- AmeriHealth Caritas Health Plan (Philadelphia, PA)
- …services. Discover more about us at www.amerihealthcaritas.com. Join a mission-driven Utilization Management team where your clinical expertise helps shape ... Multiple Opportunities | RN & Behavioral Health Licensure | Remote...ICU, ED, Med-Surg, pediatrics, behavioral health, or similar. Prior Utilization Management or managed care experience preferred.… more
- Mass General Brigham (Salem, MA)
- …preferred Can this role accept experience in lieu of a degree? No Licenses and Credentials Registered Nurse [ RN - State License] - Generic - HR Only required ... of Mass General Brigham. Ask us about our increased RN pay rates and differentials! Job Summary Summary The... pay rates and differentials! Job Summary Summary The Registered Nurse manages all aspects of the… more
- Magellan Health, Inc. (Frisco, TX)
- …- Licensed Professional Counselor - Care Mgmt, LSW - Licensed Social Worker - Care Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care ... with necessary degrees: CEAP, LMSW, LCSW, LSW, LPC or RN . Minimum 2 years experience post degree in healthcare,...time management and communication skills. Knowledge of utilization management procedures, mental health and substance… more
- Guidehealth (Rockford, IL)
- …comfortable and confident leading a team of certified but unlicensed personnel and Registered Nurse case managers Ability to read, analyze, and interpret the ... any concerns. Identifying and disseminating of Health Plan announcements applicable to Case Management Qualifications WHAT YOU'LL NEED TO HAVE RN /BSN required 5… more
- Bluestone Physician Services (Minneapolis, MN)
- …patients Qualifications: Education/Certification/Experience Licensed Social Worker or Registered Nurse 3-5 years of experience in case/care management or ... position allows for great work-life balance, with approximately 20% remote and 80% of the time allowing you to...care teams to ensure high quality team-based care Use utilization management tools to facilitate appropriate transitional… more
- NorthShore (Arlington Heights, IL)
- …Management Program is responsible for the case management , care coordination management , and utilization management of his/her population of patients ... for appropriate consultations and support services within established protocols Completes Utilization Management for assigned patients. Applies Milliman Care… more
- Strive Health (Newport News, VA)
- …high-quality care. Minimum Qualifications Associate's degree from accredited school of nursing. Current Registered Nurse ( RN ) license in the state of ... outcomes for people with kidney disease, reducing emergency dialysis and inpatient utilization . Our high-touch care model integrates with local providers and uses… more
- The Jane Pauley Community Health Center, Inc (Indianapolis, IN)
- …Experience: Graduation from accredited Nursing Program required. Current state licensure as a Registered Nurse required. Two years' experience as a triage, or in ... patients and employees Job Summary - Patient Care Coordinator, RN : The Patient Care Coordinator, RN is...years' experience in chronic disease management , case management , utilization management , and adult… more
- EmblemHealth (New York, NY)
- …required, with current active RN license CCM certification (Preferred) Certification in utilization or care management (Preferred) 4 - 6 years of clinical ... Experience in case management /care coordination, managed care, and/or utilization management (Preferred) Strong communication skills - verbal, written,… more
- LanceSoft (New York, NY)
- …New York State *Prefer minimum of 1-3 years relevant experience in case management , utilization review and/or quality assurance *Experience in acute episodic ... Job Description: Position Purpose: Provide case management and clinical services to employees within their...transitional (modified) or full return to work assignments. *Assist nurse practitioner as needed with patient care activities such… more
- LCG Boston (Boston, MA)
- …off to CCA in a timely manner. Supervisory Responsibilities Directly supervises RN Nurse Assessors Provides clinical backup by conducting urgent assessments ... Oversees all aspects of the operational and clinical work of the RN Nurse Assessors, including comprehensive MDS-HC and Supplemental Assessments Oversees… more
- Sanford Health (Bemidji, MN)
- …minimum of five years of clinical practice. Knowledge and experience in case management , utilization management and/or Coding highly preferred. Currently ... Hours: 40 Salary Range: $31 - $49.50 Union Position: No Department Details Remote Work Flexibility: Enjoy the option to work remotely, offering a better work-life… more
- Blue Cross and Blue Shield of Minnesota (Duluth, MN)
- …and disease management processes, skill sets and tools. This role requires a Registered Nurse ( RN ) licensed in the state of Minnesota with psychiatric ... and transition of care between settings. Required Skills and Experiences Registered Nurse with Psychiatric experience or Behavioral Health Professional… more
- CenterWell Primary Care (Duluth, GA)
- …Bachelor of Science in Nursing (BSN) strongly preferred. License/Certifications: Active and unrestricted Registered Nurse ( RN ) license or Compact State RN ... Branch Location : Duluth, GA This is not a remote or work-from-home position. This position requires you to...reliable transportation. Two years as a Registered Nurse with at least one-year of management … more
- HEALTH FIRST CAREERS (Melbourne, FL)
- …reimbursement analysts as necessary. Is an active member of the Utilization Management Committee. Work Experience MINIMUM QUALIFICATIONS Education: Associate's ... Job Requirements POSITION SUMMARY The Utilization Review (UR) nurse performs medical...Department Nursing Knowledge/Skills/Abilities: Current working knowledge of care transitions, utilization management , case management and… more
- VIA Health Partners (Fort Mill, SC)
- …Bachelor's Degree preferred. A current, active, and unrestricted compact (multistate) license as a Registered Nurse ( RN ) is required. The Nurse Licensure ... care. Conducts nursing assessments to assist in the overall management of patient/caregiver needs. Make visits to provide appropriate...Compact (NLC) allows a registered nurse ( RN ) and licensed practical/vocational … more
- Indiana University Health (Indianapolis, IN)
- …CCS-P, CPC, CIC, COG or CHDA (based on position/focus). Clinical Position - Requires an active Registered Nurse ( RN ) license in the state of Indiana or an ... active Nurse Licensure Compact (NLC) RN license. BSN...in revenue cycle operations in various positions related to utilization management , coding, billing, collections, payment adjustments,… more
- Ardent Health Services (Albuquerque, NM)
- Overview Join our team as a day shift, full-time, Community Outreach Programs Registered Nurse ( RN ) Population Health Coordinator in Albuquerque, NM. Why ... at least one year physician office experience (adult / family medicine). Quality Improvement, Case Management , Utilization Review, Risk Mgt./Safety experience more
- TriWest Healthcare (Phoenix, AZ)
- …and regulatory requirements, and HIPAA privacy regulations. Thorough knowledge of Case Management , Utilization Management , HIPAA Privacy and Security ... This posting is for RN 's with Behavioral Health and Chronic Disease experience....Management (DM) services to TRICARE beneficiaries. The DM nurse will collaboratively assess, plan, implement, coordinate, monitor and… more
- ambercare (Albuquerque, NM)
- …Bachelor's degree in Nursing; Master's degree preferred. Current state licensure as a Registered Nurse . Five years of healthcare experience; 3 years of home ... This position requires fifty percent travel and fifty percent remote work. Nursing license in the State of NM...in-person training and content development for an on-line Learning Management System (LMS) Develops yearly educational plan to ensure… more
