- ACI Federal (Cannon AFB, NM)
- Registered Nurse Utilization Management EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive ... services. This role involves assessing patient care plans, ensuring compliance with utilization management protocols, and collaborating with healthcare teams to… more
- Humana (Santa Fe, NM)
- **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... interpretation and independent determination of the appropriate courses of action. The Utilization Management Registered Nurse 2 uses clinical knowledge,… more
- Veterans Affairs, Veterans Health Administration (Albuquerque, NM)
- Summary The New Mexico VA Health Care System Community Care Service seeks a Registered Nurse for the position of Women's Health Outcome Case Coordinator! ... improvement process and initiatives as well as customer service programs. The Registered Nurse (Women's Health Outcome Case Coordinator) duties include:… more
- Veterans Affairs, Veterans Health Administration (Albuquerque, NM)
- …equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion ... Summary The New Mexico VA Health Care System is seeing Registered Nurses (Admissions/Transfer/Discharge Coordinator) to join the team! Responsibilities VA offers a… more
- Fresenius Medical Center (Albuquerque, NM)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... + Preferred but not required: + 3+ years supervisory or project/program management experience. + Med/surg or ICU/CCU experience. **PHYSICAL DEMANDS AND WORKING… more
- Veterans Affairs, Veterans Health Administration (Albuquerque, NM)
- …equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion ... to join our Nursing leadership team. We are seeking an Assistant Nurse Manager (ANM) for Mental Health Residential Rehabilitation Treatment Programs (MHRRTP). The… more
- Molina Healthcare (Rio Rancho, NM)
- …driver's license **PREFERRED EDUCATION:** **PREFERRED EXPERIENCE:** + 3-5-year experience as a Registered Nurse and/or Nurse Practitioner, ideally in a ... **JOB DESCRIPTION** **Job Summary** The Care Connections Nurse Practitioners focus on screening and preventive primary care services delivered in the home,… more
- Molina Healthcare (Rio Rancho, NM)
- …and production levels are maintained + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case ... our Appeals and Grievances department. We are seeking a Registered Nurse with previous Appeals and Grievances... Management (CM), Member Assessment Team (MAT), Health Management (HM), and/or Disease Management (DM) and… more
- CenterWell (Albuquerque, NM)
- …license, auto insurance and reliable transportation. + Two years as a Registered Nurse with at least one-year of management experience in a home care, ... clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- LifePoint Health (Las Cruces, NM)
- …utilizes hospital resources in the development of care, discharge planning and Utilization Review. * Utilization Management performs prospective, admissions, ... concurrent review according to standard policies and procedure. * Utilization Management reviews and analyze processes designed...is desirable. * Current New Mexico licensure as a Registered Nurse . * Certification as CCM or… more
- Highmark Health (Santa Fe, NM)
- …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health care ... Experience in a clinical setting **Preferred** + Certification in utilization management or a related field +...and Family Therapist (LMFT) + Licensed Behavior Specialist + Registered Nurse . **Preferred** + None **SKILLS** +… more
- Magellan Health Services (Albuquerque, NM)
- …the management , direct supervision and coordination of clinical and/or nonclinical management staff, including utilization management and intensive care ... staff, providing expertise in designated programs. + Assists clinical management in the development and on-going management ...PC - Professional Counselor - Care Mgmt, RN - Registered Nurse , State and/or Compact State Licensure… more
- Molina Healthcare (NM)
- …program/process execution to achieve goals **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational ... Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of RN license....years in one or more of the following areas: utilization management , case management , care… more
- Molina Healthcare (Rio Rancho, NM)
- …State Registered Nursing (RN) license in good standing. + Utilization Management Certification (CPHM) Certified Professional in Health Care Quality ... _This position requires an actively licensed Registered Nurse_ **JOB DESCRIPTION** **Job Summary** The mission of Clinical Operations is to drive value through an… more
- Children's Home Healthcare (Las Cruces, NM)
- …as an RN, BSN preferred + Current CPR + At least 2 years experience as a Registered Nurse + At least 1 year experience as a Clinical Supervisor in Home Health ... communication skills and willing to travel to patient homes + Utilization Management Experience + Reliable transportation for patient visits + Reside in… more
- Magellan Health Services (Carlsbad, NM)
- …Magellan Credentialing criteria. 2+ years' post-licensure clinical experience. Experience in utilization management , quality assurance, home or facility care, ... in analyzing trends based on decision support systems. Business management skills to include, but not limited to, cost/benefit...Mgmt, PSY - Psychologist - Care Mgmt, RN - Registered Nurse , State and/or Compact State Licensure… more
- Genesis Healthcare (NM)
- …*Graduate of an accredited school of nursing, college, or university with a current registered nurse licensure by the State Board of Nursing. *A minimum of ... including strategic planning, budget preparation, and effective oversight of resource utilization . *Ensures the realization of high quality and cost-effective health… more
- Veterans Affairs, Veterans Health Administration (Albuquerque, NM)
- …years of experience in clinical documentation improvement; OR, Clinical experience, such as Registered Nurse (RN), Medical Doctor (MD), or Doctor of Osteopathy ... Summary This position is located in the Health Information Management (HIM) section at the New Mexico VA Medical...and to optimize the medical center's authorized reimbursement for utilization of resources provided. As a technical expert in… more
- LifePoint Health (Las Cruces, NM)
- …possess familiarity with case management issues, discharge planning and utilization management . * Licensure/Certification: NM Social Work license or ... work under the NM license and supervision of a current Licensed Social Worker or Registered Nurse for up to 6 months. *About our Health System* Memorial Medical… more
- Magellan Health Services (Portales, NM)
- …Healthcare-related field, or relevant experience in lieu of degree., Experience in utilization management , quality assurance, home or facility care, community ... in analyzing trends based on decision support systems. Business management skills to include, but not limited to, cost/benefit...Licensed Clinical Social Worker - Care Mgmt, RN - Registered Nurse , State and/or Compact State Licensure… more