- Humana (Tallahassee, FL)
- …health, and identified medical metrics (ex. HEDIS, admissions, readmissions, ED utilization , polypharmacy, pre-term delivery rate, cesarean section rate, etc.). In ... skills to make an impact** **Required Qualifications** + **FL RN License** + **Must reside in the state of...a plus) (ie HEDIS, CMS Stars)** + Proficient/ intermediate utilization of Excel and PowerPoint. + Prior experience in… more
- Highmark Health (Pittsburgh, PA)
- …with operational areas regarding issues related to supported technology. Manage utilization review, translation of foreign claims, coordination of benefits (COB), ... benefits/requirements/limits, discharge planning requirements, length of stay and resource utilization issues. + Adheres to the policies, procedures, rules,… more
- Essentia Health (Deer River, MN)
- …and accurate information to payers. The role integrates and coordinates utilization management, care facilitation and discharge planning functions. This role is ... meet patient needs, manage length of stay, and promote efficient utilization of resources for a designated caseload. **Education Qualifications:** Educational… more
- Genesis Healthcare (King Of Prussia, PA)
- …and goal setting. *Manage specialty support surfaces, ensuring appropriate utilization , collaborating on audits, and leading quality improvement initiatives related ... negative pressure wound therapy use. *Collaborate to ensure appropriate product utilization and support the nursing process for continence and incontinence… more
- Humana (Tallahassee, FL)
- …conditions and identified medical metrics (ex. HEDIS, APT, readmissions, ED utilization , polypharmacy, etc.). In this role, you will actively engage providers, ... skills to make an impact** **Required Qualifications** + FL RN License + Must reside in the state of...Medicare (Medicaid quality improvement a plus). + Proficient/ intermediate utilization of Excel and PowerPoint. + Prior experience in… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …includes coordinating discharge needs, quality of care, and implementing the utilization management process for acute inpatients. Case Managers perform concurrent ... of care. MINIMUM QUALIFICATIONS: BLS for Health Providers (American Heart Association) California RN License Bachelor's Degree in Nursing 4 years nursing in an acute… more
- Fresenius Medical Center (Marietta, GA)
- …contracted facilities. Ensure efficient staff/ patient scheduling and efficient staffing utilization following company policy while maintaining a safe environment. + ... and in compliance with all applicable regulatory requirements. + Ensure efficient utilization of supplies and equipment. + Assist with various projects as assigned.… more
- Calvary Hospital (Bronx, NY)
- …Education: + Bachelors in nursing or health care related field preferred. + Registered professional nurse , currently unencumbered NYS licensure. + Qualified PRI ... getting a job, you're joining a family. Requirements The RN Case Manager (RNCM) will be responsible for all...length of stay (ELOS). The RNCM participates in the Utilization Review, Discharge Planning, Risk Management, and Quality Assessment… more
- Carle Health (Normal, IL)
- …Case Management Association (ACMA), Education: Bachelor's Degree: Nursing, Work Experience: RN >2yrs Responsibilities Act as a liaison working with patient/family ... of care to meet patient goals and outcomes.Documents plan of care and utilization issues in appropriate locations, including but not limited to: case management/… more
- The County of Los Angeles (Los Angeles, CA)
- …-AND- 2. Two years of experience at the level of LA County classification of Registered Nurse II . -AND- 3. One year of professional teaching experience. -AND- ... include ALL members of the PCMH team including providers, RN I, RN II, RN ...4. A license to practice as a Registered Nurse issued by the California Board… more