- Elevance Health (Columbus, OH)
- **Hours of this position: Mon - Friday 8am - 5pm CST or 8am - 5pm EST** The Med Mgmt Nurse is responsible for review of the most complex or challenging cases ... judgment to determine whether treatment is medically necessary and provides consultation to Medical Director on cases that are unclear or do not satisfy relevant… more
- Elevance Health (Los Angeles, CA)
- The Med Mgmt Nurse CA is...whether treatment is medically necessary and provides consultation to Medical Director on cases that are unclear or do not ... on clinical presentation, and apply clinical guidelines and/or policies to evaluate medical necessity. + Works with healthcare providers to promote quality member… more
- Elevance Health (Costa Mesa, CA)
- The Med Mgmt Clinician Sr is responsible for ensuring appropriate, consistent administration of plan benefits by reviewing clinical information and assessing ... not require the training or skill of a registered nurse . Acts as a resource for more junior Clinicians....efficiency and effectiveness of the utilization reviews within the medical management processes. + Assesses and applies… more
- Providence (Portland, OR)
- … Nurse License + 3 years of experience and expertise in case management in a hospital, medical group/clinic, substance use treatment, insurance, State/County ... Team, City Call and/or the Transition Call Team. The department provides case management services for at-risk patients, including patients with complex medical … more
- Hartford HealthCare (Farmington, CT)
- …now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system. ... *Documentation Review* . Provides extensive and accurate reviews of medical records within specified timelines. . Recognizes opportunities for documentation… more
- LifePoint Health (Bullhead City, AZ)
- …regulatory agency standards, performance improvement, quality of care and risk management . Participates in Valley View Medical Centers' (VVMC) Culture ... policy or organizational changes and making recommendations for final approval by senior management , medical staff and the board of trustees.The governing body… more
- Baptist Memorial (Jackson, MS)
- Summary The Utilization Review Nurse is responsible for evaluating the medical necessity and appropriateness of healthcare services and treatment as prescribed ... ensure cost-effective and appropriate care. Areas of work include status management , medical necessity reviews, verification of authorization, resource… more
- Hartford HealthCare (Farmington, CT)
- … *Experience* . Minimum: Two years' experience of hospital health information management experience to include analyzing medical records for physician record ... now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system.… more
- Prime Healthcare (Reno, NV)
- …10hr smrmc-utilization- mgmt /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilitySaint ... by Fortune/Merative and America's Best 250 hospitals by Healthgrades, Saint Mary's Regional Medical Center is a 380-bed acute care hospital offering a robust line of… more
- BayCare Health System (Tampa, FL)
- …the communities we serve. **Title:** Risk Manager - Clinical Risk Management **Facility:** St. Joseph's Hospital **Responsibilities:** + Responsible for risk ... management activities, including event management , event analysis,...the department policies and procedures. + May access patient medical records to perform job functions. + Supports physicians… more
- Baptist Memorial (Oxford, MS)
- …- RN-Pre Admission Facility: BMH - North Mississippi Oxford Hospital Department: NM Case Mgmt Administration BMH North MS Category: Nurse RN Type: Non Clinical ... and call back may be required. Reports to the Director of Case Management . Performs other duties as assigned. Responsibilities + Assesses and evaluates clinical and… more
- Penn State Health (Camp Hill, PA)
- …genetic information._ **Position** Nursing Assistant Certified (Float) - NIGHT SHIFT - Resource Mgmt Ctr **Location** US:PA: Camp Hill | Medical Assistant | Full ... **Penn State Health** - **Holy Spirit Medical Center** **Location:** US:PA: Camp Hill **Work Type:**...**SUMMARY OF POSITION:** Under the direction of a Registered Nurse , contributes to the basic patient care activities and… more
- LifePoint Health (Georgetown, KY)
- …Hospital(Versailles, KY),Bourbon Community Hospital(Paris, KY),Clark Regional Medical Center(Winchester, KY), andGeorgetown Community Hospital(Georgetown, KY) ... . Free Parking Essential Functions Under the supervision of physician or nurse , assists with performing patient assessments and treatments. Performs basic diagnostic… more
- Guthrie (Binghamton, NY)
- … Management Full Time Day Shift Monday-Friday Summary The LPN-Transitional Care Management Nurse (TCMN) provides telephonic outreach to all patients that have ... of an accredited LPN program. Licenses The Transitional Care Management Nurse must be licensed in the...system to identify recently discharged patients and review patient medical record. + Reviews hospital discharge list identifying those… more
- Sharp HealthCare (San Diego, CA)
- …other members of the health care team as well as the respective medical groups to facilitate the utilization management process.Identify and refers situations ... **Shift End Time** Bachelor's Degree; Associate's Degree in Nursing; California Registered Nurse (RN) - CA Board of Registered Nursing; Accredited Case Manager (ACM)… more
- Stanford Health Care (Palo Alto, CA)
- …team. You can put your bedside RN experience to great use in case management . Our RN Case Managers work with multidisciplinary teams dedicated to the continuity of ... of the month following employment eligibility. Our core benefits include medical insurance, dental insurance, vision insurance, an employee assistance program,… more
- Queen's Health System (Ewa Beach, HI)
- …in one (1) of the following: Medical Assistant, Nursing Assistant, Emergency Medical Technician, Licensed Practical Nurse or Registered Nurse ; OR o ... (preferably in a physician practice setting) or six (6) months of administrative medical office experience in any one (1) of the following areas: patient access… more
- Nuvance Health (Poughkeepsie, NY)
- …in addressing issues of end of life care. Job Responsibilities: * Provides psychosocial/resource management expertise to the Nurse Case Manager and care team on ... in Connecticut, and Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York - plus multiple primary and specialty care… more
- Nuvance Health (Poughkeepsie, NY)
- …in addressing issues of end of life care. Job Responsibilities: * Provides psychosocial/resource management expertise to the Nurse Case Manager and care team on ... legal, advocacy and ethical issues related to domestic violence, abuse, and medical care planning. * Performs psychosocial assessments, and intervenes with patients… more
- Parkview Health (Fort Wayne, IN)
- …of Science in Nursing (BSN) required. Licensure/Certification: Valid Indiana Registered Nurse license required. Certification in Case Management highly ... facilitate patient progression to discharge. Ensures clinical documentation supports medical necessity criteria and meets regulatory requirements. Communicates the… more