- Intermountain Health (Las Vegas, NV)
- …key metrics, analyze trends, and ensure regulatory compliance. **Minimum Qualifications** + Current Registered Nurse ( RN ) license in state of practice. + ... **Job Description:** The RN Hospital Care Manager I delivers comprehensive care...Case Management Certification + Demonstrated experience in case management, utilization review , value-based care, and/or discharge planning.… more
- FlexStaff (Flushing, NY)
- …active and unrestricted license and registration in New York State as a Registered Nurse required. Additional Requirements: - Be legally authorized (for example, ... Number** 158924 Full-Time, Monday-Friday, 8:30AM - 5:00PM. In Office/Clinic; no remote /hybrid. JOB PURPOSE: Responsible for supporting the nursing standards of… more
- BrightSpring Health Services (Dunbar, WV)
- …Education: Degree from an accredited school of nursing Qualifications:* Must be a Licensed Registered Nurse ( RN ) in good standing and currently licensed by ... performance reviews* Responsible to ensure that there is a nurse on call after hours for all homes (and...State Health Services Director and Assigned Director, Clinical Practice* Review utilization report at least monthly to… more
- Kadlec (Richland, WA)
- …+ Graduation from an accredited school of nursing. + Upon hire: Washington Registered Nurse License **Preferred Qualifications:** + Bachelor's Degree from an ... facility or ambulatory clinic + Previous Case Management, discharge planning, utilization review experience, clinical quality, or process improvement experienc… more
- Prime Therapeutics (Phoenix, AZ)
- …Patient Programs. **Education & Experience** + Associates - Nursing + Bachelors - Nursing + RN - Registered Nurse , State and/or Compact State Licensure - ... for work visa or residency sponsorship. **Additional Qualifications** + Registered Nurse ( RN ). + 5...Experience in managed care, specialty drugs, care management and utilization review . + Meets Credentialing criteria. +… more
- Access Dubuque (Dubuque, IA)
- …remotely within Iowa. **Key Responsibilities:** + Provide telephonic case management and utilization review for assigned consumers. + Develop, implement, and ... Bilingual RN Case Manager **Cottingham & Butler/ SISCO** 1...Minimum 2 years of clinical practice. Case management or utilization review experience strongly preferred. + **Skills:**… more
- Guthrie (Sayre, PA)
- …and autonomy in nursing practice. Preferred experience with PCMH process, care management/ utilization review , and payer knowledge. Fast paced ambulatory care ... experience preferred. Education Licensed Registered Nurse with 5 years' experience, preferably...patient/family engagement. + Uses technology, such as tele-visits and remote monitoring capabilities, to engage patients and monitor chronic… more
- Mayo Clinic (Rochester, MN)
- …Financial Management Association (HFMA) Certification Preferred. **Preferred Qualifications:** + Current Registered Nurse ( RN ) license in the United ... lead a team of clinicians and appeal specialists, interfacing with payers, compliance, utilization review , legal, and clinical departments. This is a critical… more
- Molina Healthcare (Worcester, MA)
- …identifying opportunities for improvement. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational ... performing one or more of the following activities: care review / utilization management (prior authorizations, inpatient/outpatient medical necessity,... Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of … more
- Magellan Health Services (San Diego, CA)
- …Master Social Worker - Care Mgmt, LPC - Licensed Professional Counselor - Care Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care ... This is a remote position in California, candidates must be licensed...member education and care management. Conducts initial and concurrent review for prior authorization of higher levels of care… more