- Right Hire Consulting (Lowell, MA)
- About the job Psychiatric Mental Health Nurse Practitioner - Hybrid (PMH NP) You'll Love This Role Meaningful Benefits Include: Sign-On Bonus Choice of Three ... services to patients in long-term care settings as a Nurse Practitioner (NP) . This role offers flexible work...role offers flexible work arrangements, including in-person, telehealth, and hybrid models, allowing you to find the best fit… more
- Blue Shield of California (Long Beach, CA)
- …preferred. Requires relevant behavioral health experience. Comprehensive knowledge of case management , discharge planning, utilization management , disease ... 10:30-7:00 F 9:30-6:00 Your Role The Behavioral Health Registered Nurse Case Manager will report to the FEP Department...The Federal Employee Program (FEP) team performs integrated case management (CM) and disease management (DM) activities… more
- Elevance Health (Norfolk, VA)
- …RN license from the Commonwealth of Virginia is required. Preferred Qualifications Utilization Management ; discharge planning in an inpatient setting, home ... Anticipated End Date: 2025-07-28 Position Title: RN Nurse Case Manager I (Tidewater) Job Description: LOCATION:...I (Transition of Care) is responsible for performing care management within the scope of licensure for members with… more
- Iconma LLC (Detroit, MI)
- Our Client, a Health Insurance company, is looking for a Registered Nurse -Review Analys for their Detroit, MI/ Hybrid location. Responsibilities: Perform ... clinical experience which may include acute patient care, discharge planning, case management , and utilization review, etc. Demonstrated clinical knowledge and… more
- Zenith (Sarasota, FL)
- This role is eligible to participate in Zenith's hybrid work schedule which provides the flexibility to work from home on select days of the week according to the ... and communicate with medical providers to obtain the best outcome. Assists management in identifying areas of opportunity based on current medical billing… more
- DaVita, Inc. (Owensboro, KY)
- …required. Preferred Qualifications: 2+ years of Case Management or Chronic Care Management 1+ years of utilization management experience DaVita IKC ... of America As a DaVita Integrated Kidney Care Registered Nurse (RN) Case Manager you will support some of...Owensboro, KY area. Must live locally. Position Details: Location: Hybrid -Remote. Work from home (telehealth) and travel within an… more
- Strive Health (Grand Rapids, MI)
- …outcomes for people with kidney disease, reducing emergency dialysis and inpatient utilization . Our high-touch care model integrates with local providers and uses ... in healthcare. Join us in making a real difference. Benefits & Perks Hybrid -Remote Flexibility -Work from home while fulfilling in-person needs at the office,… more
- VA Maine Healthcare System (Augusta, ME)
- …include, but are not limited to: Supports clinics regarding clinic profile management . Collects and updates insurance information from Veterans, family members and ... the data into VISTA if applicable. Promotes Veterans registration for and utilization of MyHealthyVet (MHV) and kiosks usage. Follows procedures regarding Community… more
- Strive Health (Nashville, TN)
- …outcomes for people with kidney disease, reducing emergency dialysis and inpatient utilization . Our high-touch care model integrates with local providers and uses ... us in making a real difference. Benefits & Perks Hybrid -Remote Flexibility -Work from home while fulfilling in-person needs...needs while adhering to NCQA standards for complex case management . Communicates updates to the care team and family… more
- Elevance Health (Grand Prairie, TX)
- …Job Level: Non- Management Non-Exempt Workshift: Job Family: MED > Licensed Nurse Please be advised that Elevance Health only accepts resumes for compensation ... hands-on engagement. The LTSS Service Coordinator-RN is responsible for overall management of member's case within the scope of licensure; provides supervision… more
- Medical Information Technology, Inc. (Canton, MA)
- …health record solutions and services to C-suite, boards, physician and nurse leadership, and other senior healthcare leaders at health systems, independent ... those which impact hospitals and health systems Maintaining active territory management and engagement to achieve assigned individual performance and bookings… more
- Highmark Health (Buffalo, NY)
- Company : Highmark Inc. Job Description : JOB SUMMARY *This role is a hybrid role in the Greater Buffalo Area with offsite travel up to 50% in the Buffalo area This ... result in the greatest ROI for the Organization. Further, in a matrix management environment, will be responsible for collaborative work with the other members of… more
- Humana (Charleston, WV)
- **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...appropriate courses of action at an onsite facility. This hybrid position will have limited hours working at home… more
- Actalent (Sunrise, FL)
- Actalent is hiring a Utilization Management Nurse ! Job Description The Utilization Management Nurse (UMN) collaborates closely with the ... activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management ...medical record software. Work Environment This position offers a hybrid work schedule, with in-office work in Sunrise on… more
- Humana (Tallahassee, FL)
- **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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CareFirst (Baltimore, MD)
- …week. **ESSENTIAL FUNCTIONS:** + Trains staff on standards of practice of Utilization Management and reimbursement methodologies and treatment coding. + Manages ... who is willing and able to work in a hybrid model. The incumbent will be expected to work...medical practices and insurance benefit structures. + Proficient in utilization management processes, standards, and managed care.… more
- AmeriHealth Caritas (LA)
- …Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... in a fast-paced environment. ;The Clinical Care Reviewer - Utilization Management will also be counted upon...Degree in Nursing (BSN) preferred. + An active Registered Nurse (RN) license in good standing is required. +… more
- McLaren Health Care (Indianapolis, IN)
- We are looking for a Utilization Management RN, to join us in leading our organization forward. McLaren Integrated HMO Group (MIG) is a fully owned subsidiary of ... Inc. at https://www.mdwise.org/ . **Position** **Summary:** This position is responsible for utilization management functions. This includes but is not limited… more
- AmeriHealth Caritas (Washington, DC)
- …Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... overtime, and weekends based on business needs **Responsibilities:** + Conduct utilization management reviews by assessing medical necessity, appropriateness of… more
- WellSpan Health (Chambersburg, PA)
- …in the management of patient care between visits. + Assists in the management of patient utilization of health care system and provides patient education ... **Schedule** 8:00a - 5:00p Monday - Friday Once trained, Hybrid Schedule - 3 days office/2 days remote Sign-on...year Clinical nursing experience. Required **Licenses:** + Licensed Practical Nurse Upon Hire Required or + Licensed Practical … more
