- Veterans Affairs, Veterans Health Administration (Gainesville, FL)
- …The North Florida/South Georgia Veterans Health System (NF/SG VAHS) is recruiting for a Registered Nurse Care Coordinator to work in the Office of Community Care ... and from the community. Possesses the knowledge related to VHA guidelines, utilization review criteria, current evidence-based standards of care, compliance… more
- CVS Health (Juneau, AK)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- Luke Staffing (Montgomery, AL)
- ** REGISTERED NURSE - CASE MANAGER** **SITE OF SERVICE** **:** . Maxwell Ambulatory Healthcare Center, 300 South Twining Street, Bldg. 760, Maxwell AFB, AL. . ... . **Licensure:** Current, full, active, and unrestricted license to practice as a Registered Nurse . **Travel:** Travel may be required for this position for… more
- Access Dubuque (Dubuque, IA)
- …office and is also available remotely within Iowa. **Key Responsibilities:** + Provide telephonic case management and utilization review for assigned ... Bilingual RN Case Manager **Cottingham & Butler/ SISCO** 1...Minimum 2 years of clinical practice. Case management or utilization review experience strongly preferred. + **Skills:**… more
- ChenMed (Pembroke Pines, FL)
- …engagement with patient and family. + Facilitate patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... we need great people to join our team. The Nurse Case Manager I position is responsible for achieving...achieving desired clinical outcomes within specific timeframe. + Conducts review for appropriate utilization of services from… more
- Humana (Hallandale Beach, FL)
- …+ Bachelor's degree in social work or behavioral health-related field + Active licensed Registered Nurse , RN in the state of Florida without disciplinary ... ensure interaction between the company and members are optimized. The Telephonic Behavioral Health Care Manager Internship provides transitioning service members… more
- US Tech Solutions (Columbia, SC)
- **Duration: 3+ Months Contract (Possible temp to hire)** **Job Description:** + Must be an RN in SC and have an active and unrestricted SC RN license. + ... have critical thinking skills. + Experience in case management or care coordination and telephonic care experience is preferred. + A typical day would be managing a… more
- CVS Health (Frankfort, KY)
- …all with heart, each and every day. **Position Summary** The Care Manager RN is responsible for driving and supporting care management and care coordination ... care (assessing, planning, implementing, coordinating, monitoring, and evaluating). The CM RN utilizes advanced clinical judgment and critical thinking skills to… more
- US Tech Solutions (Columbia, SC)
- **Job Description:** + Must be an RN in SC and have an active and unrestricted SC RN license. + Hours/Schedule - M-F 8:30am - 5pm. + Onsite training for the ... to determine the priority of our cases. Then we review the requests against the policy and the member's...with members and providers regarding health care delivery system, utilization on networks and benefit plans. Serves as member… more
- US Tech Solutions (Columbia, SC)
- …the United States and in the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC) **About US Tech ... promote quality, cost effective outcomes. Performs medical or behavioral review /authorization process. Ensures coverage for appropriate services within benefit and… more
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