- Baystate Health (Springfield, MA)
- …- American Heart AssociationAmerican Heart Association, Driver License - OtherOther, Registered Nurse - State of MassachusettsState of Massachusetts Equal ... RN , ACO Nurse Care Manager, High...face visits, home visits if necessary, as well as telephonic interactions. In addition, they will assist with advance… more
- Trinity Health (Schenectady, NY)
- …will need: Must have Active Licensure as a Physical Therapist, Occupational Therapist, or Registered Nurse A minimum of 2 years of clinical experience ; ... license or NYS Occupational Therapist (OTR) license or NYS RN License What you will do: Sunnyview Rehab Hospital...available resources. Screening of clients through on site and/or telephonic assessment and record review in collaboration… more
- UnitedHealth Group (Oxford, PA)
- …Experience in discharge planning Experience in utilization review , concurrent review or risk management Experience in a telephonic role Experience in ... health care industry forward. As a Field Case Manager RN with UnitedHealth Group, you'll support a diverse member...you may be interested in. Required Qualifications: Current, unrestricted RN license in the state of Pennsylvania Certified in… more
- Blue Cross and Blue Shield of Minnesota (Duluth, MN)
- …partnership, case and disease management processes, skill sets and tools. This role requires a Registered Nurse ( RN ) licensed in the state of Minnesota with ... and transition of care between settings. Required Skills and Experiences Registered Nurse with Psychiatric experience or Behavioral Health Professional… more
- UnitedHealth Group (El Paso, TX)
- …an undergraduate or graduate degree in social work or a related field. Registered Nurse (preferred), Nurse Practitioner, Licensed Social Worker, Physician ... case within the scope of licensure; provides supervision and direction to non- RN clinicians participating in the member's case in accordance with applicable state… more
- InGenesis (Columbia, SC)
- Managed Care II / Social Worker Job Details Professional Discipline : Registered Nurse Specialty : Utilization Review Employment Type : Full Time City : ... Description: InGenesis is currently seeking a Social Worker Case Manager to review and evaluate medical or behavioral eligibility regarding benefits. In this role,… more
- AdventHealth (Altamonte Springs, FL)
- …Remote **The role you'll contribute:** A Workers Comp Support Registered Nurse is responsible for providing telephonic medical case management for Workers ... injuries and rehabilitation is essential **LICENSURE, CERTIFICATION, OR REGISTRATION REQUIRED:** + Active Registered Nurse ( RN ) license in the state of… more
- Option Care Health (Austin, TX)
- …and/or Experience Requirements:** + Graduate of an accredited school of nursing + Current Registered Nurse ( RN ) licensure in the state of practice + ... telephonic nursing support and management. + Provide excellent communication to nurse colleagues regarding patients on service with review of current status,… more
- CVS Health (Boise, ID)
- …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... in a hospital setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- Humana (Hallandale Beach, FL)
- …+ Bachelor's degree in social work or behavioral health-related field + Active licensed Registered Nurse , RN in the state of Florida without disciplinary ... ensure interaction between the company and members are optimized. The Telephonic Behavioral Health Care Manager Internship provides transitioning service members… more
- CVS Health (Charleston, WV)
- …2+ years CM, discharge planning and/or home health care coordination experience + Registered Nurse with active unrestricted state license in good standing within ... all with heart, each and every day. **Position Summary:** The Care Manager RN is responsible for driving and supporting care management and care coordination… more
- Access Dubuque (Dubuque, IA)
- …office and is also available remotely within Iowa. **Key Responsibilities:** + Provide telephonic case management and utilization review for assigned ... RN Case Manager **Cottingham & Butler/ SISCO** 1...Minimum 2 years of clinical practice. Case management or utilization review experience strongly preferred. + **Skills:**… more
- ICW Group (Lisle, IL)
- …Discharge Planning, or Home Health preferred. **CERTIFICATES, LICENSES, REGISTRATIONS** Current unrestricted Registered Nurse ( RN ) or Licensed Vocational ... evaluate needs for treatment in worker's compensation claims. The Telephonic Nurse Case Manager will negotiate and...+ Interfaces with external agencies in relation to the utilization review process including, Third-Party Payers, Insurance… more
- US Tech Solutions (Columbia, SC)
- **Duration: 3+ Months Contract (Possible Extension)** **Job Description:** + Must be an RN in SC and have an active and unrestricted SC RN license. + ... promote quality, cost effective outcomes. + Performs medical or behavioral review /authorization process. Ensures coverage for appropriate services within benefit and… more
- LA Care Health Plan (Los Angeles, CA)
- …requirements for health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... Utilization Management Nurse Specialist RN...Actively monitors for admissions in any inpatient setting. Performs telephonic and/or onsite admission and concurrent review ,… more
- Commonwealth Care Alliance (Boston, MA)
- …CCA-Auth & Utilization Mgmt **Position Summary:** The Sr Clinician, Behavioral Health Utilization Review will review behavioral health and substance use ... in behavioral health managed care preferred + Experience in behavioral health utilization review or medical necessity evaluation preferred **Required Knowledge,… more
- Cedars-Sinai (Marina Del Rey, CA)
- …the established/communicated timeframe + Documents appropriate reviews for assigned patients using utilization review tool. + Provides telephonic review ... Hospitals! **What You Will Do in This Role:** A Registered Nurse Case Manager plans and coordinates...in Nursing (preferred). **Certifications/Licenses:** + Current and valid California RN License (required). + Certified Case Manager (CCM) or… more
- Centene Corporation (Springfield, IL)
- …**Candidates must reside within 30 miles of Peoria.** **What We're Looking For:** + ** Registered Nurse ( RN ) with active Illinois license** + **Experience in ... case management and/or utilization review ** + **Previous work in an...4 - 6 years of related experience. **License/Certification:** + RN - Registered Nurse -… more
- Albany Medical Center (Albany, NY)
- …States of America) Salary Range: $60,028.00 - $99,023.00 Salary range: $33/hr. - $47.60/hr. Registered Nurse ( RN ) - Full TimeHIV Medicine Clinic - Albany, ... advanced practice provider (APP) and the supervision of the Nurse Manager ( RN ) and/or Nurse ...Nursing program is required* Current NYS license as a Registered Nurse is required* Minimum of 1-2… more
- Albany Medical Center (Albany, NY)
- …Work Shift: Day (United States of America) Salary Range: $60,028.00 - $99,023.00 Registered Nurse ( RN ) - Full Time Pediatric Endocrine Department ... advanced practice provider (APP) and the supervision of the Nurse Manager ( RN ) and/or Nurse ...may provide direct patient care, patient triage (in-person and telephonic ), assessment, planning, directing and evaluating of a patient's… more
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