- 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
- Dignity Health (Northridge, CA)
- …insurance setting is required. + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification preferred. + Knowledge of ... care centers. Visit dignityhealth.org/northridgehospital (https://www.dignityhealth.org/socal/locations/northridgehospital) for more information. RN Case Manager (Care Coordinator) Case … more
- Magellan Health Services (Hodge, LA)
- …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
- 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
- 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
- Elevance Health (Durham, NC)
- …and depression, and insightful analytics to improve the delivery of care. **BH Care Manager I, UM /Crisis Line - North Carolina** Candidate must live AND be ... or 7:30 am to 8 pm (EST) and Rotating Holiday coverage.** The **BH Care Manager I, UM /Crisis Line** is responsible for managing psychiatric and substance abuse… more
- Elevance Health (FL)
- …necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to Peer Reviewers as ... and substance abuse or substance abuse disorder assessment coordination implementation case planning monitoring and evaluating to promote quality member outcomes to… more
- ManpowerGroup (Columbia, SC)
- …+ Identify and make referrals to appropriate staff (eg, Medical Director, Case Manager , Preventive Services, etc.). + Participate in data collection/input ... + **Title:** Managed Care Coordinator UM II + **Location:** Initial on-site work required...spreadsheet and database software. + **Experience:** + Background in case management or care coordination, and telephonic care experience.… more
- Elevance Health (Grand Prairie, TX)
- …States. + Requires minimum of 3 years acute care clinical experience or case management, utilization management or managed care experience; or any combination of ... equivalent background. **Preferred Qualifications** + Knowledge of medical management process ( UM /UR) and ability to interpret and apply member contracts, member… 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
- Dignity Health (Long Beach, CA)
- …(5) years of nursing experience. + Certified Case Manager (CCM) Accredited Case Manager (ACM-RN) or UM Certification preferred + Knowledge of managed ... acute hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of 1...Professional communication skills. + Understand how utilization management and case management programs integrate. + Ability to work as… more
- Catholic Health Initiatives (Chattanooga, TN)
- …is required. Preferred + Certified Case Manager (CCM) Accredited Case Manager (ACM-RN) or UM Certification preferred Required Minimum Knowledge ... acute hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of 1...Professional communication skills. + Understand how utilization management and case management programs integrate. + Ability to work as… more
- Virginia Mason Franciscan Health (Seattle, WA)
- …(5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification preferred + Able to apply ... acute hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of 1...Professional communication skills. + Understand how utilization management and case management programs integrate. + Ability to work as… more
- Catholic Health Initiatives (Omaha, NE)
- …(5) years of nursing experience. + Certified Case Manager (CCM) Accredited Case Manager (ACM-RN) or UM Certification preferred + Able to apply ... acute hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of 1...Professional communication skills. + Understand how utilization management and case management programs integrate. + Ability to work as… more
- Catholic Health Initiatives (Omaha, NE)
- …(5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification preferred + Able to apply ... acute hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of 1...Professional communication skills. + Understand how utilization management and case management programs integrate. + Ability to work as… more
- Dignity Health (Los Angeles, CA)
- …years of nursing experience. + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification preferred + Knowledge of managed ... acute hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of 1...Professional communication skills. + Understand how utilization management and case management programs integrate. + Ability to work as… more
- Virginia Mason Franciscan Health (Burien, WA)
- …within hospital Preferred + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification preferred \#LI-VMFH* **Pay Range** ... two (2) years of acute hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of 1 year experience. Preferred + Bachelor's… more
- Virginia Mason Franciscan Health (Tacoma, WA)
- …within hospital Preferred + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification preferred **Pay Range** $48.84 ... two (2) years of acute hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of 1 year experience. Preferred + Bachelor's… 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
- Virginia Mason Franciscan Health (Bremerton, WA)
- …(CCM or ACM) preferred + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification preferred **Pay Range** $46.52 - ... findings to management. Recommends and provides education in collaboration with their manager . The Denials RN follows a standardized approach to managing denials in… more
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