- UPMC (Pittsburgh, PA)
- UPMC Health Plan is hiring a full-time Behavioral Health UM Care Manager to support our UM Clinical Operations team. This role will primarily work Monday ... for authorization for behavioral health services. The Utilization Management ( UM ) Care Manager is responsible...Case management certification or approved clinical certification preferred + Registered Nurse ( RN ) *Current licensure… more
- Elevance Health (FL)
- …outpatient professional treatment health benefits through telephonic or written review. The BH Care Manager ( UM ) job progression is primarily a ... **JR169828 Behavioral Health Care Manager II** Responsible for managing...behavioral healthcare in a cost-effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to… more
- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management ( UM ) Reviewer is responsible for day-to-day timely ... Ensures accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying...applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance… more
- Molina Healthcare (Salt Lake City, UT)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal...to overarching strategy to provide quality and cost-effective member care . Candidates with UM and Appeals experience… more
- ERP International (Yuma, AZ)
- **Overview** ERP International, LLC is seeking a ** Registered Nurse - Case Manager ** for a full-time position at the Camp Pendleton **Branch Health Clinic** ... Credentialing Center (ANCC). Licensure:** Current, full, active and unrestricted license as a Registered Nurse Security** : Must possess ability to pass a… 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
- Excellus BlueCross BlueShield (Rochester, NY)
- …varied clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, ... All Levels + Associates degree required. Bachelor's degree preferred. + Active NYS RN or Registered Dietician or Physical Therapist licensure required. + Minimum… more
- Vanderbilt University Medical Center (Nashville, TN)
- …negative elements. **Position Qualifications:** **Responsibilities:** **Certifications:** LIC- Registered Nurse - Licensure-OthersLicensure-Others **Work ... mission is to advance health and wellness through preeminent programs in patient care , education, and research. **Organization:** TMO/ UM Team E **Job Summary:**… more
- University of Michigan (Ann Arbor, MI)
- REGISTERED NURSE - University Hospital -Operating Room Apply Now **Mission Statement** Michigan Medicine improves the health of patients, populations and ... communities through excellence in education, patient care , community service, research and technology development, and through...Recruitment at ###. **Required Qualifications Current licensure as a Registered Nurse in the state of Michigan.… more
- University of Miami (Miami, FL)
- …. CORE JOB SUMMARY The Registered Nurse 2 delivers patient-family centered care in ... of quality, safety, and service while ensuring population-specific patient care . The Registered Nurse 2...and clinical practice standards. Provides documentation to the Research Nurse and/or Data Manager . Meets study timelines… more
- Trinity Health (Langhorne, PA)
- …experienced Registered Nurse to join our team in Utilization Review! The UM Registered Nurse is responsible for the coordinating and facilitating all ... as related to the clinical review and level of care . Management of all review and appeals utilizing a...RN License required. + CCM or Accredited Case Manager certification preferred. + Previous experience in Utilization review… more
- University of Miami (Miami, FL)
- …worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Registered Nurse works as a part of ... a team to provide quality care to designated patients. The RN works...effectively and cooperatively in groups/teams to ensure quality patient care . Communicates effectively with directors and/or manager … more
- University of Miami (Miami, FL)
- …not require direct physician involvement as per physician orders and within the scope of RN licensure 7. Renders dire ct patient care by assisting providers with ... any abnormal results (non - critical values) to the nurse who in turn will contact the physician accordingly...and cooperativel y in groups/teams to ensure quality patient care . 21. Communicates effective with manager and… more
- CenterWell (Atlanta, GA)
- …**Use your skills to make an impact** **Required Qualifications** + Must be a licensed Registered Compact Nurse license ( RN ) with no disciplinary action and ... caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent critical thinking… more
- UNC Health Care (Raleigh, NC)
- …North Carolina. **Professional Experience Requirements:** * Two (2) years of health care experience as a Registered Nurse . **Knowledge/Skills/and Abilities ... of case management, utilization review and discharge planning. The Care Manager must be highly organized professional...CAPP as appropriate. As necessary meet with the Utilization Manager ( UM ) and SW after the meeting… more
- LA Care Health Plan (Los Angeles, CA)
- …needs of LA Care 's culturally diverse membership. The position supports the UM Manager /Director. This role also assists UM Educator/ Manager /Director ... is responsible for executing the day-to-day operations of the UM department, and monitoring the Care Management...player. Must be able to work independently. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- OhioHealth (Columbus, OH)
- …State of Ohio Board of Nursing, BLS - Basic Life Support - American Heart Association, RN - Registered Nurse - Ohio Board of Nursing **Additional Job ... careers and in our communities. **Job Description Summary:** The Care Manager works in partnership with patients,...**Work Shift:** Day **Scheduled Weekly Hours :** 40 **Department** UM Care Coord-South Central Hu Join us!… more
- HCA Healthcare (Lake City, FL)
- …chain of command in a timely manner. **What qualifications you will need:** + ( RN ) Registered Nurse + Associate Degree + One year experience ... benefits may vary by location._** We are seeking an RN Case Manager for our team to...setting required. + Current State of Florida license for Registered Nurse or appropriate compact licensure. If… more
- ERP International (Macdill AFB, FL)
- …Counselor (CRC) o American Nurses Credentialing Center Nurse Case Manager ( RN -NCM) o National Academy of Certified Care Managers: Care Manager ... **Overview** ERP International is seeking ** Registered ** ** Nurse ( RN )** for...Education (CCNE). **Experience:** Minimum 1 years experience as a RN Case Manager within the past 24… more
- University of Michigan (Ann Arbor, MI)
- RN CASE MANAGER : University Hospital ( Care Management) Apply Now **Job Summary** The RN Case Manager assesses, develops, implements, coordinates and ... Case Manager reports directly to the Manager of Care Management. The RN...Time** Full-Time **Regular/Temporary** Regular **FLSA Status** Nonexempt **Organizational Group** Um Hospital **Department** MM OH Care Mgt… more