- Beth Israel Lahey Health (Cambridge, MA)
- …SKILLS, AND ABILITIES REQUIRED** 1. RN with experience in risk management , quality assessment, or utilization management . 2. Strong spreadsheet, ... Quality & Patient Safety, the Quality and Patient Safety nurse specialist plays a role in reviewing publicly reported...on the key performance indicators and quality measures, the RN specialist also aims to foster a culture of… more
- US Tech Solutions (Columbia, SC)
- **Duration: 3+ Months Contract (Possible temp to hire)** **Job Description:** + Must be an RN in SC and have an active and unrestricted SC RN license. + ... prioritize effectively and have critical thinking skills. + Experience in case management or care coordination and telephonic care experience is preferred. + A… more
- BayCare Health System (Tampa, FL)
- …**On Call:** No **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred ACM (Case Management ) + Preferred CCM (Case Manager ) ... of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/ RN responsibilities include:** +...Case Management or + Required 3 years Registered Nurse + Preferred experience in Critical… more
- Banner Health (Mesa, AZ)
- …to ensure excellent patient care. Actively develops leadership of entry level nurse manager (s) while leading clinical improvement initiatives. Internal customers ... the operations of the unit to ensure smooth and efficient patient care management and resource utilization . 2. Leads change by developing, implementing and… more
- LifePoint Health (Wilson, NC)
- …delivery of healthcare services. The Case Manager integrates the roles of Utilization Management , Case Management and Discharge Planning. The Case ... resources for optimal discharge planning Drag Edit Delete *Required Licenses* Registered Nurse - Current/active North Carolina or compact RN license - BLS… more
- Whidbey General Hospital (Coupeville, WA)
- …health, Hospice, skilled nursing, anti-biotic regime, etc. The RN - Care Manager follows the hospital's Case Management / Utilization Plan that integrates ... regarding Utilization Review and Discharge Planning. The RN - Care Manager will lead an...resource utilization , the discharge planning and appeal/denial management . The RN - Care Manager… more
- HCA Healthcare (Salem, VA)
- …**. In a RN Case Manager role, you will perform utilization management reviews and communicates information to third party payers** **. You will ... **Introduction** Do you have the career opportunities as a RN Case Manager Behavioral Health you want...member of this team, you will develop a case management plan of care for new and reoccurring patients… more
- Molina Healthcare (Las Vegas, NV)
- …Active, unrestricted Certified Case Manager (CCM) Some experience with Utilization Management processes is also desirable (InterQual, MCG guidelines) To ... care or medical or behavioral health settings. Prior experience in Utilization Management and discharge planning. **Preferred License, Certification,… more
- Ascension Health (Baltimore, MD)
- …options for post-discharge care. **Requirements** Licensure / Certification / Registration: + Registered Nurse obtained prior to hire date or job transfer ... Heart Association or American Red Cross accepted. + Case Manager credentialed from the Commission for Case Manager...**Additional Preferences** + One year of **recent** experience in Utilization Management required. + Local and national… more
- Elevance Health (Costa Mesa, CA)
- RN Utilization Management Nurse (NICU / Peds) - California (JR169694) **Virtual:** This role enables associates to work virtually full-time, with the ... - 6pm PST. Rotating Weekends and holidays. The **Medical Management Nurse ** is responsible for review of...clinical experience in NICU / Peds strongly preferred. + Utilization management /review within managed care or hospital… more