- Covenant Health Inc. (Morristown, TN)
- …Excellence, women can have their annual mammograms, biopsies, and can meet with a nurse navigator if needed. The Women's Center offers six newly remodeled labor and ... in quality improvement principles, regulatory, and Care Management standards. The manager is responsible for budget management, staffing, hiring, discipline, and… more
- Elevance Health (Los Angeles, CA)
- ** Nurse Reviewer I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ... time,** **with rotating weekends.** **New Grads are encouraged to apply!** The ** Nurse Reviewer I** will be responsible for conducting preauthorization, out of… more
- UnityPoint Health (Des Moines, IA)
- …agencies and payers to plan and execute a safe discharge + Collaborate with Utilization Management team on continued stay review . + Collaborates with patients, ... continuity through elimination of fragmentation of care/service and facilitates the effective utilization of resources. Serves as educator and a central source of… more
- Amergis (Orange, CA)
- … Manager to help support a health insurance agency! The Medical Case Manager (BHI Utilization Management) will be responsible for reviewing and processing ... providers. The incumbent will be responsible for prior authorizations, concurrent review and related processes. Position Details: Location: Orange (Full Office, no… more
- Elevance Health (Atlanta, GA)
- …fraud and over- utilization by performing medical reviews via prepayment claims review and post payment auditing + Correlates review findings with appropriate ... ** Nurse Auditor Senior - Payment Integrity Complex and...responsible for identifying, monitoring, and analyzing aberrant patterns of utilization and/or fraudulent activities by health care providers through… more
- HCA Healthcare (Dallas, TX)
- …staff committees as necessary. + Assists with staff performance evaluations. + Acts as manager in charge as assigned. + Provides review and guidance on physician ... participates in daily multidisciplinary and bedside rounds + Completes drug utilization reviews to promote rational drug therapy and implement improvements… more
- Bassett Healthcare (Cooperstown, NY)
- …+ 1 year leadership experience, preferred Licensure/Certifications: + Current NYS Registered Professional Nurse license, required + Current BLS certification, ... discharge planning and others as appropriate to assess quality of care and review outcomes data and develop performance improvement plan when applicable. + Conducts… more
- Elevance Health (Wilmington, DE)
- **Telephonic Nurse Case Manager II** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... the assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope… more
- Elevance Health (WA)
- …or equivalent. Requires a minimum of 2 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted LPN/LVN or ... RN license and/or certification to practice as a health...in multiple states. **Preferred Skills, Capabilities and Experiences:** + Utilization Management and/ore Case Management experience strongly preferred. +… more
- HCA Healthcare (Richmond, VA)
- …and personal growth, we encourage you to apply for our Clinical Research Nurse opening. We promptly review all applications. Highly qualified candidates will ... We care like family! Jump-start your career as a Clinical Research Nurse today with Chippenham Hospital. **Benefits** Chippenham Hospital offers a total rewards… more