- Cognizant (Jackson, MS)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... 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
- Humana (Jackson, MS)
- …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 assignments are...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse (RN) in a compact state… more
- Humana (Jackson, MS)
- **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 ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state)… more
- Humana (Jackson, MS)
- **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 ... 7pm EST approximately 3-4 Thursday and Friday's annually. The Utilization Management Nurse 2 uses clinical...Qualifications** + Minimum of an Associate's degree + Licensed Registered Nurse (RN) with no disciplinary action… more
- CVS Health (Jackson, MS)
- …good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult inpatient… more
- Fresenius Medical Center (Jackson, MS)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
- CVS Health (Jackson, MS)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… more
- Humana (Jackson, MS)
- **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 ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse (RN)** in the (appropriate state)… more
- Community Health Systems (Flowood, MS)
- …concerns with professionalism and empathy. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact State Licensure required ... with hospital policies and regulatory standards, serving as a resource for clinical and non- clinical staff. **Essential Functions** + Oversees hospital… more
- Community Health Systems (Brandon, MS)
- …concerns with professionalism and empathy. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact State Licensure required ... with hospital policies and regulatory standards, serving as a resource for clinical and non- clinical staff. **Essential Functions** + Oversees hospital… more
- Sharecare (Jackson, MS)
- …to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they… more
- Datavant (Jackson, MS)
- …clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for...by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well… more
- Community Health Systems (Flowood, MS)
- …concerns with professionalism and empathy. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact State Licensure required ... compliance with hospital policies and regulatory standards, serving as a resource for clinical and non- clinical staff. **Why Merit Health?** We know it's not… more
- Community Health Systems (Jackson, MS)
- …concerns with professionalism and empathy. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact State Licensure required ... with hospital policies and regulatory standards, serving as a resource for clinical and non- clinical staff. **Essential Functions** + Oversees hospital… more
- Highmark Health (Jackson, MS)
- …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
- Community Health Systems (Flowood, MS)
- …software systems, and data analysis tools. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact State Licensure required + ... with hospital policies and regulatory standards, serving as a resource for clinical and non- clinical staff. **Essential Functions** + Oversees hospital… more