinical Case Manager facilitates the integration and coordination of major aspects of utilization review and discharge planning for patient needs. This position… more
- Veterans Health Administration (Butler, PA)
- Summary This Outpatient Mental Health (MH) Registered Nurse (RN) is located at the Butler VA Medical Center. This position is responsible for providing competent, ... education, orientation, competencies and providing quality improvement and outcomes utilization consultation. The incumbent independently provides patient centered and… more
- Palms Medical Group (Branford, FL)
- …achieved (Productivity, RVU etc.) Position Summary The Advanced Practice Registered Nurse (APRN) works independently or in collaboration with other healthcare ... Participate in community service and health promotion programs. Participate in the review of all medical policies, procedures and protocols. Perform any other duty… more
- UNC HEALTH (Raleigh, NC)
- …care and cost effectiveness through the integrating and functions of case management, utilization review and discharge planning. The Care Manager must be highly ... from CAPP as appropriate. As necessary meet with the Utilization Manager (UM) and SW after the meeting to...patient needs and concerns through scheduled touch points and review of documentation . Escalate urgent or complex… more
