- Humana (Jackson, MS)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Hartford HealthCare (Willimantic, CT)
- …**Windham Hospital* **Title:** * Registered Nurse Case Manager ( RN ) - Utilization Management * **Location:** *Connecticut-Willimantic-Windham Community ... the direction of the Manager of Continuing Care and Utilization Management and in collaboration with physicians,... experience preferred. *LICENSURE/CERTIFICATION* * Current license as a registered nurse in the State of Connecticut.… more
- Cedars-Sinai (CA)
- …as a condition of continued employment. **Req ID** : 13443 **Working Title** : Registered Nurse Care Coordinator- Inpatient Specialty Program - 8 Hour Days $5K ... nurse practitioner and case manager assigned to the SNF 's for continued review and follow up. + Authorizes...TPL carrier of all injured worker cases receiving case management services. + Ensures appropriate utilization of… more
- AmeriHealth Caritas (Washington, DC)
- **$5,000.00 SIGN ON BONUS** **Role Overview** Our Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient services, ensuring ... in the least restrictive and most effective manner. The Utilization Management Reviewer must maintain a strong...of 3 years of diverse clinical experience as a Registered Nurse in an Intensive Care Unit… more
- Alameda Health System (San Leandro, CA)
- Clinical Nurse III, Acute Inpatient Behavioral Health Utilization Management + San Leandro, CA + John George Psychiatric Hospital + JGP Care Coordination + ... fields in EHR. 17. Maintains current knowledge of clinical practice and Utilization Management by literature review, membership in a professional organization.… more
- CenterWell (Austin, TX)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous… more
- Sharp HealthCare (La Mesa, CA)
- …3 Years Recent acute care nursing experience or case management experience. + California Registered Nurse ( RN ) - CA Board of Registered Nursing ... Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA...and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge… more
- ChenMed (Philadelphia, PA)
- …RN with bachelor's degree in a related clinical field preferred + A valid, active Registered Nurse ( RN ) license in State of employment required + Compact ... the remaining hours. The Acute Care Manager, Complex Care ( RN ) is responsible for achieving positive patient outcomes, managing...required + A minimum of one (1) year of utilization review and/or case management , home health,… more
- ChenMed (Newport News, VA)
- …We're rapidly expanding and we need great people to join our team. The Nurse Case Manager 1 ( RN ) is responsible for achieving positive patient outcomes ... post-acute facilities, as well as, their home environments. The Nurse Case Manager 1 ( RN ) role also...preferred providers. + Coordinates the integration of social services/case management functions in the pre-acute, ER, acute and post-acute… more
- Fallon Health (Worcester, MA)
- … Nurse in a clinical setting required. * 2 years' experience as a Utilization Management /Prior Authorization nurse in a managed care payer preferred. * ... degree in nursing required **License/Certifications:** Active and unrestricted licensure as a Registered Nurse in Massachusetts. **Experience:** * A minimum of… more
- Catholic Health Initiatives (Lisbon, ND)
- …+ Graduate of an accredited nursing program. + Bachelor's in Nursing (BSN) + Registered Nurse License in the state of North Dakota (ND) **Preferred** + ... obtaining referrals, prior authorization for Home Health Care, DME, SNF , etc. + Acts as a patient advocate and...clinical experience in acute care settings + Prior Case Management / Utilization Review **Where You'll Work** CHI Lisbon… more
- Accura Healthcare (Shell Rock, IA)
- …to ensure complete, current, and accurate medical records. QUALIFICATIONS: + Hold current Registered Nurse ( RN ) license with applicable state, without ... to welcome an Assistant Director of Nursing (ADON) - RN to join our team! We're seeking a skilled...join our team! We're seeking a skilled and compassionate registered nurse to manage and oversee the… more
- Billings Clinic (Billings, MT)
- …care. * Maintains respectful and professional communication skills. Insurance and Utilization Management *Maintains working knowledge of CMS requirements and ... * 1 Experience working in Billings Clinic, preferred. License and Certification * Current Registered Nurse license in the state of Montana, at hire Billings… more
- ChenMed (Columbus, OH)
- …We're rapidly expanding and we need great people to join our team. The Nurse Case Manager 1 ( RN ) is responsible for achieving positive patient outcomes ... post-acute facilities, as well as, their home environments. The Nurse Case Manager 1 ( RN ) role also...preferred providers. + Coordinates the integration of social services/case management functions in the pre-acute, ER, acute and post-acute… more
- Sharp HealthCare (San Diego, CA)
- …3 Years case management , utilization review, care coordination experience. + California Registered Nurse ( RN ) - CA Board of Registered Nursing ... Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA...and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge… more
- Washington County Hospital and Clinics (Washington, IA)
- …Time Job Shift Day Category Health Care Description SUMMARY The Transitional Care Utilization RN coordinates seamless patient transitions across the continuum of ... of patient information during hospitalization with LTC facilities. coordinates WCHC SNF referrals and collaborates with insurance payors as needed. + Serves… more
- Sharp HealthCare (San Diego, CA)
- …**Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered ... or equivalent experience in the healthcare setting. + California Registered Nurse ( RN ) - CA...and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge… more
- Tufts Medicine (Haverhill, MA)
- …our High Pointe House Facility in Haverhill, MA, and Skilled Nursing Facility management and oversight. Hours: Full Time 40 Hours Location: Lowell MA and Haverhill ... **Minimum Qualifications:** 1. Bachelor's degree in Nursing (BSN). 2. Massachusetts RN Licensure. 3. Five (5) years of palliative, hospice, complex care… more
- Pine Acres Rehabilitation & Care Center (Nebraska City, NE)
- …accountability to Administrator Reporting to this position: None Job Classification: Registered nurse with administrative duties/ management Position Purpose: ... a current, unencumbered, active license to practice as a registered nurse in Nebraska. Must have 3...primary resource for problem solving in regards to the SNF prospective payment system and quality reporting program. Infection… more
- ChenMed (Bradenton, FL)
- … management programs, clinical meetings and other meetings. The Nurse Practitioner will adhere to strict departmental goals/objectives, standards of performance, ... role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education and identify post- SNF needs. +… more
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