- 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. + ... prioritize effectively and have critical thinking skills. + Experience in case management or care coordination and telephonic care experience is preferred. + A… more
- Veterans Affairs, Veterans Health Administration (Tulsa, OK)
- …orientation, competencies and providing quality improvement and enhance outcomes utilization . Provides clinical community-based case management services to ... level degree in Nursing may have opportunity to become registered as a nurse with a state...including positive education and licensure/certification. Preferred Experience: One year Behavioral Health and one year of Case Management… more
- Molina Healthcare (Sacramento, CA)
- …and Monitoring team responsible for prior authorizations, inpatient/outpatient medical necessity/ utilization review, and/or other utilization management ... clinical and non-clinical team activities to facilitate integrated, proactive utilization management , ensuring compliance with regulatory and accrediting… more
- CDPHP (Latham, NY)
- …Mental Health Counselor (Valid New York State license is required) + In lieu of behavioral health license, Registered Nurse with valid New York State ... care experience in a hospital setting required. + Minimum one (1) year quality/ utilization management experience in health care setting preferred. + Experience… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …Conduct pre-certification, concurrent, and retrospective reviews with emphasis on utilization management , discharge planning, care coordination, clinical ... maternity, reproductive and gender affirming health, preferred. + 2-3 years of Utilization Management experience. + Active licensure in Massachusetts is… more
- Prime Healthcare (Lynwood, CA)
- …experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum 5 ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/228577/ rn -case-manager utilization… more
- Molina Healthcare (Spokane, WA)
- … licensure required **KNOWLEDGE/SKILLS/ABILITIES** + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management ... them. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ) Program and..., disease management or utilization management in managed care, medical or behavioral … more
- Molina Healthcare (Henderson, NV)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. **Required...care unit (ICU) or emergency room. ASAM Certification for behavioral health Previous experience with MCG guidelines. At least… more
- UnityPoint Health (Cedar Rapids, IA)
- …of accredited nursing program + Current licensure in good standing to practice as a Registered Nurse in [type in State]. + Must possess and maintain current ... implementation and evaluation of patient care in the outpatient setting for behavioral health home care. Responsible for case coordination of patients and insurance… more
- UnityPoint Health (Cedar Rapids, IA)
- …efficiency. License(s)/Certification(s): Current licensure in good standing to practice as a Registered Nurse in [type in State]. Must possess and maintain ... . Is knowledgeable regarding managed care implications - precertification and utilization review procedures. . Provides consultation regarding behavioral health… more
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