- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …of clinical nursing experience, including behavioral/mental health + Experience in a managed care , case management , or utilization review setting + Strong ... guidelines and insurance coverage. + Provide telephonic and/or in-person case management and member education regarding conditions,...criteria for medical necessity for the requested level of care /patient status to the Medical Director . +… more
- BrightStar Care (Merrillville, IN)
- …Medical * Dental * Vision * Term Life * PRN options available * Home Health Case Management shifts available * Travel time reimbursement * Mobile shift access * ... for a job where you can provide direct quality care in the patients home? Do you want to...in the client/patient's conditions and needs, and keeps the Director of Nursing and any other appropriate personnel informed… more
- McLaren Health Care (Indianapolis, IN)
- …year previous experience in Managed Care Utilization Management , Medical Management , Case Management . **Preferred:** + Two (2) years' experience and ... the member advocate with emphasis on education regarding managed care , disease management and PCP treatment plans....and under and overuse of services. Collaborates with Medical Director and senior management on complex cases… more
- Volunteers of America Los Angeles (Los Angeles, CA)
- …care services where Veterans are not eligible for VA care . SSVF health care navigators provide case management and care coordination, health ... team, including medical, nursing, and administrative specialists, and case management personnel. The SSVF health care navigator works within this… more
- St. Peters Health (Helena, MT)
- …within the department, service lines, facility, and St Peter's community and managed care organizations relevant to case management and utilization review ... with the patient/family, physicians, and the interdisciplinary team, the Case Management /Utilization Review RN facilitates the patient's...+ Functions as a member of a self directed Care Management work team ensuring appropriate coverage… more
- ChenMed (Lakeland, FL)
- …works for ChenMed or not). + Responsible for assessment, diagnosis, treatment, management , education, health promotion and care coordination and documentation ... hospital, SNF, LTC or home-bound, the CMD will engage with the transitional care team and others including case managers, acute and transitional- care… more
- Community Health Systems (Oro Valley, AZ)
- …Manager - RN is responsible for coordinating and overseeing discharge planning, transitions of care , and case management activities to ensure optimal patient ... and Abilities** + Strong understanding of case management principles, discharge planning, and transitions of care...part of the application or hiring process, contact the director of Human Resources at the facility to which… more
- Providence (Apple Valley, CA)
- …will be considered on a case -by- case basis at each ministry by the Director of Care Management in consultation with the human Resources. + RNs ... payers, support staff, other practitioners and the community. The Case Management process facilitates communication and care coordination along a continuum… more
- Mirror (Lawrence, KS)
- … Care Coordinator shall be responsible for person centered, strengths-based case management services for individuals seeking treatment services. The Community ... facilitates educational presentations as needed and required. 2. Provides case management and referral services for program...other job responsibilities as assigned by the Regional Area Director or members of the Mirror Management … more
- AdventHealth (Altamonte Springs, FL)
- …delay and other data for specific performance and/or outcome indicators as determined by Director of Care Management . * Documents key clinical path variances ... to avoid unnecessary denials. Working in collaboration with facility Care Management to ensure that high quality.... + Interacts with physicians, physician office personnel, and/or case management departments on an as-needed basis… more