- Humana (Columbus, OH)
- **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
- Elevance Health (Tampa, FL)
- ** Telephonic Nurse Case Manager Senior** **Location: This is a virtual position. Candidates must reside within 50 miles of an Elevance Health Pulse Point ... 48 hours of receipt and meet the criteria._** The ** Telephonic Nurse Case Manager Senior** is responsible...claims or service issues. + Assists with development of utilization /care management policies and procedures, chairs and… more
- Elevance Health (GA)
- …criteria._** The ** Telephonic Nurse Case Manager I** is responsible for telephonic care management within the scope of licensure for members with complex ... ** Telephonic Nurse Case Manager I -...** Telephonic Nurse Case Manager I - $3000 Sign-On Bonus...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- Elevance Health (Norfolk, VA)
- ** Telephonic Nurse Case Manager II** **Location: This is a virtual position. Candidates must reside within 50 miles of an Elevance Health Pulse Point location.** ... service members in different states; therefore, Multi-State Licensure will be required.** The ** Telephonic Nurse Case Manager II** is responsible for care … more
- Elevance Health (Palo Alto, CA)
- ** Telephonic Nurse Case Manager II** **Location: This is a virtual position. Prefer candidates reside in a PST or MST state and within 50 miles of an Elevance ... service members in different states; therefore, Multi-State Licensure will be required.** The ** Telephonic Nurse Case Manager II** is responsible for care … more
- Elevance Health (Grand Prairie, TX)
- …is provided during regular business hours, 8:30 am - 5:00 pm.** **The Transplant Nurse II** is responsible for providing case management and/or medical ... problem solving with providers, claims or service issues. Assists with development of utilization /care management policies and procedures. + Within the medical … more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist LVN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist LVN...Actively monitors for admissions in any inpatient setting. Performs telephonic and/or on site admission and concurrent review, and… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... to support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and… more
- HCA Healthcare (Campbell, CA)
- …purpose and integrity. We care like family! Jump-start your career as a(an) Utilization Management RN today with HCA Healthcare. **Benefits** HCA Healthcare, ... vary by location._** Come join our team as a(an) Utilization Management RN. We care for our...been identified as high risk for hospital readmissions through telephonic case management Perform other duties as… more
- Ventura County (Ventura, CA)
- Senior Medical Management Nurse - VCHCP Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4591361) Apply Senior Medical Management ... nursing classifications in that they will provide Care/Case management , Disease Management , Wellness and Prevention, Utilization Management and tasks… more
- The Cigna Group (Philadelphia, PA)
- …works as part of the team to manage heath care cost and utilization **Provider Support** 1. Completes telephonic nursing assessments including social ... and make appropriate referrals to social work, pharmacy, case management and engagement _Other telephonic patient care...needed 3) 3+ years of experience as a Registered Nurse 4) Proficient level of experience with Microsoft Office… more
- Elevance Health (Columbus, OH)
- ** Telephonic Nurse Disease Management II** **$2000 Sign on Bonus** At **Federal Health Products and Services - FHPS** , a proud member of the Elevance ... - Friday 12:30 pm - 9 pm, or 2:30 pm - 11 pm EST.** The ** Telephonic ** **N** **urse Disease Management II** will be responsible for telephonic outreach,… more
- ERP International (Camp Pendleton, CA)
- …algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with ... databases for community resources, etc. + Integrate CM and utilization management (UM) and integrate nursing case...the certifications below **OR** Possess a Master's Degree in Nurse Case Management from a program accredited… more
- The Cigna Group (Bloomfield, CT)
- ** Nurse Case Management Lead Analyst -Remote -Full-Time** **Bilingual in Dari or Pashto language** **Required Work Hours: 9:00 am-5:30 pm PST.** **Major Job ... case management needs and assigning to a client based CM for further management when appropriate.** **Must be skilled in utilization of Cigna resources when… more
- ERP International (Scott AFB, IL)
- …literacy. * Educates/trains team/facility staff on policies and procedures for utilization of guidelines, protocols and other disease management activities. ... Management Society of America (CMSA); American Accreditation Healthcare Commission/ Utilization Review Accreditation Commission (URAC); CAMH; (AAAHC); Health Services… more
- Fenway Health (Boston, MA)
- …objective scientific principles, and the patient's subjective experiences. + Conducts virtual, telephonic , or in-person nurse assessment and triage to assess the ... Registered Nurse , Per Diem Boston, MA (http://maps.google.com/maps?q=1340+Boylston+St+Boston+MA+02215) * Nursing...to the care team with primary responsibilities for disease management , care coordination, and advice/triage needs for the care… more
- Elevance Health (Indianapolis, IN)
- ** Telephonic Nurse Case Manager II** At **Federal Health Products and Services - FHPS** , a proud member of the Elevance Health, Inc. family of companies, it's a ... - Friday 10 am - 7 pm EST.** The ** Telephonic ** ** Nurse Case Manager II** is responsible...or service issues. + Assists with the development of utilization /care management policies and procedures. **Minimum** **Requirements:**… more
- Spectrum Health Services (Philadelphia, PA)
- …medical, behavioral health and/or psychosocial problems through practice and home-based visits and telephonic support on a care management or case management ... care team, assesses patients for risk of adverse health outcomes, inappropriate utilization , and monitors the impact of care management interventions. Essential… more
- The Cigna Group (Harlingen, TX)
- …Nursing. * Three to Five (3-5) years recent experience in an acute-care environment, case- management or utilization management position (experience can be a ... provider practices * Identifies high-risk/high-cost patients for possible case management intervention. * Interfaces with providers of medical services and… more
- ERP International (Lemoore, CA)
- …algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with ... **Overview** ERP International is seeking **Registered Nurse (RN) Case Managers** for full-time positions in...charting on the computer, utilizing various programs. Integrate case management with utilization management and… more