• Telephonic Nurse Case Manager I

    Elevance Health (Atlanta, 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 -...** Telephonic Nurse Case Manager I - $3000 Sign-On Bonus...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
    Elevance Health (11/08/24)
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  • Utilization Management Nurse

    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
    LA Care Health Plan (11/09/24)
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  • Utilization Review Nurse

    US Tech Solutions (Columbia, SC)
    …independently, prioritize effectively and have critical thinking skills. Experience in case management or care coordination and telephonic care experience is ... mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review/case management /clinical/or combination; 2 of 4 years… more
    US Tech Solutions (10/31/24)
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  • Utilization Management RN (mostly…

    VNS Health (Manhattan, NY)
    …in development of plans to address improvement needs as appropriate. * For Utilization Management Only: * Issues Determinations, Notices of Action, and other ... quality and cost-effective outcomes at all times. * Provides telephonic case management to members, balancing clinical,...by state or federal regulations are saved in the Utilization Management System. * Reviews, evaluates and… more
    VNS Health (11/05/24)
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  • Senior Medical Management Nurse

    Ventura County (Ventura, CA)
    Senior Medical Management Nurse - VCHCP Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4591361) Apply  Senior Medical Management ... nursing classifications in that they will provide Care/Case management , Disease Management , Wellness and Prevention, Utilization Management and tasks… more
    Ventura County (11/12/24)
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  • Registered Nurse - In Home Primary Care-…

    The Cigna Group (Philadelphia, PA)
    …works as part of the team to manage heath care cost and utilization **Provider Support** 1. Completes telephonic nursing assessments including social ... and make appropriate referrals to social work, pharmacy, case management and engagement _Other telephonic patient care...needed 3) 3+ years of experience as a Registered Nurse 4) Proficient level of experience with Microsoft Office… more
    The Cigna Group (10/18/24)
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  • Nurse Disease Mgmt II (US)

    Elevance Health (Columbus, OH)
    ** Telephonic Nurse Disease Management II** **$2000 Sign on Bonus** At **Federal Health Products and Services - FHPS** , a proud member of the Elevance ... - Friday 12:30 pm - 9 pm, or 2:30 pm - 11 pm EST.** The ** Telephonic ** **N** **urse Disease Management II** will be responsible for telephonic outreach,… more
    Elevance Health (11/12/24)
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  • Registered Nurse - Case Manager

    ERP International (Camp Pendleton, CA)
    …algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with ... databases for community resources, etc. + Integrate CM and utilization management (UM) and integrate nursing case...the certifications below **OR** Possess a Master's Degree in Nurse Case Management from a program accredited… more
    ERP International (08/30/24)
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  • Registered Nurse - Case Management

    ERP International (Vandenberg AFB, 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 a full-time **Registered Nurse (RN) Case Manager** in support of the30th Medical Group at Vandenberg AFB, CA… more
    ERP International (10/11/24)
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  • Registered Nurse Case Manager

    US Tech Solutions (Columbia, SC)
    …previous case management experience preferred but not required. This is a telephonic case management position. Members are outreached for enrollment into the ... mental health/chemical dependency, orthopedic, general medicine/surgery. Or, 4 years utilization review/case management /clinical/or combination; 2 of the 4… more
    US Tech Solutions (11/14/24)
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  • Registered Nurse Case Manager

    US Tech Solutions (Columbia, SC)
    …+ A typical day would like in this role: Employee will be providing telephonic case management for our members. + Past job instability. Registered nurses ... more of RECENT clinical experience. + Strong communication skills required to provide telephonic case management to patients and to coordinate with team,… more
    US Tech Solutions (10/18/24)
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  • Registered Nurse - Outpatient

    ERP International (Scott AFB, IL)
    …literacy. * Educates/trains team/facility staff on policies and procedures for utilization of guidelines, protocols and other disease management activities. ... Management Society of America (CMSA); American Accreditation Healthcare Commission/ Utilization Review Accreditation Commission (URAC); CAMH; (AAAHC); Health Services… more
    ERP International (09/28/24)
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  • Nurse Case Mgr II

    Elevance Health (Las Vegas, NV)
    ** Telephonic Nurse Case Manager II** At **Federal Health Products and Services - FHPS** , a proud member of the Elevance Health, Inc. family of companies, it's a ... - Friday 10 am - 6:30 pm EST.** The ** Telephonic ** ** Nurse Case Manager II** is responsible...or service issues. + Assists with the development of utilization /care management policies and procedures. **Minimum** **Requirements:**… more
    Elevance Health (11/08/24)
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  • Registered Nurse , Part-Time

    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 , Part-Time Boston, MA (http://maps.google.com/maps?q=1340+Boylston+St+Boston+MA+USA+02215) * Nursing Job Type Part-time Description As a Registered … more
    Fenway Health (10/19/24)
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  • Nurse Care Manager

    Spectrum Health Services (Philadelphia, PA)
    …medical, behavioral health and/or psychosocial problems through practice and home-based visits and telephonic support on a care management or case management ... care team, assesses patients for risk of adverse health outcomes, inappropriate utilization , and monitors the impact of care management interventions. Essential… more
    Spectrum Health Services (09/19/24)
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  • Registered Nurse Case Manager

    ERP International (Lemoore, 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...charting on the computer, utilizing various programs. Integrate case management with utilization management and… more
    ERP International (08/26/24)
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  • Registered Nurse - Case Manager

    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
    ERP International (09/17/24)
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  • Nurse Case Manager - Full Time, Days

    Nuvance Health (Poughkeepsie, NY)
    …case from physiological and economic perspectives. Has overall accountability for the utilization management and transition management for patients within ... affiliates, Position Summary: Under the general supervision of the Director, The Nurse Case Manager role provide clinically-based case management to support… more
    Nuvance Health (10/06/24)
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  • R&E Nurse - Med Care Services- Advanced

    Health Advocates Network (Harrisburg, PA)
    …setting, behavioral health setting, drug and alcohol setting, managed care, quality management / utilization review or other related clinical experience; or An ... R&E Nurse - Med Care Services- Advanced **Pay Rate:** $28...(MA), health care services, human services, long term care, utilization review, or knowledge of home care Knowledge of… more
    Health Advocates Network (11/16/24)
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  • RN - Registered Nurse Case Manager…

    Geisinger (Danville, PA)
    …and efficiency results for assigned population. + Works to appropriately apply benefits and utilization management serving as a resource to the patient or member ... services with the goal of optimizing the patient or member's health status. Manages utilization and practice metrics to further refine the delivery of care model to… more
    Geisinger (11/12/24)
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