- Humana (Montgomery, AL)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...appropriate courses of action. As a Utilization Management RN working on the OneHome/ Home Solutions… more
- Humana (Montgomery, AL)
- **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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CenterWell (Montgomery, AL)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- Humana (Montgomery, AL)
- **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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Fresenius Medical Center (Mobile, AL)
- …staff training, equipment, physician and patient relations, cost containment, supply management , medical records, patient billing, OSHA and all company, state and ... quality of patient care, as defined by the quality goals, by working with management to ensure that policies and procedures are followed. + Assists with implementing… more
- CVS Health (Montgomery, AL)
- …is subject to change based on business needs. **Preferred Qualifications** 6+ months Case Management or Utilization Management experience Case Management ... responsible for telephonically assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the… more
- Veterans Affairs, Veterans Health Administration (Montgomery, AL)
- …nursing education, orientation, competencies and providing quality improvement and outcomes utilization . This nurse integrates knowledge, skills, abilities, and ... Central Alabama Veterans Health Care System (CAVCS) is looking for a Registered Nurse (RN) for Primary Care Service in Outpatient Clinic at Montgomery VA Clinic… more
- Aveanna Healthcare (Greenville, AL)
- Hospice Registered Nurse RN Part Time ApplyRefer a FriendBack Job Details Requisition #: 207171 Location: Greenville, AL 36037 Category: Nursing Salary: $31.00 - ... Position Details Position Overview: The Hopsice Registered Nurseis responsible for pain management , symptom control in the delivery of care to hospice patients, as… more
- Aveanna Healthcare (Pelham, AL)
- Hospice Registered Nurse RN Part Time Weekends ApplyRefer a FriendBack Job Details Requisition #: 208777 Location: Pelham, AL 35124 Category: Nursing Salary: $31.00 ... hour Position Details Position Overview: TheHospiceRegistered Nurseis responsible for pain management , symptom control in the delivery of care to hospice patients,… more
- Evolent (Montgomery, AL)
- …responsible for support and assistance for all cardiology administrative and clinical utilization management and quality improvement functions under the auspices ... is 11:30-8:00 eastern** **OTHER SKILLS and ABILITIES:** Strong clinical, management , communication, and organizational skills. Demonstrated leadership skills Analytic… more
- CVS Health (Montevallo, AL)
- …high-quality, cost-effective care for our members. These strategies encompass utilization management , quality improvement, network coordination, and clinical ... physical, behavioral, and psychosocial services. **Key Responsibilities** + Conduct in- home , face-to-face assessments using comprehensive tools for members enrolled… more
- Fresenius Medical Center (Huntsville, AL)
- …and acting on adverse events and action thresholds. + Oversees facility's Home Therapies Program if applicable. + Accountable for compliance with all applicable ... and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely… more
- Fresenius Medical Center (Opelika, AL)
- …Quality, and Technical Services departments. + Collaborates with or functions as the Home Therapies Program Manager to oversee the facility's Home Therapies ... Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. +… more
- CenterWell (Prattville, AL)
- …+ Two years as a Registered Nurse with at least one-year of management experience in a home care, hospice or equivalent environment. **Scheduled Weekly ... patient information related to the case, including disciplines required, to determine home health or hospice needs. Accountable to ensure patients meet admission… more
- BrightSpring Health Services (Springville, AL)
- … utilization and hospital admission reduction + Provides survey management support/ follow-up/and coordination of corrective actions plans related to care ... and direction in performance improvement, provision of clinical services, survey management , documentation management , incident management , EMR/EHR… more
- Sharecare (Montgomery, AL)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more
- Gentiva (Montgomery, AL)
- …licensed Registered Nurse (RN) with strong leadership experience in hospice care, home health, or clinical operations management . If you're a natural leader ... budgeting while driving branch revenue growth through census development, referral management , and efficient resource utilization + Maintain strong relationships… more
- Community Health Systems (Huntsville, AL)
- …health, or nursing home setting required + 2-4 years of care management experience preferred **Knowledge, Skills and Abilities** + Strong understanding of case ... coordinating and overseeing discharge planning, transitions of care, and case management activities to ensure optimal patient outcomes. This role involves… more