• Case Manager RN

    Prime Healthcare (Woonsocket, RI)
    …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... post-graduation of an accredited school of nursing and a current state Registered Nurse license2. Grandfathered prior to April 1, 2015. Minimum 5 years post graduate… more
    Prime Healthcare (09/26/25)
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  • Clinical Documentation Specialist

    Brockton Hospital (Brockton, MA)
    …Medicine, Nursing, Case Management, the Quality Department and ancillary staff to perform concurrent analytical review of the medical record to ensure an ... license from Commonwealth of Massachusetts to practice as a Registered Nurse Experience: Minimum of five years clinical experience required. Software/Hardware: Word,… more
    Brockton Hospital (09/25/25)
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  • Case Manager

    Prime Healthcare (East Liverpool, OH)
    …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... post-graduation of an accredited school of nursing and a current state Registered Nurse license. + Grandfathered prior to April 1, 2015. Minimum 5 years post… more
    Prime Healthcare (09/24/25)
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  • Manager, Clinical Care Coordination and Discharge…

    UPMC (York, PA)
    …for timely and accurate documentation of appropriate data relating to concurrent denials. Assures regulatory compliance in determining denial of service and/or ... AND SKILLS:Expertise in care management, discharge planning and utilization review processes. Ability to build credible and effective relationships with… more
    UPMC (09/19/25)
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  • Manager, Health Information Management, Coding

    Carle Health (Urbana, IL)
    …(COC) or + Certified Inpatient Coder (CIC) or + Licensed Registered Professional Nurse (RN) or + Certified Coding Specialist - Physician-Based (CCS-P) or + ... changes related to coding. + Ensures proper coordination between Concurrent Clinical Documentation Specialists, inpatient coders, outpatient coders, physician… more
    Carle Health (09/18/25)
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  • RN Case Manager Emergency, Allegheny General

    Highmark Health (Pittsburgh, PA)
    …operational areas regarding issues related to supported technology. Manage utilization review , translation of foreign claims, coordination of benefits (COB), and ... other members of the interdisciplinary team. + Completes and documents admission, concurrent , and discharge reviews of all inpatients and selected outpatients. +… more
    Highmark Health (09/13/25)
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  • Medical Management Clinician

    Elevance Health (Independence, OH)
    …complex case types that do not require the training or skill of a registered nurse . **How you will make an impact.** Primary duties may include, but are not limited ... less experienced staff. + Conducts and may approve precertification, concurrent , retrospective, out-of-network, and/or appropriateness of treatment setting reviews… more
    Elevance Health (09/10/25)
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  • RN, Hospital Case Manager Per Diem

    Baystate Health (Springfield, MA)
    …Hospital Case Manager** The **RN Hospital Case Manager** is a registered nurse responsible for the coordination of clinical care, quality, and financial outcomes ... and implements interventions for patients at risk for readmissions + Manages concurrent denials and works with physicians to overturn for appropriate reimbursement… more
    Baystate Health (09/09/25)
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  • RN Navigator Cardiovascular PRN

    HCA Healthcare (Charleston, SC)
    …up education to staff as indicated. Assists with analysis and action plans for concurrent database monitoring. Role also acts as a resource internally and in the ... 90 days of employment start date + (RN) Registered Nurse + Associate Degree Trident Health is a 445-bed...apply for our RN Navigator Cardiovascular PRN opening. We review all applications. Qualified candidates will be contacted for… more
    HCA Healthcare (09/06/25)
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  • Case Manager (RN) - Social Work

    Prime Healthcare (Victorville, CA)
    …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... post-graduation of an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum 5 years post… more
    Prime Healthcare (09/04/25)
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