- Humana (Concord, NH)
- **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
- Humana (Concord, NH)
- **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 (Concord, NH)
- …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 (Concord, NH)
- **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
- Cognizant (Concord, NH)
- …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- CenterWell (Concord, NH)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... **Required Qualifications** + Must be a licensed Registered Compact Nurse license (RN) with no disciplinary action and ability...volume and fast paced environment + Previous experience in utilization management + Education: BSN or bachelor's… more
- Humana (Concord, NH)
- **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... and communication of behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work… more
- Sharecare (Concord, NH)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
- HCA Healthcare (Portsmouth, NH)
- …we support our colleagues in their positions. Join our Team as a(an) Registred Nurse Inpatient Wound Care and access programs to assist with every stage of your ... affordable to gain certifications and job skills. Apply today for our Registered Nurse Inpatient Wound Care opening and continue to learn! **Job Summary and… more
- Humana (Concord, NH)
- …experience in an acute care, skilled or rehabilitation setting, home health, DME, triage, utilization , or case management . + **Ability to work ANY 8-hour shift ... caring community and help us put health first** The Nurse Advice Line is a fast-paced inbound call center...+ Bachelor's degree in nursing (BSN) + Previous case management , utilization review, or triage experience +… more
- Beth Israel Lahey Health (Exeter, NH)
- Registered Nurse Case Manager + Full Time + Exeter, NH 03833 ... one weekend per month (may change), alternating holiday rotation The Nurse Case Manager/Discharge Planner collaborates, facilitates and negotiates the delivery of… more
- Highmark Health (Concord, NH)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... within the first 6 months of employment. **Preferred** + Certification in utilization management or a related field + Certification in Case Management … more
- HCA Healthcare (Portsmouth, NH)
- …in their positions. Join our Team as a Patient Safety Coordinator Registered Nurse and access programs to assist with every stage of your career. **Benefits** ... skills. Apply today for our Patient Safety Coordinator Registered Nurse opening and continue to learn! **Job Summary and...to achieve the goals of case review, data abstraction, management and reporting. The Patient Safety Coord will actively… more
- Beth Israel Lahey Health (Exeter, NH)
- Clinical Resource Nurse + Part Time + Exeter, NH 03833 (https://maps.google.com/maps?q=Exeter%2C%20NH%20%2003833&zoom=14&size=512x512&maptype=roadmap&sensor=false) + ... 18 months of hire **Major Responsibilities:** 1. Assumes responsibility for clinical management functions on the assigned shift. 2. Models excellence in nursing… more
- Datavant (Concord, NH)
- …function as delegated by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and appeal ... of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for...expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in… more
- HCA Healthcare (Portsmouth, NH)
- …throughput while supporting a balance of optimal care and appropriate resource utilization . Provides case management services for both inpatient and observation ... **Job Summary and Qualifications** **Job Summary and Qualifications** The Registered Nurse (RN) CM is responsible for promoting patient-centered care by coordinating… more
- HCA Healthcare (Portsmouth, NH)
- …throughput while supporting a balance of optimal care and appropriate resource utilization . Provides case management services for both inpatient and observation ... opening and continue to learn! **Job Summary and Qualifications** The Registered Nurse (RN) CM is responsible for promoting patient-centered care by coordinating the… more
- Highmark Health (Concord, NH)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... 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
- Beth Israel Lahey Health (Stratham, NH)
- …collaboration . BCLS within 6 months of hire . Completion of required management training courses within 1 year of hire **Responsibilities:** 1. Provides oversight ... staffing to maintain smooth patient flow. 2. Responsible for human resource management of department staff including hiring, firing, evaluating, and development in… more
- Genesis Healthcare (Rochester, NH)
- …is required. *Experience with Medicare/Medicaid reimbursement, MDS completion, clinical resource utilization and/or case management is highly desirable. *Must ... making a meaningful impact in the communities we serve. Responsibilities The MDS Nurse -- RN manages the overall process and tracking of all Medicare/Medicaid… more