- Dignity Health (Long Beach, CA)
- …experience. + Certified Case Manager (CCM) Accredited Case Manager (ACM- RN ) or UM Certification preferred + Knowledge of managed care and payer environment ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for...Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines… more
- Catholic Health Initiatives (Plainview, NE)
- **Job Summary and Responsibilities** **Job Summary / Purpose** The RN Care Coordinator is responsible for overseeing the progression of care and discharge ... planning for identified patients requiring these services. The RN Care Coordinator performs this role to...Preferred + Certified Case Manager (CCM), Accredited Case Manager (ACM- RN ), or UM Certification preferred **Required Minimum… more
- Dignity Health (Los Angeles, CA)
- …experience. + Certified Case Manager (CCM), Accredited Case Manager (ACM- RN ), or UM Certification preferred + Knowledge of managed care and payer environment ... to exceed 10% of salary for this position. The RN Care Coordinator is responsible for overseeing...Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines… more
- Virginia Mason Franciscan Health (Silverdale, WA)
- **Job Summary and Responsibilities** Job Summary / Purpose The RN Care Coordinator is responsible for overseeing the progression of care and discharge ... planning for identified patients requiring these services. The RN Care Coordinator performs this role to meet the individual's health needs while promoting… more
- Henry Ford Health System (Troy, MI)
- …of experience in Utilization or Quality Management, required. CERTIFICATIONS/LICENSURES REQUIRED: + Registered Nurse ( RN ) with current Michigan licensure. ... RN REFERRAL MANAGEMENT COORDINATOR (VIRTUAL) - PRIOR AUTHORIZATIONS...looking to grow our Prior Authorization Team with experienced Registered Nurses! We are a team of Registered… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …varied clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, ... program criteria; assessing for opportunities to educate, support, coach, coordinate care and review treatment options, through collaboration with providers… more
- Molina Healthcare (NM)
- …**JOB QUALIFICATIONS** **Required Education** Any of the following: Completion of an accredited Registered Nurse ( RN ), Licensed Vocational Nurse (LVN) ... medical clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ), Licensed Vocational Nurse … more
- Sharp HealthCare (San Diego, CA)
- …2 Years Medical Management experience, preferably in a managed care setting + California Registered Nurse ( RN ) - CA Board of Registered Nursing ... **Job Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** California Registered Nurse ( RN ) - CA Board of Registered Nursing;… more
- AmeriHealth Caritas (LA)
- …company holidays and 1 to 2 weekends per year **Education & Experience** + Registered Nurse candidates: Associate Degree in Nursing (required) or Bachelor Degree ... all information necessary to perform a thorough medical necessity review . It is within the BH UM ... coordination opportunities and refer those cases to integrated care management as needed. The BH UM … more
- Stony Brook University (Stony Brook, NY)
- …communication skills while adhering to our high standard of excellence. **Duties of a RN Case Manager in the Care Management Department may include the following ... but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes...required. **Qualifications** **Required** : A Bachelor's degree or a nurse working on their degree with an RN… more