- Stony Brook University (Stony Brook, NY)
- …and other duties as required. **Qualifications** **Required** : A Bachelor's degree or a nurse working on their degree with an RN license and working history ... excellence. **Duties of a Care Manager in the Care Management Department may include the following but are not...the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity… more
- Humana (Lincoln, NE)
- **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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Cedars-Sinai (Beverly Hills, CA)
- …Angeles Fair Chance Initiative for Hiring. **Req ID** : 12949 **Working Title** : Registered Nurse - ISP Care Coordinator - PER_DIEM 8 Hour Days **Department** ... nurse practitioner and case manager assigned to the SNF 's for continued review and follow up. + Authorizes...TPL carrier of all injured worker cases receiving case management services. + Ensures appropriate utilization of… more
- CVS Health (Oklahoma City, OK)
- …and timely discharge, appropriate follow-up care, and next steps. + Coordinate with the Utilization Management team to review medical and payer records to ensure ... teams across various sites of care (eg ED, hospital, SNF , primary care clinics). This role prioritizes the relationship...stay and identify any barriers to discharge. + Assist Utilization Management team with access to external… more
- PeaceHealth (Bellingham, WA)
- **Description** PeaceHealth is seeking a RN Admissions/ Utilization Behavioral Health - Care Management for a Full Time, 1.00 FTE, Day position. The salary ... Review experience, someone who can talk to providers. **Credentials** + Required: Registered Nurse in state of practice + Preferred: Psychiatric/Mental Health… more
- AmeriHealth Caritas (Washington, DC)
- **$5,000.00 SIGN ON BONUS** **Role Overview** Our Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient services, ensuring ... in the least restrictive and most effective manner. The Utilization Management Reviewer must maintain a strong...of 3 years of diverse clinical experience as a Registered Nurse in an Intensive Care Unit… more
- Sharp HealthCare (La Mesa, CA)
- …3 Years Recent acute care nursing experience or case management experience. + California Registered Nurse ( RN ) - CA Board of Registered Nursing ... Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA...and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge… more
- Actalent (Atlanta, GA)
- Utilization Review ( Registered Nurse ) Job Description...- Appeals, and Risk Management . Essential Skills + Registered Nurse ( RN ) with a valid ... license in GA or Compact. + 1+ years of experience in Utilization Management (UM). + 1+ years of experience in managed care. Job Type & Location This is a… more
- CenterWell (San Juan, PR)
- … RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous… more
- CenterWell (Austin, TX)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous… more
- ChenMed (Philadelphia, PA)
- …RN with bachelor's degree in a related clinical field preferred + A valid, active Registered Nurse ( RN ) license in State of employment required + Compact ... the remaining hours. The Acute Care Manager, Complex Care ( RN ) is responsible for achieving positive patient outcomes, managing...required + A minimum of one (1) year of utilization review and/or case management , home health,… more
- ChenMed (Newport News, VA)
- …We're rapidly expanding and we need great people to join our team. The Nurse Case Manager 1 ( RN ) is responsible for achieving positive patient outcomes ... post-acute facilities, as well as, their home environments. The Nurse Case Manager 1 ( RN ) role also...preferred providers. + Coordinates the integration of social services/case management functions in the pre-acute, ER, acute and post-acute… more
- University of Southern California (Los Angeles, CA)
- …(CMSA) Nationally recognized certification such as CCM and/or ACM Required Licenses/Certifications: + Req Registered Nurse - RN (CA Board of Registered ... The RN Transitional Care Program Coordinator provides oversight of...such as home health, home infusion, Skilled Nursing Facility ( SNF ), Long Term Acute Care (LTAC), Acute Rehabilitation Unit… more
- Billings Clinic (Billings, MT)
- …care. * Maintains respectful and professional communication skills. Insurance and Utilization Management *Maintains working knowledge of CMS requirements and ... * 1 Experience working in Billings Clinic, preferred. License and Certification * Current Registered Nurse license in the state of Montana, at hire Billings… more
- Sharp HealthCare (San Diego, CA)
- …**Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered ... or equivalent experience in the healthcare setting. + California Registered Nurse ( RN ) - CA...and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge… more
- Pine Acres Rehabilitation & Care Center (Nebraska City, NE)
- …accountability to Administrator Reporting to this position: None Job Classification: Registered nurse with administrative duties/ management Position Purpose: ... a current, unencumbered, active license to practice as a registered nurse in Nebraska. Must have 3...primary resource for problem solving in regards to the SNF prospective payment system and quality reporting program. Infection… more
- ChenMed (Norfolk, VA)
- … management programs, clinical meetings and other meetings. The Nurse Practitioner will adhere to strict departmental goals/objectives, standards of performance, ... role. + Facilitate patient/family conferences to review treatment goals, optimize resource utilization , provide family education and identify post- SNF needs. +… more
- ChenMed (Norfolk, VA)
- … management programs, clinical meetings and other meetings. The Nurse Practitioner will adhere to strict departmental goals/objectives, standards of performance, ... role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education and identify post- SNF needs. +… more
- UPMC (Pittsburgh, PA)
- …post-acute care such as Inpatient Rehab and/or Skilled (ie: SNF ). Are you an RN or social worker interested in care management , case management , or care ... and placing a focus on an optimal discharge plan with timely utilization of hospital resources. This optimal discharge plan reviews discipline recommendations and… more
- Hartford HealthCare (Wethersfield, CT)
- …professional position, working as a member of the ICP Community Care Management team. The ICP Community Care Manager facilitates transitions as patients move ... uninterrupted quality care, as well as providing ongoing education and diseased management for ICP attributed patients with chronic conditions. They are responsible… more
