- CVS Health (Charleston, WV)
- …on business needs) Travel Required up to 5% for meetings/audits. Location: 100% Remote (US only) **About Us** American Health Holding, Inc. (AHH), a division of ... Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible,...other key business areas. + May develop/assist in development and/ review new training content. + May collaborate/deliver inter and… more
- CVS Health (Little Rock, AR)
- …on business needs) Travel Required up to 5% for meetings/audits. Location: 100% Remote (US only) **About Us** American Health Holding, Inc. (AHH), a division of ... Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective care management solutions that promote… more
- GE Vernova (Wilmington, NC)
- …in tooling and operational processes. **Job Description** **Essential Responsibilities:** + Review and accept inspection data per applicable codes and procedures. + ... role is at the GVH Headquarters Wilmington, NC but highly qualified (US based) remote candidates will be considered + Ability and willingness to travel up to 75%… more
- GE Vernova (Wilmington, NC)
- …Nuclear headquarters in Wilmington, NC (hybrid work arrangements available), but permanent remote work arrangements are also possible. This role is within the ... and provide inputs on team capability and availability. + Perform manager review and approval of engineering technical deliverables for GNF/GVH customers. + Provide… more
- Cleveland Clinic (Independence, OH)
- …needs, coordinate nurse visits, and arrange for medications, supplies, or medical equipment as needed. In this role, you'll document encounters, offer hospice ... organizations in the world. As a Telephone Triage Registered Nurse , you will be a compassionate and reassuring voice...peace of mind in every interaction. **This is a remote PRN position after orientation. Hours and days vary… more
- CenterWell (Tallahassee, FL)
- …treats center patients in accordance with standards of care. + Follows level of medical care and quality for patients and monitors care using available data and ... limited to specialty referrals, hospital and SNF coordination, durable medical equipment and home health care. + Acts as...Leadership. + Meets with RMD about quality of care, review of outcome data, policy, procedure, and records issues.… more
- Sharp HealthCare (San Diego, CA)
- …from provider and communicates this to the care team.Refer defined cases for medical secondary review and share findings with providers.Provide advice to Revenue ... **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** California Registered Nurse (RN) - CA Board of Registered Nursing; Certified Case Manager (CCM) -… more
- TEKsystems (Milwaukee, WI)
- …TO BE CONSIDERED**Key Responsibilities + Perform concurrent reviews of inpatient medical records to ensure documentation accurately reflects patient acuity and ... and maintain awareness of organizational updates and policies. Qualifications + Registered Nurse (RN) certification required + Minimum 5 years of full-time adult… more
- Magellan Health Services (San Diego, CA)
- …care plan, member education and care management. Conducts initial and concurrent review for prior authorization of higher levels of care against medical ... needs assessment including, but not limited to, psycho-social, physical, medical , behavioral, environmental, and financial parameters. + Develops, documents,… more
- Magellan Health Services (Boise, ID)
- …and on-going management of designated staff. + Performs care management review activities consistent with Magellan policies, procedures, and standards. + Conducts ... but ASN considered with additional experience. Thorough knowledge of physical, medical specialty and/or mental health community resources and providers. Thorough… more