- Stony Brook University (Stony Brook, NY)
- …and other duties as required. **Qualifications** **Required** : A Bachelor's degree or a nurse working on their degree with an RN license and working history ... excellence. **Duties of a Care Manager in the Care Management Department may include the following but are not...the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity… more
- Humana (Lincoln, NE)
- **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...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- HCA Healthcare (Houston, TX)
- …service organizations, agencies and healthcare facilities. **What qualifications you will need:** + ( RN ) Registered Nurse + Associate Degree, or Bachelors ... from any other healthcare provider. We are seeking a(an) Registered Nurse Case Manager to join our...and overall evaluation of individual patient needs. Care coordination, utilization review and management , as well as… more
- Cedars-Sinai (CA)
- …as a condition of continued employment. **Req ID** : 13443 **Working Title** : Registered Nurse Care Coordinator- Inpatient Specialty Program - 8 Hour Days $5K ... nurse practitioner and case manager assigned to the SNF 's for continued review and follow up. + Authorizes...TPL carrier of all injured worker cases receiving case management services. + Ensures appropriate utilization of… more
- Beth Israel Lahey Health (Exeter, NH)
- Registered Nurse Case Manager + Full Time + Exeter, NH 03833 ... the patient's health care needs following the current phase of illness. **Requirements** + Registered Nurse - NH State or Compact State + BSN Preferred +… more
- CVS Health (Oklahoma City, OK)
- …and timely discharge, appropriate follow-up care, and next steps. + Coordinate with the Utilization Management team to review medical and payer records to ensure ... teams across various sites of care (eg ED, hospital, SNF , primary care clinics). This role prioritizes the relationship...stay and identify any barriers to discharge. + Assist Utilization Management team with access to external… more
- Actalent (Atlanta, GA)
- …Service, Claims, Contracts and Benefits - Appeals, and Risk Management . Essential Skills + Registered Nurse ( RN ) with a valid license in GA or Compact. + ... Job Title: Utilization Review - FULLY REMOTE Job Description This...1+ years of experience in Utilization Management (UM). + 1+ years of...1+ years of experience in Utilization Management (UM). + 1+ years of experience in managed… more
- AmeriHealth Caritas (Lafayette, LA)
- …in a fast-paced, high-volume utilization review environment. **Licensure:** + An active Registered Nurse ( RN ) license in Louisiana or multi state license ... **Role Overview:** Under the direction of a supervisor, the Utilization Management Reviewer evaluates medical necessity for inpatient and outpatient services,… more
- Sharp HealthCare (La Mesa, CA)
- …3 Years Recent acute care nursing experience or case management experience. + California Registered Nurse ( RN ) - CA Board of Registered Nursing ... Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA...and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge… more
- CenterWell (Austin, TX)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous… more
- ChenMed (Philadelphia, PA)
- …RN with bachelor's degree in a related clinical field preferred + A valid, active Registered Nurse ( RN ) license in State of employment required + Compact ... the remaining hours. The Acute Care Manager, Complex Care ( RN ) is responsible for achieving positive patient outcomes, managing...required + A minimum of one (1) year of utilization review and/or case management , home health,… more
- ChenMed (Newport News, VA)
- …We're rapidly expanding and we need great people to join our team. The Nurse Case Manager 1 ( RN ) is responsible for achieving positive patient outcomes ... post-acute facilities, as well as, their home environments. The Nurse Case Manager 1 ( RN ) role also...preferred providers. + Coordinates the integration of social services/case management functions in the pre-acute, ER, acute and post-acute… more
- Centene Corporation (Austin, TX)
- …4-6 years of related experience. Bachelor's degree in Nursing preferred **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact ... days of hire required + **Preferred Experience:** + Clinical Registered Nurse with experience in Acute Care...Medicine, LTC, SNF , or Nursing Rehab + RN Case Management and/or RN … more
- Accura Healthcare (Waite Park, MN)
- …to ensure complete, current, and accurate medical records. QUALIFICATIONS: + Hold current Registered Nurse ( RN ) license with applicable state, without ... to welcome an Assistant Director of Nursing (ADON) - RN to join our team! We're seeking a skilled...join our team! We're seeking a skilled and compassionate registered nurse to manage and oversee the… more
- Billings Clinic (Billings, MT)
- …care. * Maintains respectful and professional communication skills. Insurance and Utilization Management *Maintains working knowledge of CMS requirements and ... * 1 Experience working in Billings Clinic, preferred. License and Certification * Current Registered Nurse license in the state of Montana, at hire Billings… more
- Sharp HealthCare (San Diego, CA)
- …**Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered ... or equivalent experience in the healthcare setting. + California Registered Nurse ( RN ) - CA...and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge… more
- ChenMed (Norfolk, VA)
- … management programs, clinical meetings and other meetings. The Nurse Practitioner will adhere to strict departmental goals/objectives, standards of performance, ... role. + Facilitate patient/family conferences to review treatment goals, optimize resource utilization , provide family education and identify post- SNF needs. +… more
- ChenMed (Norfolk, VA)
- … management programs, clinical meetings and other meetings. The Nurse Practitioner will adhere to strict departmental goals/objectives, standards of performance, ... role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education and identify post- SNF needs. +… more
- Presbyterian Homes and Services (Roseville, MN)
- …sites by directing the other RAI Directors on the approved plan. Qualifications + Registered nurse with current licensure the State Board of Nursing in states ... the SNF setting. + Experience with MDS completion, reimbursement, clinical resource utilization and/or case management + Ability to work flexible work hours… more
- Hartford HealthCare (Wethersfield, CT)
- …professional position, working as a member of the ICP Community Care Management team. The ICP Community Care Manager facilitates transitions as patients move ... uninterrupted quality care, as well as providing ongoing education and diseased management for ICP attributed patients with chronic conditions. They are responsible… more
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