- TrackFive (Colorado Springs, CO)
- …ORYX Core Measures, and accreditation bodies (TJC & HFAP) preferred. Case Management experience including utilization review and discharge planning preferre ... have current RN License, Quality Experience, TJC and CMS Experience ** Onsite ONLY** Position Highlights: Position: Quality RN Job Type: Full-Time Location:… more
- UnitedHealth Group (Lacey, WA)
- …(as indicated) according to CMS criteria When H&C Transitions is delegated for utilization management , review referral requests that cannot be approved for ... the business Keep current on federal and state regulatory policies related to utilization management and care coordination (CMS guidelines, Health Plan policies,… more
- CenCal Health (Santa Barbara, CA)
- …Central Coast Salary Range: $84,877 - $123,072 Annually Job Summary The Health Plan Nurse Coordinator - Adult Utilization Management (HPNC - Adult UM) ... is a Registered Nurse assigned to the Utilization Management unit. This position reports to...UM will be responsible for performing utilization management activities, which may include telephonic or onsite… more
- Elevance Health (Indianapolis, IN)
- …End Date: 2025-08-01 Position Title: Med Mgmt Nurse (US) Job Description: Medical Management Nurse Work schedule: M-F 8:00am to 5:00pm EST. Will work 2-3 ... accommodation is granted as required by law. The Medical Management Nurse is responsible for review of...experience and requires a minimum of 2 years clinical, utilization review, or managed care experience; or any combination… more
- Kaiser Permanente (Antioch, CA)
- …resources in assigned clinical areas to ensure appropriate assignment and utilization ; supervising the use and maintenance of equipment, supplies and medications; ... development to talent for growth opportunities; supports execution of performance management guidelines and expectations. Implements, adapts, and stays up to date… more
- Kaiser Permanente (South San Francisco, CA)
- …human resource, employee, department safety, care experience, and risk- management issues. Essential Responsibilities: Recommends developmental opportunities for ... development to talent for growth opportunities; supports execution of performance management guidelines and expectations. Implements, adapts, and stays up to date… more
- Veterans Health Administration (Aurora, CO)
- …responsibility for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care. This is ... education, orientation, competencies and providing quality improvement and outcomes utilization consultation. Demonstrates leadership in delivering and improving holistic… more
- Kaiser Permanente (Clackamas, OR)
- …resource needs in several clinical areas to ensure appropriate assignment and utilization ; managing the use and maintenance of equipment, supplies and medications; ... opportunities; strategically evaluates talent for succession planning; sets performance management guidelines and expectations across teams / units. Oversees… more
- Veterans Health Administration (Seattle, WA)
- …Washington. The Nurse Manager directly supervises the RN Utilization Management /Discharge Planners, AMSA Discharge Coordinators, Patient Access Center ... managing complex client care. The position directly supervises the RN Utilization Management /Discharge Planners, AMSA Discharge Coordinators, Patient Access… 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
- Kaiser Permanente (Santa Rosa, CA)
- …resource needs in clinical areas to ensure appropriate assignment and utilization ; evaluating the use and maintenance of equipment, supplies and medications; ... oversees the recruitment, selection, and development of talent; ensures performance management guidelines and expectations to achieve business needs. Stays up to… more
- Blue Cross and Blue Shield of Minnesota (St. Paul, MN)
- …difference, join us. The Impact You Will Have This job implements effective utilization management strategies including: review of appropriateness of pre and ... relevant clinical experience. 1+ years of managed care experience (eg case management , utilization management and/or auditing experience). Bachelors degree… 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
- UNC HEALTH (Raleigh, NC)
- …of care and cost effectiveness through the integrating and functions of case management , utilization review and discharge planning. The Care Manager must be ... discharge plan. Refer administrative tasks (eg, faxing, form processing) to Care Management Assistant. Consult Social Worker and/or Utilization Manager per… more
- NR Consulting (Dallastown, PA)
- …from the RN as necessary. At the direction of the RN, participates in Utilization Management or Interdisciplinary Care Management Meeting to facilitate ... Job Name- Licensed Practical Nurse Job Type- Local contract only Specialty- LPN...year of LPN experience. Preferred Skillset/Experience: N/A Work location- Onsite at 100 W Queen St Dallastown PA 17313… more
- Kaiser Permanente (Washington, DC)
- …Job Summary: The Patient Care Coordinator is responsible for overseeing the management and coordination of care for the acute inpatient population. The PCC ... collaborates with rounding MAPMG Hospital Based Service Physicians, patient/family, nursing, utilization review and other members of the healthcare team to assure… more
- Elevance Health (Los Angeles, CA)
- …Job Level: Non- Management Non-Exempt Workshift: Job Family: MED > Licensed Nurse Please be advised that Elevance Health only accepts resumes for compensation ... The LTSS Service Coordinator - RN Clinician is responsible for overall management of member's case within the scope of licensure; provides supervision and… more
- Lehigh Valley Health Network (Bethlehem, PA)
- …and quality outcomes. Manages care and resources to reduce unnecessary utilization and collaborates in the development and implementation of performance improvement ... and makes suggestions for areas of improvement. Establishes patient care management plans, interventions, treatment goals, and self- management goals and… more
- Kaiser Permanente (La Mesa, CA)
- …a clinical practice expert/resource to staff. Participates in program management , including licensing, budgeting, utilization and quality assessment/improvement ... state and local regulations. Monitors the quality of service/care, utilization and standards. Essential Responsibilities: Responsible for first line supervision… more
- Trinity Health (Syracuse, NY)
- …to providing quality care and excellent outcomes. RN Supervisor - Capacity Management Hub Night Shift Position Purpose: This leadership position directs patient care ... adequate care coverage to promote safe quality care coverage 24/7. Coordinate bed management for all admissions and transfers throughout the hospital to achieve most… more
