- Brockton Hospital (Brockton, MA)
- …include the development and supervision of staff (RNs, LPN's,SWs and non- clinical support), evaluation and maintenance of case management skills and outcomes, ... include the development and supervision of staff (RNs, LPN's, SWs and non- clinical support), evaluation and maintenance of case management skills and outcomes,… more
- Ellis Medicine (Schenectady, NY)
- …The Discharge Planner's primary function is to work with the Social Worker, Nurse Case Manager, or Utilization Management Nurse to facilitate patient discharge ... in utilization management activities under the direction of a registered nurse and/or social worker. Responsibilities include maintaining case files, updating… more
- Highmark Health (Pittsburgh, PA)
- …and contractual requirements. + Documents, monitors, intervenes/resolves and reports clinical denials/ appeals and retrospective payer audit denials. ... Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Registered nurse who is proficient in the coordination of care...lieu of a degree + 3 years in a clinical nursing role + Current State of PA RN… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …needs across the continuum of care by leveraging member partnership, pre-service clinical utilization review, case and disease management processes, skill sets and ... * Identifies opportunities for connecting members to group related benefits; eg Nurse Line, Employee Assistance Program, or other specialists with in BCBS Health… more
- CommonSpirit Health Mountain Region (Westminster, CO)
- …provide excellent patient-centered care with teamwork and compassion. Our department appeals to anyone interested in furthering their skillset, specifically in the ... and leaders who care about your success. We offer Certification pay and a Clinical Career Ladder to help you grow and recognize your contributions to clinical… more
- CommonSpirit Health Mountain Region (Westminster, CO)
- …pre-and post-operative care for orthopedic, abdominal, and general surgeries. 5 West appeals to anyone interested in broadening their skillset as we receive overflow ... and leaders who care about your success. We offer Certification pay and a Clinical Career Ladder to help you grow and recognize your contributions to clinical… more
- CommonSpirit Health Mountain Region (Westminster, CO)
- … Clinical Career Ladder to help you grow and recognize your contributions to clinical excellence! As a Nurse with us you will assume responsibility and ... pre-and post-operative care for orthopedic, abdominal, and general surgeries. 5 West appeals to anyone interested in broadening their skillset as we receive overflow… more
- US Tech Solutions (Columbia, SC)
- …and appeals . Documents decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical claims and utilization practices. ... Nursing or Licensed Vocational Nursing. Required Experience: 2 years clinical experience. Required Licenses and Certificates: Active, unrestricted LPN/LVN licensure… more
- Centene Corporation (Little Rock, AR)
- …Systems), HOS (Health Outcomes Survey), CTMs (Complaints to Medicare), Disenrollments, Appeals , and Grievances. + Collaborates with Provider Relations and other ... provider facing teams to improve provider performance in Quality ( Clinical and Member Experience measures). Provides clear insight into provider group dynamics,… more
- City and County of San Francisco (San Francisco, CA)
- …class is a first line supervisor responsible for providing leadership on clinical standards for Mental Health Rehabilitation Workers, Licensed Vocational Nurses and ... of staff and program needs; + Participates in establishing clinical standards; inputs on unit issues; + Makes shift...as a Licensed Psychiatric Technician or a Licensed Vocational Nurse providing psychiatric nursing care in a skilled facility… more