- Northeast Georgia Health System, Inc (Gainesville, GA)
- …organizational standardization. Participates in identifying expanded use of and improvement management utilization of NGHS continuum. Participates in identifying ... Job Category:Nursing - Registered Nurse Work Shift/Schedule:VariesNortheast Georgia Health System is...Services. Eligibility requirements for certification: 12 months full-time case management experience supervised by a certified case manager… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …school of nursing. Eligibility requirements for certification: 12 months full-time case management experience supervised by a certified case manager , or 24 ... Job Category:Nursing - Registered Nurse Work Shift/Schedule:8 Hr Morning - AfternoonNortheast...management experience not supervised by a certified case manager . Minimum Experience: Three (3) to five (5) years… 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
- Protouch Staffing - Permanent (El Paso, TX)
- Protouch Staffing - Permanent is seeking a Registered Nurse (RN) Case Management for a nursing job in EL Paso, Texas.Job Description & RequirementsSpecialty: ... per weekShift: 8 hours, daysEmployment Type: StaffPerks: Benefits: All Standards benefits are covered. Manager of Case Management RN - El Paso, TX Job Type: Full… more
- LHC Group (Reno, NV)
- LHC Group is seeking a Registered Nurse (RN) Home Health Clinic for a nursing job in Reno, Nevada.Job Description & RequirementsSpecialty: ClinicDiscipline: ... salary will be commensurate with experience. Summary We are hiring a Patient Care Manager /Clinical Manager (RN) with Home Health experience. At St Mary's Home… more
- Blanchard Valley Hospital (Findlay, OH)
- PURPOSE OF THIS POSITION The purpose of the role of the RN Case Manager is to develop, implement and evaluate an organized inpatient case management service for ... the direction of the attending provider. The RN Case Manager will assist in identifying and addressing the physical...meetings to contribute information regarding transitions of care and utilization of care resources for the purpose of improving… 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 ... of the interdisciplinary care transition team. The acute care transition manager fosters communication and collaboration across the health system, develop safe,… more
- Northeast Georgia Health System, Inc (Braselton, 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 Excellence in Minimally Invasive Surgery and Robotic Job SummaryThe Nurse Manager (NM) functions as the first-line administrative nursing leader, with 24-hour… more
- Pacer Staffing (Atlanta, GA)
- …direction and build group engagement. Technical Skills: Thorough knowledge of Case Management , Utilization Management , TRICARE policies and procedures, HIPAA ... serious disabilities, physical disabilities.) Job Summary: The position provides case management services for TRICARE beneficiaries registered in the Extended… more
- Cambia Health Solutions, Inc (Lewiston, ID)
- …Associates or Bachelor's Degree in Nursing or related field3 years of case management , utilization management , disease management , or behavioral ... least one of the following: Certification as a case manager from the URAC-approved list of certifications; or Bachelor's...degree in Behavioral Health preferred for behavioral health care management ); or Registered nurse (RN) license (must… more
- ERP International (Corpus Christi, TX)
- **Overview** ERP International is seeking a ** Registered Nurse (RN)** ** Utilization Manager ** for a full-time position in support of the **Naval Health ... staff, newcomers, as appropriate. * Participate in all phases of the Utilization Management Program (UMP) and ensure that the UMP meets established … more
- Sutter Health (Burlingame, CA)
- **Organization:** Bay Administration **Position Overview:** Responsible for Utilization Management and accurate bed placement for patients coming in from the ED. ... acute care patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the… more
- Cedars-Sinai (Los Angeles, CA)
- …thereafter as a condition of continued employment. **Req ID** : 4870 **Working Title** : Registered Nurse - Utilization Management 8 Hour Days Per Diem ... Hospitals! **What You Will Do in This Role:** The Utilization Review Case Manager validates the patient's...**Department** : Utilization Management **Business Entity** : Cedars-Sinai Medical Center **Job Category**… more
- Humana (Louisville, KY)
- …a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... services and/or benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work assignments are varied and… more
- Commonwealth Care Alliance (Boston, MA)
- …required. + CCM (Certified Case Manager ) preferred + 1 to 2 years Utilization Management experience required. + 2 or more years working in a clinical ... under the provisions of CCA's benefits plan. The Nurse Utilization Management (UM) Reviewer is responsible for...accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy + Works… more
- Centene Corporation (Jefferson City, MO)
- …2+ years supervisory experience preferred. Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse ... Clinical Review team to ensure appropriate care to members. Manages utilization management issues related to member care, provider interactions, and facilitates… more
- Lucile Packard Children's Hospital Stanford (Palo Alto, CA)
- …include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient charts for timeliness ... of services as well as appropriate utilization of services; and ensuring optimum use of resources,...delivery and quality of patient care. A hospital-based case management system has as its primary goal to ensure… more
- Molina Healthcare (NV)
- …not a compact state at this time.** **Prior experience with managed care (Medicaid, Medicare) Utilization Management processes and 3 + years in management / ... performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.),… more
- UNC Health Care (Hillsborough, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection by reconciling physician orders,… more
- Trinity Health (Silver Spring, MD)
- …acute healthcare setting required. + Extensive knowledge of payer mechanisms and clinical utilization management is required **Preferred:** + At least 5-7 years ... - 4:30pm + Reporting to the Director of Care Management + The RN Manager is responsible...RN Case Managers for in inpatient care coordination and utilization review. Oversees interactions of staff with outside activities… more
