• Medical Claim Review Nurse (RN)

    Molina Healthcare (Warren, MI)
    …Certified Clinical Coder, Certified Medical Audit Specialists, Certified Case Manager , Certified Professional Healthcare Management , Certified Professional ... for denial or modification of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and… more
    Molina Healthcare (09/06/25)
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  • Clinical Program Coordinator RN, Medicare…

    Providence (OR)
    …date: Current unencumbered Registered Nurse License in Washington State + Case Management Experience (EX. Triage and Referral, Transition of Care Planning, ... Medicare / Medicaid who will:** + Provide care coordination, case management and care management ...are terminal and nearing end of life + Care management services include: nurse education, care coordination… more
    Providence (08/23/25)
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  • Utilization Review Analyst - Registered…

    Beth Israel Lahey Health (Burlington, MA)
    …5 8-hour shifts. The Utilization Analyst works with physicians, the payers and inpatient case management team to validate the medical necessity of the hospital ... clinical documentation improvement and revenue integrity, these specialized case managers analyze medical documentation to ensure that proper reimbursement will… more
    Beth Israel Lahey Health (09/12/25)
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  • Registered Nurse Care Manager

    AdventHealth (Daytona Beach, FL)
    …for each position may vary based on geographical location. **Category:** Case Management **Organization:** AdventHealth Daytona Beach **Schedule:** Full-time ... Manager ensures efficient and cost-effective care through appropriate resources monitoring, and clinical care escalations. The RN Care Manager is under the general… more
    AdventHealth (09/15/25)
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  • Trauma Nurse Clinician

    Prime Healthcare (Lynwood, CA)
    …service! Responsibilities The clinician is responsible for performing an integral role in case management of patients admitted to the Trauma Service, evaluates ... in the practice of trauma nursing, expert knowledge of trauma systems, case management , quality improvement, knowledge of adult learning theories, computer… more
    Prime Healthcare (09/17/25)
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  • RN - Registered Nurse Care Manager…

    Geisinger (Wilkes-Barre, PA)
    …of care using predetermined criteria, reporting potential risk and quality management issues identified from medical record review to appropriate departments through ... to support quality improvement initiatives into appropriate system. + Conducts on-going case review for delays or variances in care; raises issues with appropriate… more
    Geisinger (09/15/25)
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  • RN - Registered Nurse Care Manager…

    Geisinger (Middleburg, PA)
    …of care using predetermined criteria, reporting potential risk and quality management issues identified from medical record review to appropriate departments through ... to support quality improvement initiatives into appropriate system. + Conducts on-going case review for delays or variances in care; raises issues with appropriate… more
    Geisinger (09/15/25)
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  • Public Health Nurse

    Allegan County (Allegan, MI)
    …family and makes appropriate referrals, utilizing resources + Provides comprehensive case management and coordinates services provided through a ... agency and in the community as assigned. + Provides prevention and health education, case management , and care to individuals and families, in coordination with… more
    Allegan County (09/13/25)
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  • Rapid Response Nurse - Full Time Day Shift

    Virtua Health (Mount Holly, NJ)
    …unit/department. Communicates and collaborates extensively with other caregivers, physicians, case management , patient and/or patients' families or significant ... unit/department as well as those of individual patients.Interacts with physicians and case management to coordinate care and effectively problem solves to… more
    Virtua Health (09/11/25)
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  • Inpatient Hospice Nurse Care Coordinator

    University of Washington (Seattle, WA)
    …may substitute for education. + Three years of professional nursing experience. + Case management and discharge planning; hospice case management ... Care** **departments** have an outstanding opportunity for an **Inpatient Hospice Nurse Care Coordinator** to join our team. **DEPARTMENT DESCRIPTION** With the… more
    University of Washington (09/06/25)
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