- Accounting Now (Carson City, NV)
- …quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contractPerforms psychiatric and substance abuse or substance ... abuse disorder assessment coordination implementation case planning monitoring and evaluating to promote quality member...if all of the following criteria are met: performs UM approvals only, reviews requests for Applied Behavioral Analysis… more
- Staffing Now (Carson City, NV)
- …quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. Performs psychiatric and substance abuse or ... substance abuse disorder assessment coordination implementation case planning monitoring and evaluating to promote quality member outcomes to optimize member health… more
- LifePoint Health (Las Cruces, NM)
- …state or local law./ **Job:** **Nursing* **Organization:** **Memorial Medical Center* **Title:** *RN Case Manager - UM - PRN* **Location:** *New Mexico-Las ... Memorial Medical Center is a 199-bed hospital offering a spectrum of care, including diagnostic, therapeutic, and rehabilitative services, both on an inpatient and outpatient basis. *Where We Are:* From national parks and monuments to one of the top-rated… more
- Actalent (Santa Barbara, CA)
- …+ CA RN license + Flexible to work a 3-month contract + Whole person case management experience WHAT'S IN IT FOR YOU: + Remote opportunity + Gain experience with ... units include, but are not limited to, the Utilization Management, Case Management, Enhanced Care Management, Disease Management, Pediatric-Whole Child Model, and… more
- Actalent (Santa Barbara, CA)
- URGENT READY TO HIRE!! A leading nationwide care company is looking for a Remote Case Manager to join their team!! With immense opportunity for growth, this ... + Local to San Jose or Ventura County + Case Management experience. + Experience working with Medicare/Medi-caid. +...+ Assisting with Backlog-referrals from CA-members sending referrals to case managers + Will be Assigned 5-10 referrals daily.… more
- Magellan Health Services (Honolulu, HI)
- …at provider, customer, UM and CM meetings as needed. + Audits and reviews case manager , Health guide, UM staff, vendor, and provider documentation and ... of care standards in the participating provider network, vendors, UM staff, Health Guides, and for case managers. + Assists in the planning and implementation of… more
- Integra Partners (Troy, MI)
- …educator to join our Operations Training & Development team as an Operations UM Training Specialist, specializing in Utilization Management ( UM ) processes. The ... of the Operations training and development program. The Operations UM Training Specialist will work in collaboration with Operations...but are not limited to: + Works with the Manager of Operations Training to develop an end-to-end training… more
- Apex Health Solutions (Houston, TX)
- Summary: The UM Reviewer serves as a contact and resource person to Health Solutions' members for the utilization review (UR) of healthcare services. The UM ... or issues arise. To support care management initiatives, the UM Reviewer should also identify enrollees in need of... Reviewer should also identify enrollees in need of case /disease management services so that proactive interventions can occur.… more
- Elevance Health (Olathe, KS)
- …health care field or MBA with Health Care concentration preferred. + Certified Case Manager preferred. **Job Level:** Director **Workshift:** **Job Family:** MED ... **Anticipated End Date:** 2024-09-16 **Position Title:** Director I HCMS - UM /CM - Kansas **Job Description:** **Director I HCMS - UM /CM - Kansas** **Location:**… more
- Elevance Health (Chicago, IL)
- **Anticipated End Date:** 2024-10-04 **Position Title:** UM Medical Director - Cardiology **Job Description:** **This position will work a hybrid model (remote and ... with providers and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss… more
- Apex Health Solutions (Houston, TX)
- …and support to improve health outcomes via a coordinated approach. The Care Manager works in collaboration and continuous partnership with patients and their family ... process to identify patients/members at risk for poor outcomes, the Care Manager establishes care plans and goals, and coordinates care and services throughout… more
- The Cigna Group (Bloomfield, CT)
- …is a licensed professional with a background in the insurance industry as a care manager in a behavioral healthcare role, or an individual who has worked in a mental ... service as a mental health or chemical dependency counselor. As an Inpatient Care Manager at Evernorth, you will use your clinical knowledge and skills to evaluate… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …the care for a designated patient caseload. Collaborates with the attending LIP, Clinical Case Manager , nurse, and other members of the treatment team, ACCESS ... department to ensure appropriate utilization of resources and benefits on a case by case basis. Applies case management and utilization review principles in… more
- Catholic Health Initiatives (Roseburg, OR)
- …+ BLS within 3 months of hire. + Certified Case Manager , Accredited Case Manager or UM Certification preferred. **Experience:** + Two (2) years acute ... hospital experience. A Master's degree in Case Management or Nursing is accepted in lieu of 1 year of experience. **Education:** + Associates degree in Nursing. BSN… more
- Stanford Health Care (Palo Alto, CA)
- …| Stanford Health Care (SHC)? Here is your opportunity to mentor and support the UM professionals. Here is your opportunity to put your UM experience and ... an onsite Stanford Health Care job.** **A Brief Overview** The Dir-Utilization Management ( UM ) leads and shapes the UM Strategy, while providing management… more
- ERP International (Camp Pendleton, CA)
- **Overview** ERP International, LLC is seeking a **Registered Nurse - Case Manager ** for a full-time position supporting **Branch Health Clinic Port Hueneme, ... for community resources. * Integrate CM and utilization management ( UM ) and integrating nursing case management with...for professional growth and development as related to the case manager position and maintenance of CM… more
- Omaha Children's Hospital (Omaha, NE)
- …team to assess for diagnosis, care needs, and discharge plans. + Introduces Nurse Case Management (NCM) role to family. + Completes NCM assessment and documents in ... policies. + Communicates and collaborates with the Utilization Management ( UM ) Nurse, or other NCMs as necessary to provide...and placement, as applicable. + Monitors system to report case management outcomes and works as a change agent… more
- Omaha Children's Hospital (Omaha, NE)
- …team to assess for diagnosis, care needs, and discharge plans. * Introduces Nurse Case Management (NCM) role to family. * Completes NCM assessment and documents in ... processes. + Communicates and collaborates with the Utilization Management ( UM ) Nurse, or other NCMs as necessary to provide...and placement, as applicable. + Monitors system to report case management outcomes and works as a change agent… more
- Elevance Health (Indianapolis, IN)
- **Anticipated End Date:** 2024-09-19 **Position Title:** RN Transplant Case Manager II (Telephonic) **Job Description:** **LOCATION** **: This is a remote ... pm.** **The Transplant Nurse II** is responsible for providing case management and/or medical management ( UM /UR) for...and managed care products preferred. + Certification as a Case Manager is preferred. + Previous work… more
- The Arora Group (Twentynine Palms, CA)
- Registered Nurse Case Manager Nurse Currently recruiting a Registered Nurse (RN) Case Manager near Palm Springs, California, to provide care to family ... per two week period. DUTIES OF THE REGISTERED NURSE CASE MANAGER (RN): + P articipate in...including assessment, planning, implementation, coordination, and monitoring. + Integrate case management (CM) with utilization management ( UM )… more
