- Elevance Health (Atlanta, GA)
- ** Telephonic Nurse Case Manager I - $3000 Sign-On Bonus Offered** **Location: This is a virtual position, but you must reside in the State of Georgia.** **Work** ... must complete the assessment within 48 hours of receipt and meet the criteria._** The ** Telephonic Nurse Case Manager I** is responsible for telephonic care… more
- Elevance Health (Costa Mesa, CA)
- ** Telephonic Nurse Case Manager II** **Location: This is a virtual position. Candidates must reside within 50 miles of an Elevance Health Pulse Point location.** ... members in different states; therefore, Multi-State Licensure will be required.** The ** Telephonic Nurse Case Manager II** is responsible for care management… more
- US Tech Solutions (Columbia, SC)
- …mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review /case management/clinical/or combination; 2 of 4 years ... and have critical thinking skills. Experience in case management or care coordination and telephonic care experience is preferred. + A typical day would like in this… more
- Trinity Health (Fort Lauderdale, FL)
- **Employment Type:** Part time **Shift:** **Description:** The Utilization Review (UR) Nurse has well-developed knowledge and skills in areas of ... requirements of various commercial and government payers. On-Site Position** **_Position Purpose:_** Utilization Review (UR) Nurses play a vital role in… more
- VNS Health (Manhattan, NY)
- …subject matter experts, physicians, member representatives, and discharge planners in utilization tracking, care coordination, and monitoring to ensure care is ... general supervision. Compensation Range:$85,000.00 - $106,300.00 Annual * Conducts comprehensive review of all components related to requests for services which… more
- Ventura County (Ventura, CA)
- …Duties may include but are not limited to the following: + Performs utilization review with pre-certification, concurrent, retrospective, out of network and ... experience in Case Management, Disease Management, Quality Assurance, HEDIS and/or Utilization Review . NECESSARY SPECIAL REQUIREMENTS + Must possess and… more
- The Cigna Group (Philadelphia, PA)
- …works as part of the team to manage heath care cost and utilization **Provider Support** 1. Completes telephonic nursing assessments including social ... and make specific recommendations based on their goals 4. Review paperwork for patients to ensure it meets all...to nursing team by clinical support staff. 2. Provide telephonic nursing assessment and triage supported by triage protocols.… more
- Actalent (Tampa, FL)
- …to established healthcare goals and care plans. + Use clinical expertise to review utilization information concerning patient care and match those needs to ... Coach Nurse Job Description As a Coach Nurse...an acute care setting to the home setting through telephonic outreach. You will provide education, coaching, and care… more
- Actalent (Santa Barbara, CA)
- …the HPNC may perform utilization management activities, which may include telephonic or onsite clinical review ; case or disease management, care coordination ... Nurse Coordinator Non-profit healthcare network is looking for a utilization management registered nurse to join their team on a contract basis! Opportunity… more
- US Tech Solutions (Columbia, SC)
- …mental health/chemical dependency, orthopedic, general medicine/surgery. Or, 4 years utilization review /case management/clinical/or combination; 2 of the 4 ... + A typical day would like in this role: Employee will be providing telephonic case management for our members. + Past job instability. Registered nurses MUST have… more
- Veterans Affairs, Veterans Health Administration (Morehead City, NC)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... Responsibilities VA offers a comprehensive total rewards package: VA Nurse Total Rewards Pay: Competitive salary, regular salary increases, potential for performance… more
- ERP International (Scott AFB, IL)
- …Case Management Society of America (CMSA); American Accreditation Healthcare Commission/ Utilization Review Accreditation Commission (URAC); CAMH; (AAAHC); Health ... **Overview** ERP International is seeking a full time **Registered Nurse (RN)** to support the Family Medicine Clinic -375th Medical Group at Scott AFB, IL… more
- AmeriHealth Caritas (Greenville, SC)
- **Care Manager II Registered Nurse (BSN) - Foster Care Program -SC** Location: Greenville, SC Primary Job Function: Medical Management ID**: 37923 **Job Brief** This ... position is a telephonic Care Manager that is required to reside in...and evaluation of the effectiveness of the plan. 2. Review medication list and educate Members with pharmacy needs,… more
- Spectrum Health Services (Philadelphia, PA)
- …from the hospital, specialty care practices, health plan staff, and others, the Nurse Care Manager identifies and proactively manages the needs of patients with high ... health and/or psychosocial problems through practice and home-based visits and telephonic support on a care management or case management basis appropriate… more
- Nuvance Health (Poughkeepsie, NY)
- …or BSN preferred. Must have current RN license. Preferred experience in Utilization Review /Management. Company: Vassar Brothers Medical Center Org Unit: 1190 ... affiliates, Position Summary: Under the general supervision of the Director, The Nurse Case Manager role provide clinically-based case management to support the… more
- Lowe's (Charlotte, NC)
- …in a clinical position. + 3-5 Years of Experience as a Case Manager or Utilization Review Nurse in worker's compensation + Experience in a clinical ... **Your Impact** The Care Manager is a telephonic medical case management position with emphasis on...for medically managing a minimum caseload of 65 including review of claims identified for Medicare Set-Aside. **What you… more
- The Cigna Group (Nashville, TN)
- …with chronic illnesses in an effort improve clinical outcomes and decrease utilization . We provide physical, emotional, and spiritual support for patients who are ... facing life-threatening illnesses. We are currently seeking nurse practitioners who are passionate about serious illness care and management to join our growing… more
- The Cigna Group (Bloomfield, CT)
- …skills. + Typing and computer knowledge- able to type 35WPM. + Knowledge of utilization review requirements and procedures. + Knowledge of current health care ... weekly Complete Health Team rounds -market dependent. + Perform telephonic outreach. + Communicates with all departments to resolve...office. **Experience** : + Current Licensure as a registered nurse , in the state of residence in good standing.… more
- Baystate Health (Springfield, MA)
- …through face-to-face visits, home visits, if necessary, as well as telephonic interactions. In addition, they will assist with advance directives, palliative ... facility/program, emergency room, or from a skilled nursing facility. Responsible to review the discharge summaries, follow up on testing that is pending, ensure… more
- AmeriHealth Caritas (Florence, SC)
- **REMOTE | Care Manager II Registered Nurse (BSN) - Foster Care Program -SC** Location: Florence, SC Primary Job Function: Medical Management ID**: 34390 **Job ... Brief** This position is a telephonic Care Manager that is required to reside in...and evaluation of the effectiveness of the plan. 2. Review medication list and educate Members with pharmacy needs,… more