- 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...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse ( RN ) in a… more
- CVS Health (Montgomery, AL)
- …+ Active and good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC ... experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal… 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 ... 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
- CVS Health (Montgomery, AL)
- …active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include weekends, ... **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care...or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing… 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 ... 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
- Cognizant (Montgomery, AL)
- …have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- CenterWell (Montgomery, AL)
- …clinical experience. + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Intelligence + ... put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...Experience with Home Health preferred + Previous experience in utilization management within Insurance industry a plus… more
- Community Health Systems (Huntsville, AL)
- …platforms, healthcare software systems, and data analysis tools. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact ... + Refers cases not meeting criteria to the Physician Advisor or Utilization Management Committee and ensures appropriate follow-up. + Identifies avoidable… more
- CVS Health (Montevallo, AL)
- …new hires upon achieving proficiency in the role. **Required Qualifications** + Active, unrestricted ** Registered Nurse ( RN ) license in New Jersey** . + ... high-quality, cost-effective care for our members. These strategies encompass utilization management , quality improvement, network coordination, and clinical… 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 ... however, it is subject to change based on business needs.** The RN Case Manager is responsible for telephonically assessing, planning, implementing, and coordinating… more
- Health Care Service Corporation (Mobile, AL)
- …healthcare outcomes for customers. **Required Job Qualifications:** + Current Licensure as a registered nurse , in the state of residence in good standing. + ... Nursing + Three to Five (3-5) years recent experience in an acute-care environment, case- management , or utilization management position (experience can be a… 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: ... $40.00 per hour Position Details Position Overview: The Hopsice Registered Nurseis responsible for pain management , symptom...takes corrective action. Qualifications: + Current license as a Registered Nurse in the State of Alabama… 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: ... breaches. If breach occurs, takes corrective action. Qualifications: + Current license as a Registered Nurse in the State of Alabama + Minimum of one (1)… more
- Fresenius Medical Center (Huntsville, AL)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Fresenius Medical Center (Opelika, AL)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... of education and experience. + Graduate of an accredited School of Nursing ( RN ). + Current appropriate state licensure. **EXPERIENCE AND SKILLS:** + Required: + 6+… more
- Veterans Affairs, Veterans Health Administration (Montgomery, AL)
- Summary Central Alabama Veterans Health Care System (CAVCS) is looking for a Registered Nurse ( RN ) for Primary Care Service in Outpatient Clinic at ... members of the interdisciplinary team. Duties include but not limited to: The Registered Nurse ( RN ) is responsible for providing competent, evidence-based… more
- Healthfirst (AL)
- The Case Manager, Utilization Management coordinates the care plan for assigned members and conducts pre-certification, concurrent review, discharge planning, ... case management as assigned. The Case Manager, Utilization Management is also responsible for efficient...necessary + Additional duties as assigned Minimum Qualifications: + RN , LPN, LMSW, LMHC, LMFT, LCSW, PT, OT, and/or… more
- Fresenius Medical Center (Mobile, AL)
- …under the direction of the Facility Manager, Director of Nursing and/or Charge Registered Nurse , utilizing standard nursing techniques to assist the physician in ... on adverse events and action thresholds in collaboration with facility management . + Maintains integrity of medical records and other organization administrative… more
- Highmark Health (Montgomery, AL)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... in addressing targeted populations **LICENSES or CERTIFICATIONS** **Required** + RN license in PA or WV or DE or...first 6 months of employment. **Preferred** + Certification in utilization management or a related field +… more
- Diversicare Healthcare Services & Diversicare Ther (Hartford, AL)
- …nursing 2. RN License 3. Knowledge of healthcare reimbursement, utilization management , and discharge planning. 4. Experience providing strategic leadership, ... in and facilitate Engage/72 HR Admission meetings as part of the care management system. + Manage the restorative nursing program, integrating it with the activity… more