- Novo Nordisk Inc. (Philadelphia, PA)
- About the Department The Clinical, Medical and Regulatory (CMR) department at Novo Nordisk is one of the most diverse and collaborative groups within the ... and developing and implementing regulatory strategies with the FDA to providing medical education and collecting data to support efficacy and new product… more
- Legend Biotech USA, Inc. (Fort Worth, TX)
- …to: enhance proper administration, and educate on appropriate adverse identification and management . This is a field-based role that works closely with sales, ... Conducts peer-to-peer in-person and virtual educational programs through 1:1 APP/ Nurse and group presentations; Meet with identified customers in each… more
- GHR Healthcare (Atlanta, GA)
- Are you a detail-oriented RN with a knack for navigating complex medical cases? Do you thrive on making critical decisions that impact patient care? Join us as a ... Care Management Coordinator and play a key role in evaluating...Hourly (paid weekly) What You'll Do: Clinical Analysis: Review medical records to determine the necessity of patient services… more
- Staffing Now (Norfolk, VA)
- …and post service requests. Refers cases requiring clinical review to a Nurse reviewer. Responsible for the identification and data entry of referral requests ... combination of education and experience, which would provide an equivalent background. Medical terminology training and experience in medical or insurance field… more
- Staffing Now (Norfolk, VA)
- …and post service requests.Refers cases requiring clinical review to a Nurse reviewer.Responsible for the identification and data entry of referral requests ... combination of education and experience, which would provide an equivalent background. Medical terminology training and experience in medical or insurance field… more
- US Tech Solutions, Inc. (Columbia, SC)
- …Performs medical reviews using established criteria sets and/or performs utilization management of professional, inpatient or outpatient, facility benefits ... reviewed using the individual patient's benefits contract and our medical policies. The nurse would read through...sets or clinical guidelines. Provides support and review of medical claims and utilization practices. . May… more
- Engage Partners, Inc. (Orange, CA)
- …based, trauma informed, and culturally competent services. Ensure charts meet quality management standards per monthly utilization review and/or chart review ... The Nurse Supervisor supervises and manages nursing staff to...in a timely manner. Responsible for direct report performance management including, performance improvement plans, formal written warning notices.… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …members as needed to ensure services will be covered.Coordinate and communicate with Utilization Review Nurse on a daily, consistent basis to ensure patients ... Job Category:Nursing - Registered Nurse Work Shift/Schedule:8 Hr Morning - AfternoonNortheast Georgia...patient needs; Works collaborate with the Physicians, patient/family, nursing, utilization review and other members of the healthcare team… more
- Cambia Health Solutions, Inc (Lewiston, ID)
- Care Management Nurse (Future Opportunities)Work from home within Oregon, Washington, Idaho or Utah *Please be advised that this role is part of our candidate ... Degree in Nursing or related field3 years of case management , utilization management , disease ...degree in Behavioral Health preferred for behavioral health care management ); or Registered nurse (RN) license (must… more
- Northeast Georgia Health System, Inc (Oakwood, GA)
- Job Category:Nursing - Registered Nurse Work Shift/Schedule:8 Hr Morning - AfternoonNortheast Georgia Health System is rooted in a foundation of improving the health ... of system-wide opportunities as they relate to Value Analysis standardization, utilization and implementation. Facilitate Value Analysis Teams (VAT) to most… more
- PrideStaff (Wilmington, DE)
- Job Title: Nurse Navigator Location: Wilmington, DE Schedule: Monday - Friday SUMMARY Under the direct supervision of the Chief Medical Officer, the incumbent ... work performance. RESPONSIBILITIES Promote timely access to appropriate care. Increase utilization of preventative care. Reduce emergency room utilization and… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- Job Category:Nursing - Registered Nurse Work Shift/Schedule:VariesNortheast Georgia Health System is rooted in a foundation of improving the health of our ... all campuses operated by NGHS. Collaborates with the physicians, patients, families, nursing, utilization review and other members of the health care team to ensure… more
- GHR Healthcare (Philadelphia, PA)
- Immediate Opening: Urgent Care Nurse Practitioner Needed in Philadelphia, PA Description: We provide concierge health services using a PCP-driven care model for the ... clinically complex and vulnerable community members. Our holistic approach addresses both medical and psychosocial issues to improve outcomes for high utilizers of… more
- Russell Tobin & Associates (Remote, OR)
- …4 Month Contract You will be responsible for providing non-clinical support to the utilization management team in maintaining and managing the utilization ... manner consistent with policies and procedures as described in the Utilization Management plan. Responsibilities: Consistently exhibits behavior and… more
- Pacer Staffing (Atlanta, GA)
- …Job Description: Summary: This individual contributor position reports to the Directors of Utilization Management (UM) and Referral Management (RM) and ... Nurse , with current unrestricted license in appropriate state 4+ years Utilization Management experience Proficient at in-depth analysis of clinical policy… more
- Blanchard Valley Hospital (Findlay, OH)
- …Manager is to develop, implement and evaluate an organized inpatient case management service for pediatric and adult hospitalized patients under the direction of ... physical and psychosocial needs and plan in the electronic medical record. Duty 2: The RN Case Manager actively...meetings to contribute information regarding transitions of care and utilization of care resources for the purpose of improving… more
- Pacer Staffing (Atlanta, GA)
- …description Job Summary This individual contributor position reports to the Directors of Utilization Management (UM) and Referral Management (RM) and ... Nurse , with current unrestricted license in appropriate state . 4+ years Utilization Management experience . Proficient at in-depth analysis of clinical… more
- University Medical Center of El Paso (El Paso, TX)
- …Skills: Excellent leadership, recommendation making and delegation skills. Knowledge of care management , resource and utilization management . Skilled in care ... Job Requirements: Work Experience: Three years of experience as a Registered Nurse required. Previous case management experience or related experience preferred.… more
- Blanchard Valley Health System (Findlay, OH)
- …Acute Care Transitions Team, including the disciplines of Social Work, Case Management , Utilization Review, and Emergency Department Care Navigation to support ... with ambulatory care navigation team and other service providers for optimal utilization of available resources to ensure best possible outcomes for patients and… more
- Pacer Staffing (Atlanta, GA)
- …regulatory requirements, and HIPAA privacy regulations. . Thorough knowledge of Case Management , Utilization Management , HIPAA Privacy and Security ... Job Summary . Provides Disease Management (DM) services to TRICARE beneficiaries. . The... (DM) services to TRICARE beneficiaries. . The DM nurse will collaboratively assess, plan, implement, coordinate, monitor and… more
