- Actalent (Santa Barbara, CA)
- Non-profit healthcare network is looking for a utilization management registered nurse to join their team on a contract basis! Opportunity to gain ... 3-month contract + Medi-Cal Experience + Utilization Management WHAT'S IN IT FOR YOU: + Remote...Health Plan Nurse Coordinator (HPNC) is a Registered Nurse who is assigned to one… more
- Insight Global (New York, NY)
- Job Description Insight Global is looking for a Pre-Access Utilization Management Registered Nurse to sit remotely with one of their large health ... . Skills and Requirements - Must possess a state-specific RN License for the state the consultant resides in...state the consultant resides in - 4-5 years of Remote Utilization Management experience at… more
- Amergis (Los Angeles, CA)
- …or service + Performs other duties as assigned/necessary Minimum Requirements: + Registered Nurse or Licensed Practical Nursing license required + Certified ... + Audits medical records and monitors performance measures for health care risk management , sentinel events and trends + Oversees and monitors the development and… more
- Insight Global (Philadelphia, PA)
- …healthcare insurance company local to the Philadelphia area is looking for to hire a fully remote Case Management RN to join their Care management team. ... 100% remotely and have own equipment to work from home 3+ years of case management and utilization management experience Post acute Care experience Discharge… more
- CVS Health (Trenton, NJ)
- …care more personal, convenient and affordable. **Position Summary** This is a fulltime remote Utilization Management Nurse Consultant opportunity. ... external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working...of residence + 3+ years of experience as a Registered Nurse + 1+ years of clinical… more
- CVS Health (Jefferson City, MO)
- …care more personal, convenient and affordable. **Position Summary** This is a fulltime remote Utilization Management Nurse Consultant opportunity. ... external constituents in the coordination and administration of the utilization /benefit management function. * Typical office working...of residence + 3+ years of experience as a Registered Nurse + 1+ years of clinical… more
- Humana (Louisville, KY)
- **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 ... benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the… more
- Mayo Clinic (Rochester, MN)
- …and inclusion, and provides the resources you need to succeed. **Responsibilities** The Registered Nurse ( RN ) Case Manager works within an interdisciplinary ... by ensuring appropriate utilization management , care coordination, resource utilization , and clinical documentation. The RN Case Manager will function… more
- Banner Health (Gilbert, AZ)
- …include working in an acute care setting within the past 12 months as a Registered Nurse in the specialty area. Banner Registry and Travel physician practice ... (HUC). Clinical Care Operations is the hub of patient management for the campus, including: bed assignment, unit staffing...require a minimum of one year experience as a Registered Nurse in a physician practice or… more
- Healthfirst (NY)
- **Duties/Responsibilities:** + Provides case management services for assigned member caseloads which includes: + Pre-certification performing risk-identification, ... Negotiates rates with non-partner providers, where applicable. Ensures appropriate access and utilization of a full continuum of network and community resources to… more
- Geisinger (Danville, PA)
- …Specialty Training Program-Nursing (Required) Experience Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania; ... Job Summary Geisinger is proud to offer a full time Inpatient RN up to $24,000 hiring incentive for eligible candidates! $40.00 minimum hiring rate with increased… more
- Geisinger (Wilkes-Barre, PA)
- …(Required), Bachelor's Degree-Nursing (Preferred) Experience Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania; ... Job Summary Geisinger is proud to offer an Inpatient RN a hiring incentive up to $26,000 for eligible candidates! $35.88 minimum hiring rate with increased rates for… more
- Geisinger (Wilkes-Barre, PA)
- …and License(s) Basic Life Support Certification - Default Issuing Body; Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE & ... Job Summary Geisinger is proud to offer a full time Inpatient RN up to $26,000 hiring incentive for eligible candidates! $37.04 minimum hiring rate with increased… more
- AmeriHealth Caritas (Myrtle Beach, SC)
- ** REMOTE | Care Manager II Registered Nurse (BSN) - Foster Care Program -SC** Location: Myrtle Beach, SC Primary Job Function: Medical Management ID**: ... accurate documentation of Member interactions in ACFC electronic care management platforms where applicable. 6. Monitor appropriate utilization...is required and must hold a current and unrestricted ** Registered Nurse ( RN )** license in… more
- Banner Health (Gilbert, AZ)
- …POSITION SUMMARY This position provides administrative supervision of campus workflow, resource utilization and management , and operations for all clinical and ... Health leadership team. Clinical Care Operations is the hub of patient management for the campus, including: bed assignment, unit staffing (scheduling, balancing,… more
- Banner Health (Tucson, AZ)
- …better benefits, better opportunities and a better community. This position as an RN Navigator will be supporting a new program - Women's Health Navigation Program ... partnering with providers, reporting and more. **This is a remote hybrid role - must be local to Tucson...of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through… more
- Veterans Affairs, Veterans Health Administration (Cleveland, OH)
- Summary The VA Northeast Ohio Healthcare System is recruiting for a Registered Nurse - Risk Management Investigations Coordinator. The Registered ... will function in Quality Managements Service. Responsibilities The Investigation Coordinator, Registered Nurse takes guidance from the Chief of Consolidated… more
- CommonSpirit Health Mountain Region (Centennial, CO)
- …candidates will need the following: Required: Minimum three (3)years clinical experience as Registered Nurse ( RN ) required. Preferred: * Graduate of an ... RN experience preferred. * Minimum Three (3) years utilization management experience preferred * Denials ...work a schedule between 7:00am - 5:00pm and is remote in CO. You do have to have the… more
- Highmark Health (Harrisburg, PA)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... required depending on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field + Certification in Case … more
- HCA Healthcare (Mcallen, TX)
- …work environment where diversity and inclusion thrive? Submit your application for our Registered Nurse Case Manager PRN opening with Rio Grande Regional ... benefits may vary by location._** We are seeking a(an) Registered Nurse Case Manager PRN for our...preferred + Current Texas licensure with State Board of Nurse Examiners as an RN + 1+… more