• Registered Nurse - Community Care…

    Veterans Affairs, Veterans Health Administration (Biloxi, MS)
    …made active again for possible consideration during the open period. Responsibilities The Registered Nurse Office of Community Care (CC) is responsible and ... of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
    Veterans Affairs, Veterans Health Administration (12/06/24)
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  • Care Manager RN - Weekends ( Remote

    Highmark Health (Jackson, MS)
    …Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of health care ... depending on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field **SKILLS** + Working knowledge of… more
    Highmark Health (01/07/25)
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  • RN Clinical Consultant, Claims Shared…

    Guardian Life (Jackson, MS)
    …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...plan and length of disability. Plan for ongoing case management through proactive partnering with treating providers to move… more
    Guardian Life (12/20/24)
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  • Senior Process Improvement Professional

    Humana (Jackson, MS)
    …your skills to make an impact** **Required Qualifications** + Associate degree + Active Registered Nurse , ( RN ), License in your state of residence without ... project management and/or process improvement experience + Minimum 3 years utilization management experience with exposure to grievance and appeals +… more
    Humana (01/23/25)
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  • Nurse Community Care Coordinator

    Veterans Affairs, Veterans Health Administration (Biloxi, MS)
    Summary The Community Care Coordinator Registered Nurse is responsible for executing a streamlined approach to receiving, triaging, and directing timely, ... of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
    Veterans Affairs, Veterans Health Administration (01/15/25)
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