- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) ... service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key...applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance… more
- ERP International (Tinker AFB, OK)
- **Overview** ERP International, LLC is seeking a ** Registered Nurse - Case Manager ** for a full-time position supporting **SHG Clinic** in support of ... **Be the Best!** Join our team of exceptional health care professionals across the nation. Come discover the immense...or pending adverse actions) to practice nursing as a registered nurse in any US state/jurisdiction. Security**… more
- Stony Brook University (Stony Brook, NY)
- …communication skills while adhering to our high standard of excellence. **Duties of a RN Case Manager in the Care Management Department may include ... RN Case Manager **Position Summary** At...required. **Qualifications** **Required** : A Bachelor's degree or a nurse working on their degree with an RN… more
- Stanford Health Care (Palo Alto, CA)
- …the processes and outcomes of patient health care **Licenses and Certifications** + Nursing\ RN - Registered Nurse - State Licensure And/Or Compact State ... Manager differs from other roles in professional nursing/health care practice in that it is not intended to...collaboration with other interdisciplinary team members; arranges follow up care as appropriate. + Utilization Review --… more
- Somatus (Honolulu, HI)
- …appropriate utilization of resources and patient quality outcomes. Performs care management functions on-site or telephonically as the need arises. **This is ... Overview As the largest and leading value-based kidney care company, Somatus is empowering patients across the country living with chronic kidney disease to… more
- Commonwealth Care Alliance (Boston, MA)
- …- As a member of the management team, shared accountability for reductions in acute care utilization - Attend team meetings and huddles to provide input on ... member of Care Delivery Leadership, the Primary Care Nursing Manager is the nursing leader...clinical experience including: - 3+ years' experience as a Registered Nurse in a high-touch clinical environment… more
- Stanford Health Care (Palo Alto, CA)
- …the processes and outcomes of patient health care **Licenses and Certifications** + Nursing\ RN - Registered Nurse - State Licensure And/Or Compact State ... outcomes. A Case Manager differs from other roles in professional nursing/health care practice in that it is not intended to provide direct patient care… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …always rewarding. **It's Work That Matters.** **Overview** **Purpose Statement/Position Summary:** The Nurse Care Manager performs complex discharge planning ... degree in Nursing, Health Care Administration, or related field preferred. Current Registered Nurse licensure in the State of California and AHA CPR/BLS… more
- Commonwealth Care Alliance (Springfield, MA)
- …Long-Term Services Coordinators (LTSC) agencies, ensuring alignment with CCA's model of care and strategic objectives. The Manager fosters effective clinical and ... are met in a manner that supports quality, independence, and cost-effective community-based care . The Manager also ensures providers are educated on CCA… more
- Commonwealth Care Alliance (Boston, MA)
- …supporting high-quality, coordinated care for members. In this role, the Program Manager acts as an account manager , relationship manager , and ... teams to ensure a seamless provider experience and consistent delivery of quality care . The BH Provider Engagement Program Manager reports to the Director… more
- Battelle Memorial Institute (Fort Benning, GA)
- …planning to optimize care delivery and outcomes. Additionally, the Nurse Case Manager facilitates referrals, collaborates with healthcare providers, and ... (HRA) business line is seeking a highly motivated, full-time ** Nurse Case Manager ** to join our team...+ Current, full, active, and unrestricted license as a Registered Nurse in any US State, the… more
- Commonwealth Care Alliance (Boston, MA)
- …CCA's delegated partnerships programs, working with clinical community partners responsible for care management and utilization management across CCA's One ... providers, and supporting the implementation of CCA's model of care and strategic objectives. The Manager leads...Abilities & Language (nice to have): - Familiarity with care management and utilization management systems and… more
- Daiichi Sankyo, Inc. (Philadelphia, PA)
- …to travel up to 90% within geography and to required meetings. Licenses and Certifications RN - Registered Nurse - State Licensure and/or Compact State ... customer needs.Monitor, collect, and communicate to the Director, Clinical Nurse Manager on customer insights regarding their...Licensure The ideal candidate will be a Registered Nurse with previous relevant clinical as… more
- Luke Staffing (Agana Heights, GU)
- …and social work CM services. . Provide patient referrals. Interface with the MTF RN Case Manager (s) in the development and implementation of the Case Management ... **INDEPENDENT LICENSED SOCIAL WORKER CASE MANAGER ** **SITE OF SERVICE:** . US Naval Hospital,...to effectively communicate with all patients and other health care providers. . **Physical Capability:** Shall be physically capable… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …or Compact License in one of the following: + Nursing: Current registration as a nurse (eg, RN , ARNP) + Behavioral Health: Valid licensure (eg, LMFT, LICSW, ... motivational interviewing skill development.? + Support in earning your Chronic Care Professional (CCP) certificate, Integrated Case Manager (ICM) certificate,… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …home opportunity! Please note this position aligns to PST business hours.** The ** Manager , Case Management** Team is a Supervisor for Case Managers. This position is ... and development of professional paraprofessional, and administrative team members. + Lead Care Management teams in effective performance of job functions, which may… more
- ERP International (Luke AFB, AZ)
- …social work CM services. - Provide patient referrals. - Interface with the MTF RN Case Manager (s) in the development and implementation of the Case Management ... ERP International is seeking a **Licensed Clinical Social Worker/Case Manager ** for a Full-Time position in support of the...**Be the Best!** Join our team of exceptional health care professionals across the nation. Come discover the immense… more
- Alameda Health System (Oakland, CA)
- …Master's degree in Nursing preferred. Required License/Certifications: CCRN - Critical Care Registered Nurse is desirable. Required ... for Emergency department). Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California. Trauma Program … more
- Luke Staffing (Yigo, GU)
- …+ **Licensure:** Current, full, active, and unrestricted license to practice as a Practical OR Registered Nurse in any one of the 50 States, the District of ... ** NURSE - REFERRAL MANAGEMENT** **SITE OF SERVICE:** +...experience is required. One year of previous experience in Utilization Management is required. Full time employment in a… more
- Commonwealth Care Alliance (Boston, MA)
- …and driving record, (if applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance is an equal opportunity ... leads the strategic vision and operational execution of provider relations for Commonwealth Care Alliance's SCO and One Care lines of business. This role… more
