- 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
- The Jane Pauley Community Health Center, Inc (Indianapolis, IN)
- …care setting preferred. 2-5 years' experience in chronic disease management , case management , utilization management , and adult acute care preferred 1 ... Coordinator supports the promotion of health, disease prevention and management , teaching and education, developing nursing care plans, and...practice site. Patient Care Coordinator role will be a hybrid remote role. The Hybrid Remote terms… more
- Mindful Care (Hoboken, NJ)
- We are seeking Board Certified Psychiatric Mental Health Nurse Practitioners (PMHNP) to expand access to behavioral health care in your area. If you're passionate ... control over their schedule. We handle patient scheduling, prior authorizations, case management , billing, and other support functions. Our efficiency enables us to… more
- UnitedHealth Group (Puyallup, 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
- HonorVet Technologies (New York, NY)
- …(ie, private duty nursing and Consumer Directed Personal Assistance Services ) | Case management that is limited to utilization reviews for a health plan or ... must be under the impression they will be conducting hybrid Tele and in-field assessments Candidates can't do UAS...other duties as may be assigned by the Regional Nurse Manager or other project management . General… more
- Strive Health (Louisville, KY)
- …new enrollments/appointments. Provides health coaching to patients on disease and symptom management . Partners closely with the Strive Nurse Practitioner to ... outcomes for people with kidney disease, reducing emergency dialysis and inpatient utilization . Our high-touch care model integrates with local providers and uses… more
- Conifer Health Solutions (Federal Way, WA)
- …including attending physicians, allied health practitioners, nursing, and case management . ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may ... commitment while performing daily duties Must demonstrate initiative and discipline in time management and medical record review Travel may be required to meet the… more
- LCG Boston (Boston, MA)
- …(40 hours/week), Monday-Friday Compensation: $80/hour (Hourly, Contract) Work Location: Hybrid - Remote and Community-Based (Greater Boston) About Us: Since ... our inception in 2019, Legacy Care Group has become a leader in Nurse Staffing Solutions and community-based healthcare operations in Massachusetts. As a nurse… more
- Strive Health (Newport News, VA)
- …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
- Blue Cross and Blue Shield of Minnesota (Duluth, MN)
- …Skills and Experiences 1+ years of managed care experience; eg case management /health coach, utilization management and/or auditing experience. Outstanding ... Case Manager is a critical component of BCBSMN Care Management team as the primary clinician providing condition and...skill sets and tools. This role requires a Registered Nurse (RN) licensed in the state of Minnesota with… more
- Strive Health (Chicago, IL)
- …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
- Indiana University Health (Indianapolis, IN)
- …experience in revenue cycle operations in various positions related to utilization management , coding, billing, collections, payment adjustments, auditing, ... Job Description Flexible M-F , Remote/ Hybrid - Majority remote; on-site for quarterly meeting...is required. Associate or Bachelor Degree in Health Information Management , Coding, Nursing or Finance is preferred. Coding/HIM Position… more
- Theoria Medical (Southfield, MI)
- …country. In our national push for expansion, we're scouting for the brightest nurse practitioners and physicians eager to drive change and deliver superior care. ... by expanding our team. Essential Functions & Responsibilities Operational Management : Oversee day-to-day clinical operations for Theoria-partnered facilities,… 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
- 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
- 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
- CVS Health (Baton Rouge, LA)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. _WFH and hybrid Colleagues must ... is URAC accredited in Case Management , Disease Management and Utilization Management . AHH...thorough, independent decisions using clinical judgement. + A Registered Nurse that must hold an unrestricted license in their… 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
