- St. Luke's University Health Network (Allentown, PA)
- …Works inside with adequate lighting, comfortable temperature and ventilation. EDUCATION: Registered Nurse required, BSN preferred. Current license required. . ... regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data… more
- Highmark Health (Monroeville, PA)
- …also building relationships across the organization in a community setting. **GENERAL OVERVIEW:** Registered nurse who is proficient in the coordination of care ... coordination of care in accordance with recognized standards of practice for Care Management . Professional role model utilizing expertise in care management to… more
- UNC Health Care (Smithfield, NC)
- …of employment date. **Licensure/Certification Requirements:** * Licensed to practice as a Registered Nurse in the state of North Carolina. **Professional ... and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ensure patient needs are met and care delivery is… more
- LA Care Health Plan (Los Angeles, CA)
- …the ability to manage multiple training initiatives simultaneously. Licenses/Certifications Required Licensed Registered Nurse ( RN ) - Active, current and ... Lead Customer Solution Center Appeals and Grievances RN Job Category: Clinical Department: CSC Appeals &...position will mentor, coach, and may provide feedback to management on performance of staff. Ensure team effectiveness and… more
- HonorHealth (AZ)
- …in an acute care setting. Required1 year experience in UR/UM or Case Management RequiredLicenses and CertificationsRegistered Nurse ( RN ) State And/Or Compact ... does. Learn more at HonorHealth.com. Responsibilities Job SummaryThe Utilization Review RN Specialist reviews and monitors utilization of health care services with… more
- Baystate Health (Springfield, MA)
- …Diem Hospital Case Manager** The ** RN Hospital Case Manager** is a registered nurse responsible for the coordination of clinical care, quality, and financial ... interventions for patients at risk for readmissions + Manages concurrent denials and works with physicians to overturn for appropriate reimbursement **Required… more
- Carle Health (Champaign, IL)
- …Administrator (RHIA) - American Health Information Management Association (AHIMA); Licensed Registered Professional Nurse ( RN ) - Illinois Department of ... Overview **REMOTE RN POSITION** Performs inpatient chart review to determine...nurses, ancillary staff, and the coders in Health Information Management to identify and record principal and secondary diagnoses,… more
- Stony Brook University (Stony Brook, NY)
- …communication skills while adhering to our high standard of excellence. **Duties of a RN Case Manager in the Care Management Department may include the following ... assigned. Identifies, follows and documents Avoidable delays in Care Management Program. Reviews and documents on patients who were...required. **Qualifications** **Required** : A Bachelor's degree or a nurse working on their degree with an RN… more
- Whidbey General Hospital (Coupeville, WA)
- …etc. The RN - Care Manager follows the hospital's Case Management /Utilization Plan that integrates the functions of utilization review, discharge planning, and ... management either during admission or post discharge. The RN - Care Manager acts as a resource to...per case, avoidable days, resource utilization, readmission rates, concurrent denials , and appeals. + Supports the vision, mission, and… more
- Genesis Healthcare (Los Angeles, CA)
- …impact in the communities we serve. Responsibilities The Manager, Case Management is responsible for the clinical, administrative, and financial oversight of ... the territory's center-based care management staff. This position oversees the personnel and processes...for effectively addressing concurrent and retrospective clinical and administrative denials by payors and trains staff on same. 5.… more