- Cleveland Clinic (Cleveland, OH)
- …Department's software Preferred qualifications for the ideal future caregiver include: + Case Management Certification (CCM) + Prior Utilization Management ... respected healthcare organizations in the world. As a Utilization Management Specialist, you will perform UM activities, such as...basic disease processes + Three years of equivalent full-time clinical experience as a Registered Nurse +… more
- Humana (Springfield, IL)
- …managers to ensure alignment and operational efficiency. + Identify members for specific case management and / or disease management activities. + ... Gold Plus Integrated is looking for Managers of Care Management who will lead teams of nurses, care coordinators...the state of Illinois** + An active, unrestricted, Registered Nurse **(RN)** license, Licensed Clinical Social Worker… more
- Providence (Apple Valley, CA)
- …include a manager on-call responsibility every other week for emergent issues. Case Management is a collaborative practice including patients, caregivers, ... physicians, payers, support staff, other practitioners and the community. The Case Management process facilitates communication and care coordination along… more
- Fairview Health Services (Minneapolis, MN)
- …in Nursing + 1 year RN experience + Registered Nurse **Preferred Qualifications** + Case Management Nurse + Basic Life Support (American Heart Assoc, Red ... requirements. This position is accountable for the quality of clinical services delivered by both them and others and...Mentors internal members of the health care team on case management and managed care concepts. +… more
- Houston Methodist (Sugar Land, TX)
- …plan, regulatory guidelines, medical necessity, and accrediting standards for all requests. Provides clinical support to Case Management staff, others as ... nonclinical and clinical service areas, physicians, and Case Management staff. **QUALITY/SAFETY ESSENTIAL FUNCTIONS** +...**LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure -… more
- Covenant Health Inc. (Knoxville, TN)
- …outpatient areas.The department hires RNs with a minimum of 3 years of experience. Case Management certification is preferred, but not required. There is a ... ensure patient is meeting daily objectives. + Modifies the case management plan to meet the changing...the plan as needed to meet the patient's needs. Outcomes/ Clinical /Fiscal/Resource Management : + Utilizes statistical analysis techniques… more
- Veterans Affairs, Veterans Health Administration (Durham, NC)
- …Registered Nurse (RN), qualified by education and experience to apply advanced clinical practice and case management principles for the coordination and ... Preferred Level of Education BSN Preferred Certification(s) ANCC Certified Professional in Case Management or Care Coordination VA offers a comprehensive total… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …Information Management , or related field * Minimum 3 years of experience in clinical care, utilization review, case management , or clinical ... payer denials, coordinating peer-to-peer reviews, and working closely with physician advisors, case management , and revenue cycle teams. The UM Analyst helps… more
- UNC Health Care (Smithfield, NC)
- …medical discharge planning issues, continuing care needs by initiating appropriate case management referrals. Initiates appropriate social work referrals. 3. ... and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ensure patient...of patient data and treatments. Communicates daily with the Case Manager to manage level of care transitions &… more
- Trinity Health (Silver Spring, MD)
- …Current licensure by the Maryland State Board of Nursing as a Registered Nurse (other appropriate clinical background may be considered (eg, RT, PharmD) ... Day Shift **Description:** **General Summary:** Participates in the risk management activities of the organization. Assists in the ...on a case -by- case basis). BLS certified preferred. **Minimum Knowledge,… more