- CHRISTUS Health (Wake Village, TX)
- …years' experience in Case Management and/or Utilization Management is required. Licenses, Registrations, or Certifications RN License in the state ... Description Summary: The Registered Nurse Clinical Care Coordinator is...errors are identified to maximize hospital reimbursement and resource utilization . * Responsible for 24/7 ongoing management … more
- CHRISTUS Health (San Antonio, TX)
- …or licensed Nurse Practitioner who provides health and wellness coaching, case management services, analysis and expertise regarding CHRISTUS services. These ... Description Summary: The Registered Nurse Patient Navigator Lead is...management of an integrated medical benefit program including case management and health/disease management .… more
- Stanford Health Care (Palo Alto, CA)
- …Stanford Health Care job.** **A Brief Overview** The Utilization Management Registered Nurse (UM RN ) will be responsible for ensuring the efficient ... of transitions of care guidelines and utilization management principles. + Experience in case ...systems and other healthcare software. **Licenses and Certifications** + Nursing/ RN - Registered Nurse -… more
- Sharp HealthCare (San Diego, CA)
- …Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered Nursing ... experience + 3 Years recent case management , utilization review, care coordination experience + California Registered Nurse ( RN ) - CA Board of … more
- Trinity Health (Silver Spring, MD)
- …travel paid._** **Minimum Licensure/Certification Required (if applicable):** + State of Maryland license as a Registered Nurse + RN with BSN or RN with ... /supervision/leadership experience in an acute healthcare setting required, preferably with case management , utilization review or closely related area. +… more
- BronxCare Health System (Bronx, NY)
- …special projects and committees as determined by Director. Qualifications CERTIFICATION/LICENSURE : Registered Nurse or physician or a foreign medical graduate ... and implementation of educational programs for Denial Prevention and Management . Responsibilities - Establish and maintain positive relationships with patients,… more
- Scottish Rite for Children (Dallas, TX)
- …We're committed to giving children back their childhood! Job Posting Title: Director of Case Management and Utilization Management Location: Dallas - ... Details: Monday - Friday 8:00am to 4:30pm Job Description: Duties/Responsibilities: + Utilization Management supporting medical necessity and denial prevention +… more
- UNC Health Care (Raleigh, NC)
- …stay, and discharge reviews in accordance with federal regulations & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is ... medical discharge planning issues, continuing care needs by initiating appropriate case management referrals. Initiates appropriate social work referrals. 3.… more
- Sharp HealthCare (San Diego, CA)
- …Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered Nursing; ... in Healthcare or a related field + 3 Years Utilization Management or case ...clinical experience as defined by the CBA. + California Registered Nurse ( RN ) - CA… more
- Community Health Network (Indianapolis, IN)
- Utilization Review Registered Nurse ( RN ) Job Ref 2407583 Category Nursing Job Family Remote / Work from Home / Virtual Department Utilization Review ... couldn't do it without you. **Make a Difference** The Utilization Review Registered Nurse is...years recent clinical experience or three years recent hospital utilization review/ case management experience. (Required)… more
- Sharp HealthCare (San Diego, CA)
- …Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered Nursing; ... Degree in a health related field. + 3 Years Utilization Management or case ...clinical experience as defined by the CBA. + California Registered Nurse ( RN ) - CA… more
- R1 RCM (Pittsburgh, PA)
- …role, you must have experience in a clinical inpatient environment and hospital-based utilization or case management experience. Proficiency in basic ... testing, training, and other opportunities that promote growth. **Required Skills:** + Active Registered Nurse license For this US-based position, the base pay… more
- Mohawk Valley Health System (Utica, NY)
- Registered Nurse - Utilization Review Nurse - Full Time - Days Department: CASE MANAGEMENT Job Summary Reports to and is under direct supervision ... regulatory compliance. Education/Experience Requirements Required: + Minimum of two (2) years utilization review/ case management experience or social work… more
- Brockton Hospital (Brockton, MA)
- …while optimizing resource utilization . Provides training to staff on case management methods and techniques. Establishes monitoring mechanisms to identify ... and develops reports that clearly monitor all areas of utilization / case management . Provides data, guidance...RN with Master's Degree + Current License as Registered Nurse in the Commonwealth of Massachusetts… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN ...an acute hospital setting. At least 2 years of Utilization Management / Case Management ... achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- WellSpan Health (York, PA)
- Registered Nurse - Case Management -...General Summary Performs a variety of duties and applies utilization and case management techniques to ... patient discharge needs. Provides leadership in the integration of utilization and case management principles...., or Clinical Nursing Specialty. Preferred Licenses: + Licensed Registered Nurse Upon Hire Required or +… more
- Prime Healthcare (Ontario, CA)
- …or another relevant field + A minimum of seven (7) years' experience in Clinical Utilization Review or Case Management with a large Health Plan + ... https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Responsibilities The Corporate Director of Clinical Utilization Management (UM) provides comprehensive… more
- WellSpan Health (York, PA)
- Registered Nurse - Case Management -...General Summary Performs a variety of duties and applies utilization and case management techniques to ... care transition needs. Provides leadership in the integration of utilization and case management principles..., or clinical nursing specialty. Preferred Licenses: + Licensed Registered Nurse Upon Hire Required or +… more
- Sharp HealthCare (San Diego, CA)
- …**Job Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** California Registered Nurse ( RN ) - CA Board of Registered Nursing; ... clinical experience in area of specialty. + 2 Years Utilization / Case Management experience, preferably in...experience, preferably in a Managed Care setting. + California Registered Nurse ( RN ) - CA… more
- MetroHealth (Cleveland, OH)
- …set and Milliman Health Management Guidelines. Current working knowledge of, utilization management , case - management , performance improvement, and ... customer service standards of the MHS.** Qualifications: Bachelor's degree in nursing. Current Registered Nurse License State of Ohio. Minimum of 5 years… more
