- Elevance Health (GA)
- …criteria._** The ** Telephonic Nurse Case Manager I** is responsible for telephonic care management within the scope of licensure for members with complex ... ** Telephonic Nurse Case Manager I** **Location:...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- Elevance Health (Costa Mesa, CA)
- ** Telephonic Nurse Case Manager II** **Sign on Bonus: $5000.** **Location: This role enables associates to work virtually full-time, with the exception of ... service members in different states; therefore, Multi-State Licensure will be required.** The ** Telephonic Nurse Case Manager II** is responsible for care … more
- CVS Health (Austin, TX)
- …the department.** **Rotational late shift 9:30-6CST.** **No travel is required.** As a Utilization Management Nurse Consultant, you will utilize clinical ... Clinical Social Worker (LCSW) preferred. + Requisition Job Description **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100%… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... to support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and… more
- CVS Health (Austin, TX)
- …the department.** **Rotational late shift 9:30-6CST.** **No travel is required.** As a Utilization Management Nurse Consultant, you will utilize clinical ... with heart, each and every day. **Position Summary** This Utilization Management (UM) Nurse Consultant...experience + 1+ years' experience Managed Care + Strong telephonic communication skills + 1+ years' experience with Microsoft… more
- CVS Health (Carson City, NV)
- …1 holiday per year). There is no travel expected with this position. As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... And we do it all with heart, each and every day. **Position Summary** **This Utilization Management (UM) Nurse Consultant role is fully remote but must… more
- US Tech Solutions (Columbia, SC)
- …enrollment in care management programs and/or health and disease management programs. Provides telephonic support for members with chronic conditions, ... established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency and claims knowledge/analysis to… more
- Ventura County (Ventura, CA)
- …and patient-centered care. Under general direction, the Senior Medical Management Nurse is responsible for performing utilization review, case management ... Senior Medical Management Nurse - VCHCP Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5113983)...in Case Management , CCM. + Experience with Utilization Management and/or Quality Assurance in a… more
- ChenMed (Houston, TX)
- …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 and managing ... into acute and post-acute facilities, as well as, their home environments. The Nurse Case Manager 1 (RN) role also involves establishing relationships with patients'… more
- ERP International (Luke AFB, AZ)
- …algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with ... **Overview** ERP International is seeking a full time **Registered Nurse - Case Management ** in support of the56th Medical Group at Luke AFB, AZ… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …it pertains to patient admission/safe discharge. + Participates in utilization management initiatives/opportunities for improvement through departmental ... based on clinical guidelines and insurance coverage. + Provide telephonic and/or in-person case management and member...behavioral/mental health + Experience in a managed care, case management , or utilization review setting + Strong… more
- Fenway Health (Boston, MA)
- …objective scientific principles, and the patient's subjective experiences. + Conducts virtual, telephonic , or in-person nurse assessment and triage to assess the ... Registered Nurse Boston, MA (http://maps.google.com/maps?q=1340+Boylston+St+Boston+MA+USA+02215) * Nursing Job Type...to the care team with primary responsibilities for disease management , care coordination, and advice/triage needs for the care… more
- Elevance Health (Grand Prairie, TX)
- …to 8:00 PM EST. The ** Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care needs by ... with providers, claims or service issues. Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** + Requires… more
- Cedars-Sinai (CA)
- …reporting to the TPL carrier of all injured worker cases receiving case management services. + Ensures appropriate utilization of medical services within the ... Doing** The Case Manager is responsible for the case management of patient while hospitalized and upon discharge from...of care. Use evidence based review guidelines to conduct utilization review as is appropriate to match the payor… more
- ERP International (Hurlburt Field, FL)
- …algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with ... **Overview** ERP International is seeking a full time **Registered Nurse (RN) Case Manager** in support of the 1st Special Operations Medical Group at Hurlburt… more
- Nuvance Health (Poughkeepsie, NY)
- …case from physiological and economic perspectives. Has overall accountability for the utilization management and transition management for patients within ... - Discharge Planning primarily Under the general supervision of the Director, The Nurse Case Manager role provide clinically-based case management to support the… more
- ERP International (Anchorage, AK)
- …algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with ... **Overview** ERP International is seeking a **Registered Nurse Case Manager** for a full-time position supporting the673d Medical Group, Joint Base… more
- ERP International (Twentynine Palms, CA)
- …algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with ... **Overview** ERP International is seeking **Registered Nurse (RN) Case Managers** for full-time positions in support of the **Naval Hospital Twentynine Palms, CA**… more
- Cleveland Clinic (Port Saint Lucie, FL)
- …request in accordance with standard operating procedures. Standard operating procedures include utilization of telephonic interaction as the primary mode of ... designated to ensure the safe and efficient placement of patients and effective utilization of resources. + Demonstrate cost effective management of enterprise… more
- ERP International (Tinker AFB, OK)
- …algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with ... **Overview** ERP International, LLC is seeking a **Registered Nurse - Case Manager** for a full-time position supporting **SHG Clinic** in support of **Tinker AFB,… more
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