- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse (RN) Manager , Appeals and Grievances General Operations (Clinical) Job Category: Clinical Department: CSC Appeals & Grievances Location: Los ... for this role MUST have recent experience with healthcare/managed care grievances + The candidate selected for this role...net required to achieve that purpose. Job Summary The Manager , Appeals & Grievances (A&G) & General Operations (Clinical)… more
- Community Health Systems (Naples, FL)
- THIS IS NOT A REMOTE POSITION **Job Summary** The Care Manager - RN is responsible for coordinating and overseeing discharge planning, transitions of care ... teams (IDT) to ensure effective communication and coordination of patient care , including identifying avoidable days and resolving care transition… more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is ... clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA meets… more
- State of Michigan (Saline, MI)
- Registered Nurse Manager 13 Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/3017667) Apply Registered Nurse Manager 13 Salary ... are provided a secure, therapeutic milieu and quality nursing care . This position coordinates activities by ensuring adequate staff...a Registered Nurse 12 or a Registered Nurse Manager 12. Alternate Education and Experience… more
- CareFirst (Baltimore, MD)
- …- Certified Case Manager Upon Hire Preferred + LNCC - Legal Nurse Consultant Certified Upon Hire Preferred **Experience:** + 2 years medical-surgical or similar ... **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes regarding… more
- State of Michigan (Ypsilanti, MI)
- Registered Nurse Manager 13 Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/5027994) Apply Registered Nurse Manager 13 Salary ... staff to include Registered Professional Nurses, providing direct patient care , and assuring that all patients receive appropriate health...a Registered Nurse 12 or a Registered Nurse Manager 12. Alternate Education and Experience… more
- CenterWell (Cheyenne, WY)
- …The Clinical Care Coordinator is under the general supervision of the Manager of Care Coordination and under established performance criteria. This is a ... + **Required to work every other holiday.** The **Clinical Care Coordinator** helps to ensure optimal continuity of ...work-from-home telephonic nurse position **Essential Functions:** + Act as CenterWell Home… more
- Somatus (Annapolis, MD)
- …teammates physical and mental well-being + Community engagement opportunities + And more! The RN Care Manager is a critical member of the care team ... in a Hybrid Telehealth environment with a combination of remote days and visits to members' homes if needed...care and barriers to good health; The RN Care Manager is expected to conduct approximately… more
- Rochester Regional Health (Rochester, NY)
- …This position will not be employed by Rochester Regional Health (RRH). SUMMARYThe RN Care Manager will provide direct patient support both in-person and ... Job Title: Registered Nurse - Care ManagerDepartment: Greater Rochester...remote . They will be responsible for orchestrating ...and educating patients on chronic condition management. The RN Care Manager will act as part of… more
- Commonwealth Care Alliance (Boston, MA)
- … Nurse Supervisor and is under the general supervision of the Primary Care Manager and Clinical Director. **Supervision Exercised:** + None **Essential Duties ... 025010 Clin Alli-CCAPC **Position Summary:** The Primary Care Triage Nurse functions as a...delegated. + Completes other duties as assigned by Clinical Manager . + Have a commitment to observing, reporting, and… more