- Guthrie (Troy, PA)
- …leadership and autonomy in nursing practice. + Preferred experience with care management / utilization review , and payer knowledge. + RN considered. ... to a $15,000.00 Sign on Bonus!! Summary: The Wellness Nurse plays a key role in health promotion and...to health promotion and illness prevention, as well as management of chronic conditions. + Educates patients and their… more
- Sharp HealthCare (San Diego, CA)
- …with 0-2 errors; Have the ability to proof work.Knowledge of insurance, utilization review , scheduling requirements and support of front desk ... (AHA BLS Healthcare) - American Heart Association; California Licensed Vocational Nurse (LVN) - CA Board of Vocational Nursing & Psychiatric Technicians;… more
- Sharp HealthCare (San Diego, CA)
- …with 0-2 errors; Have the ability to proof work.Knowledge of insurance, utilization review , scheduling requirements and support of front desk ... (AHA BLS Healthcare) - American Heart Association; California Licensed Vocational Nurse (LVN) - CA Board of Vocational Nursing & Psychiatric Technicians;… more
- Childrens Hospital of The King's Daughters (Norfolk, VA)
- …Outlook, and Word. + Preferred Knowledge, Skills, and Abilities + Knowledge of utilization review and hospital finance processes preferred. + WORKING CONDITIONS ... SUMMARY + The Case Manager is responsible for coordinating the case management care plan to meet the individual/caregiver needs, promoting quality, and… more
- Mount Sinai Health System (New York, NY)
- …settings. The program manager supervises and directs a designated group of nurse clinical coordinators within the Bone Marrow Transplant and Multiple Myeloma ... Serves as a liaison to nursing, medicine, department chairs/chiefs, care management , administration, and other department leadership. Ensures the transplant program… more
- Molina Healthcare (Caldwell, ID)
- …ensure payment integrity. * Performs clinical reviews of medical records and other utilization management documentation to evaluate issues of coding and DRG ... nursing experience in claims auditing, quality assurance, recovery auditing, DRG/clinical validation, utilization review and/or medical claims review , or… more
- Carle Health (Urbana, IL)
- …utilization issues in appropriate locations, including but not limited to: case management / utilization review software and the multidisciplinary plan of ... Overview Responsible for the oversight, coordination, and management of the functional and financial outcomes during acute illness requiring hospitalization for… more
- HCA Healthcare (Savannah, GA)
- …of experience in hospital case management is required. + Certification in case management or utilization review is preferred. + InterQual experience is ... an organization that invests in you as a Registered Nurse (RN) Case Manager? At Memorial Health University Medical...stay, managing the length of stay, ensuring appropriate resource management , while developing a safe appropriate discharge plan. +… more
- University of Utah Health (Salt Lake City, UT)
- …+ Negotiates with third party payers relative to benefit levels, eligibility, utilization review , and reimbursement. + Identifies actual and potential delays ... our mission. EO/AA_ + This position provides clinical case management services aimed at enhancing patient-centered care and maximizing...following** + **Current license to practice as a Registered Nurse in the State of Utah, or obtain one… more
- Magellan Health Services (Boise, ID)
- …the management , direct supervision and coordination of clinical and/or nonclinical management staff, including utilization management and intensive care ... and on-going management of designated staff. + Performs care management review activities consistent with Magellan policies, procedures, and standards.… more