- Intermountain Health (Murray, UT)
- …a timely discharge, and to identify and resolve delays and issues. Minimum Qualifications Current RN license for state in which the nurse practices. - and - ... **Job Description:** The Nurse Case Manager utilizes clinical expertise and critical...denial prevention. Proactively intervenes with payers to prevent inpatient denials . Performs retroactive reviews on discharged patients as assigned.… more
- Veterans Affairs, Veterans Health Administration (Middleton, WI)
- …equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion ... Summary The Revenue Utilization Review (RUR) nurse is under the supervision of the ...appeals as required by the third-party payers to overturn denials and increase reimbursement. Responds to customer service issues… more
- Houston Methodist (Houston, TX)
- …in utilization review and/or case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact ... Specialist Nurse (URSN) position is a licensed registered nurse ( RN ) who comprehensively...functions through point of entry, observation progression of care management , concurrent review and denials reviews. Additionally,… more
- Catholic Health Services (West Islip, NY)
- …degree required. + Master of Science degree strongly preferred. + Licensure: New York Registered Nurse ( RN ) License & Registration. + Certification: Care ... Supports all CH and consultant initiatives addressing activities relative to Care Management and Denials . + Identifies opportunities for improvement that result… more
- Hartford HealthCare (Farmington, CT)
- … management and appeals preferred. **Licensure, Certification, Registration** * Active Registered Nurse license from the State of Connecticut * Certified ... now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system.… 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 case management software (eg, Allscripts Care Management ).The RN CM will develop and document… more
- UPMC (Washington, PA)
- …higher levels of multi-disciplinary team performance and desired patient outcomes is needed. + Registered Nurse ( RN ) *Current licensure either in the state ... experience in leadership. Licensure, Certifications, and Clearances: + Current licensure as a Registered Nurse in practicing state required. + UPMC approved Care… more
- BayCare Health System (Tampa, FL)
- …Call:** No **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred ACM (Case Management ) + Preferred CCM (Case Manager) ... or + Required 2 years in Case Management or + Required 3 years Registered Nurse + Preferred experience in Critical Care or Emergency Service **Benefits:** +… more
- Providence (Torrance, CA)
- …them. **Required Qualifications:** + Associate's Degree Nursing. + Upon hire: California Registered Nurse License. + 2 years Direct patient care experience ... **Description** **Appeals RN - Care Manager Remote. This position is...Nursing. Or Master's Degree Nursing. + Upon hire: Case management certification. + Experience working with denials … more
- Nuvance Health (Poughkeepsie, NY)
- …- Discharge Planning primarily Under the general supervision of the Director, The Nurse Case Manager role provide clinically-based case management to support the ... to prevent the denial where possible. 5. Supports the effective prevention and management of denials , including providing information as part of the appeal… more