- CVS Health (Concord, NH)
- …we do it all with heart, each and every day. **Position Summary** The ** Utilization Management Clinical Nurse Consultant** utilizes clinical skills to ... Arizona Time Zone. **Preferred Qualifications** : + Previous experience with utilization management . + Previous clinical experience in Emergency Department,… more
- CenterWell (Concord, NH)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- Humana (Concord, NH)
- **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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CVS Health (Concord, NH)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- HCA Healthcare (Portsmouth, NH)
- …we support our colleagues in their positions. Join our Team as a(an) Registred Nurse Inpatient Wound Care and access programs to assist with every stage of your ... affordable to gain certifications and job skills. Apply today for our Registered Nurse Inpatient Wound Care opening and continue to learn! **Job Summary and… more
- HCA Healthcare (Manchester, NH)
- …you have the PRN career opportunities as a(an) PRN House Supervisor RN Registered Nurse you want with your current employer? We have an exciting opportunity for you ... colleagues. Do you want to work as a(an) PRN House Supervisor RN Registered Nurse where your passion for creating positive patient interactions is valued? If you are… more
- Evolent (Concord, NH)
- …Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed ... medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care across the continuum… more
- Dartmouth Health (Lebanon, NH)
- …based in Lebanon NH Triages, coordinates and facilitates the clinical management for an assigned population. Develops, monitors and reinforces care standards ... and protocols designed to enhance quality and promote cost-effective utilization of healthcare resources. Responsibilities * Facilitates the development of a plan of… more
- Dartmouth Health (Lebanon, NH)
- …a Per Diem Float position Triages, coordinates and facilitates the clinical management for an assigned population. Develops, monitors and reinforces care standards ... and protocols designed to enhance quality and promote cost-effective utilization of healthcare resources Responsibilities 1. Facilitates the development of a plan of… more
- WellSense (NH)
- …circumstances. **Job Summary** The Clinical Care Manager provides holistic medical care management services for members throughout the continuum of care by assessing ... team to develop an Individual Care Plan (ICP) that emphasizes self- management goals, care coordination, psychosocial, socioeconomic, and community-based supports and… more
- HCA Healthcare (Derry, NH)
- …Registered Nurse license + Two or more years of clinical experience. + Case Management , Utilization & Managed Care experience and 1 or more years of ... medical necessity, admission status, level of care, and resource management . + The RN Case Manager Team Lead will...supporting a balance of optimal care and appropriate resource utilization . + The RN Case Manager Team Lead will… more
- Sharecare (Concord, NH)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more
- GE Aerospace (Hooksett, NH)
- …within manufacturing lines to achieve Operating goals using **KPI-based** performance management . + **Coach and Collaborate** with all levels of the organization ... of Lean principles. + Partner, develop and execute standard **Capacity Utilization ** process in partnership with the local Operations, Lean and Industrial… more
- HCA Healthcare (Portsmouth, NH)
- …throughput while supporting a balance of optimal care and appropriate resource utilization . Provides case management services for both inpatient and observation ... **Job Summary and Qualifications** **Job Summary and Qualifications** The Registered Nurse (RN) CM is responsible for promoting patient-centered care by coordinating… more
- HCA Healthcare (Portsmouth, NH)
- …throughput while supporting a balance of optimal care and appropriate resource utilization . Provides case management services for both inpatient and observation ... opening and continue to learn! **Job Summary and Qualifications** The Registered Nurse (RN) CM is responsible for promoting patient-centered care by coordinating the… more
- Highmark Health (Concord, NH)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
- Dartmouth Health (Hampstead, NH)
- …through the organization to promote functioning of hospital operations, including bed utilization . * Coordinates allocation of material resources. * Serves as an ... arbitrator for conflicts that arise on assigned shift. Facilitates short-term management of conflict and communicates to the appropriate departmental leadership for… more
- Beth Israel Lahey Health (Exeter, NH)
- …collaboration . BCLS within 6 months of hire . Completion of required management training courses within 1 year of hire **Responsibilities:** 1. Provides oversight ... staffing to maintain smooth patient flow. 2. Responsible for human resource management of department staff including hiring, firing, evaluating, and development in… more
- Oracle (Concord, NH)
- …alignments, Critical Care workflow implementation, Multi-Disciplinary Rounding, and various nurse chart review and documentation optimizations. The ideal candidate ... sessions, and offer ongoing consultation to support user proficiency and system utilization . Monitor project outcomes, track key metrics, and report progress to… more
- Veterans Affairs, Veterans Health Administration (Manchester, NH)
- …include, but are not limited to: Supports clinics regarding clinic profile management . Collects and updates insurance information from Veterans, family members and ... the data into VISTA if applicable. Promotes Veterans registration for and utilization of MyHealthyVet (MHV) and kiosks usage. Follows procedures regarding Community… more