- The Cigna Group (Philadelphia, PA)
- …and/or additional state licensure as needed 3) 3+ years of experience as a Registered Nurse 4) Proficient level of experience with Microsoft Office applications, ... The RN Coordinator serves as the key contact point...of the team to manage heath care cost and utilization **Provider Support** 1. Completes telephonic nursing… more
- ERP International (Scott AFB, IL)
- **Overview** ERP International is seeking a full time ** Registered Nurse ( RN )** to support the Family Medicine Clinic -375th Medical Group at Scott AFB, IL ... a one-hour lunch between 11:00am and 1:00pm No Weekends, No Holidays, No Call! **Core Registered Nurse Duties:** The duties include, but are not limited to the… more
- AmeriHealth Caritas (Greenville, SC)
- …Bachelor of Science in Nursing (BSN) is required and must hold a current and unrestricted Registered Nurse ( RN ) license in good standing in South Carolina or ... **Care Manager II Registered Nurse (BSN) - Foster Care...Management ID**: 37923 **Job Brief** This position is a telephonic Care Manager that is required to reside in… more
- AmeriHealth Caritas (Florence, SC)
- …of Science in Nursing **(BSN)** is required and must hold a current and unrestricted ** Registered Nurse ( RN )** license in good standing in South Carolina or ... **REMOTE | Care Manager II Registered Nurse (BSN) - Foster Care...Management ID**: 34390 **Job Brief** This position is a telephonic Care Manager that is required to reside in… more
- 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 the 4 ... would like in this role: Employee will be providing telephonic case management for our members. + Past job...case management for our members. + Past job instability. Registered nurses MUST have 4 years or more of… 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)
- …as assigned. QualificationsLicenses and Certifications: Current license to practice as a Registered Professional Nurse or an Occupational Therapist in New York ... subject matter experts, physicians, member representatives, and discharge planners in utilization tracking, care coordination, and monitoring to ensure care is… 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 ... skills. Experience in case management or care coordination and telephonic care experience is preferred. + A typical day...the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse … more
- Actalent (Santa Barbara, CA)
- …Title: Health Plan Nurse Coordinator Non-profit healthcare network is looking for a utilization management registered nurse to join their team on a ... Health Plan Nurse Coordinator (HPNC) is a Registered Nurse who is assigned to one...perform utilization management activities, which may include telephonic or onsite clinical review ; case or… more
- HCA Healthcare (Thornton, CO)
- …qualifications you will need:** + Current licensure in the State of Colorado as a Registered Nurse , or current active multistate Registered Nurse ... typical candidate is hired below midpoint of the range. ** RN Case Manager PRN** **Weekday, Weekend and Holiday Availability...nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want… more
- Albany Medical Center (Albany, NY)
- …Shift: Day (United States of America) Salary Range: $68.640.00 - $99,023.00 Registered Nurse Pediatric Behavioral/Developmental Office Albany, NY We are looking ... advanced practice provider (APP) and the supervision of the Nurse Manager ( RN ) and/or Nurse ...for both in person and telehealth visits* Participate in nurse visits including medication review , education and… more
- Adecco US, Inc. (Sanford, FL)
- …Case Manager (CCM) . Experience or exposure to discharge planning . Experience in utilization review , concurrent review or risk management . Previous ... & Life Sciences is hiring a **Telephone Case Manager RN ** in **Sanford, FL** ! This role is in...and Holiday pay upon meeting eligibility criteria. **IMPORTANT:** This ** Registered Nurse ** role is being recruited for… more
- Trinity Health (Albany, NY)
- …other related duties as assigned Experience and Requirements + Active Licensure as a registered nurse , preferably with a **bachelor's degree** in nursing from an ... Skilled Nursing Facilities have a unique opportunity for a RN to receive, review and process referrals...accredited school and Certified Registered Rehab Nurse preferred (CRRN). + A… more
- Truman Medical Centers (Kansas City, MO)
- …of two (2) years' experience in an acute care setting. Preferred Qualifications: + RN Experience in hospital utilization review , utilization management, ... consulting to outside organizations. **Job Description** The Case Manager (CM) is a registered nurse who is responsible for ensuring quality clinical and… more
- CVS Health (Helena, MT)
- …- Perform medical necessity reviews **Required Qualifications** - 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... setting - A Registered Nurse that holds an active, unrestricted...lower levels of care - 1+ years' experience in Utilization Review - CCM and/or other URAC… more
- Kepro (Chicago, IL)
- …Supervising and managing the day-to-day activities of the assigned case management and utilization review teams. + Mentoring, coaching, and training team members ... public sector. Acentra seeks a Clinical Operations Supervisor - RN (Remote US) to join our growing team. Job...Supervises, mentors, coaches, trains, and develops the: o Case review and utilization review teams… more
- Baystate Health (Springfield, MA)
- …Basic Life Support - American Heart Association, Driver License - Other, Registered Nurse - State of Massachusetts **Equal Employment Opportunity Employer** ... The **ACO Nurse Care Manager i** s responsible for the...face visits, home visits if necessary, as well as telephonic interactions. In addition, they will assist with advance… 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...providers office. **Experience** : + Current Licensure as a registered nurse , in the state of residence… more
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