- CVS Health (Columbus, OH)
- …1+ years of clinical experience in acute or post-acute setting, and 1+ years of Utilization Management / Care Management Experience Must have active current ... talk on the telephone, and type on the computer. Preferred Qualifications Utilization Management experience preferred Education Diploma RN acceptable; Associate… more
- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in… more
- AmeriHealth Caritas (Newtown Square, PA)
- Role Overview The Utilization Management Review Supervisor manages a remote team of clinical reviewers who process prior authorization requests for Community ... HealthChoices (CHC) and home modifications. CHC is a Medicaid managed care program...oversight, support, and direction to a remote team of Utilization Management Reviewers Clinical and technical support:… 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
- Kaiser Permanente (Olympia, WA)
- … management . Education Bachelors degree License, Certification, Registration Registered Nurse License (Washington) required at hire OR Compact License: Registered ... TO ELIGIBLE EXTERNAL HIRES! ** RN CASE MANAGER LIAISON NURSE - INPATIENT DISCHARGE PLANNING - ONSITE: ST. PETER...Qualifications Minimum two (2) years of RN experience in utilization review, ambulatory case management , care coordination… more
- Somatus (Fairfax, VA)
- …kidney disease to experience more days out of the hospital and healthier at home . It takes a village of passionate and tenacious innovators to revolutionize an ... well-being + Community engagement opportunities + And more! The Nurse Navigator is a critical member of the Somatus...a patient advocate and a strategic partner to case management teams and hospital staff. This role collaborates with… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …years nursing experience with advanced level pediatric clinical experience and utilization management and/or discharge planning experience. Thorough knowledge of ... **It's Work That Matters.** **Overview** **Purpose Statement/Position Summary:** The Nurse Care Manager performs complex discharge planning for patients...managed care, utilization management , discharges planning, and continuous quality… more
- Moses/Weitzman Health System (Meriden, CT)
- …licensure as appropriate. Fully established practice standards for productivity and appropriate utilization of care. Position is designed to support evening and or ... meeting client's health care needs. Participates with Community Health Center management in developing and achieving optimal clinical performance and organizational… more
- ERP International (Camp Pendleton, CA)
- **Overview** ERP International, LLC is seeking a **Licensed Vocational / Practical Nurse ** for a full-time position supporting the **Branch Health Clinics** at ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- Christus Health (Euless, TX)
- …care plans. The RN Navigator will manage the length of service, promote efficient utilization of resources, and ensure that a well-organized and safe plan of care is ... leaving hospitals or long-term care facilities, ensuring a smooth transition to home or another care setting. Care Coordination - Transitions of Care: Outreach… more
- Mount Sinai Health System (New York, NY)
- …are not limited to: a. Reviews all new admissions to identify patients where utilization review, discharge planning, and/or case management will be needed using ... Job Description RN/Case Manager MSH Case Management FT Days The Case Manager (CM) will...CM works collaboratively with physicians, social workers, clinical nurses, home care services, and other members of the interdisciplinary… more
- Herc Rentals (Bonita Springs, FL)
- …Ensure compliance with company policies and industry regulations regarding IT asset management . Generate regular reports on asset status, utilization , and ... IT Asset Management Analyst Location Bonita Springs, FL, US, 34134...of IT assets, ensuring accurate inventory, and optimizing asset utilization . This role requires strong analytical skills, excellent communication,… more
- Humana (Bloomington, IL)
- …health first Humana Gold Plus Integrated is looking for Managers of Care Management who will lead teams of nurses, care coordinators and behavioral health ... professionals responsible for care management . The Manager, Care Management , works within...of staff including service performance and adherence to established utilization and care coordination benchmarks. Use your skills to… more
- UnitedHealth Group (Omaha, NE)
- …oversight meetings with the outward facing Chief Medical Officers, network contractors, nurse management and other internal managers Maintain proficiency in all ... Growing together. We are currently seeking an Inpatient Care Management Medical Director to join our Optum team. This...of nurses and support staff to manage inpatient care utilization at a hospital, market, regional or national level.… more
- Sharp HealthCare (San Diego, CA)
- …of the manager of in-patient care management and the Director of Utilization Management . Required Qualifications 3 Years Experience in the acute patient care ... Facility/Regional - SCMG Operations meetings and task forces.Facilitate regional Utilization Management committees and other working regional… more
- BlueCross BlueShield of Tennessee (Memphis, TN)
- …as travel is required to meet with members\.** **Job Responsibilities** + Supporting utilization management functions for more complex and non\-routine cases as ... **SelectCommunity at BCBST is seeking a Registered Nurse ** who is compassionate about case management...acuity\. This role requires telephonic contacts and in person home visits with members on at least a monthly… more
- Novo Nordisk Inc. (Los Angeles, CA)
- …include key opinion leaders (KOL's), academic institutions, physicians, nurse practitioners, diabetes educators, pharmacists, blood bank staff, organized ... policies, legal, regulatory, and compliance requirements Ensures effective administrative management of regional business as well as operational budgets Maintains… more
- University Health (Pleasanton, TX)
- …Three years recent, full-time hospital experience preferred. Work experience in case management , utilization review or hospital quality assurance experience is ... status determinations, and the coordination of appropriate diversions to home or other level of care more appropriate for...hire date. LICENSURE/CERTIFICATION Current license from the Board of Nurse Examiners of the State of Texas to practice… more
- Memorial Hermann Health System (Kingwood, TX)
- …and when appropriate or requested when the hospitalist service is in the co- management or consultative role. Cover Code Blue and Rapid Responses in accordance with ... with the hospital on call schedule and patient assignment guidelines. Provide co- management services for subspecialty services when such services are within the… more
- Katmai (Usaf Academy, CO)
- …with military and civilian healthcare providers and staff and uses Utilization Management (UM) systems support to identify high-risk/high-cost patients ... **SUMMARY:** Performs healthcare coordination and case management activities IAW Medical Treatment Facility (MTF) instructions....States or jurisdiction, be able to practice using a nurse compact state license or Enhanced Nurse … more
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