- HCA Healthcare (Gainesville, FL)
- …recognizes physicians as important customers. What qualifications you will need: + State Registered Radiologic Technician, or Registered Nurse + Associate ... services and administrative activities including fiscal, material and human resource management .? + Maintains and monitors utilization of resources, physical… more
- Johns Hopkins University (Baltimore, MD)
- …fluids with blood borne pathogens. **Minimum Qualifications** + Master's Degree in Nursing. + Registered Nurse license and Certified as a Nurse Practitioner. ... The Department of Emergency Medicine is seeking a **_Sr. Nurse Practitioner_** to work collaboratively within a multidisciplinary health care team. Responsible for… more
- Northwell Health (Mount Kisco, NY)
- …Case Management and Social Work Services team. Develops processes to monitor utilization review inclusive of length of stay (LOS) and resource reduction ... safe discharge back to the community. Job Responsibility 1.Leads RN case management and social work services...be in Nursing. *Current license to practice as a Registered Professional Nurse in New York State,… more
- Bassett Healthcare (Cooperstown, NY)
- …this program may terminate or be suspended at any time. Bonus Amount: + RN (excluding management ) sign-on bonuses are awarded in the amount of $20,000 ... quality of life possible. What you'll do The Discharge Nurse is accountable for the delivery of safe patient...than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback +… more
- Highmark Health (Harrisburg, PA)
- …triaging members to appropriate resources for additional support. + Implement care management review processes that are consistent with established industry, ... Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or… more
- Stony Brook University (Stony Brook, NY)
- …telephonically post-discharge and assist with barriers to care * Prior experience with Care Management or Utilization Management * Understand levels of care ... may be at a high risk for readmission. The RN following these patients must have good clinical and...is provided to the patients. * Documents the case management plans such as clinical needs, barriers, utilization… more
- HCA Healthcare (Nashville, TN)
- …treatment is reimbursed by contacting managed care organizations and completing initial utilization review . Documents in Midas as required. Involves mobile ... LCSW, LADAC) + Previous experience in Needs Assessment and Utilization Management strongly preferred. + Familiarity with...patients in regard to managed care organizations + Conducts utilization review for managed care cases in… more
- Elevance Health (Los Angeles, CA)
- …in an ambulatory or hospital setting or minimum of 1 year of prior utilization management , medical management and/or quality management , and/or ... ** Nurse Reviewer I** **Virtual:** This role enables associates...required. **Preferred Skills, Capabilities, and Experiences:** + Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding,… more
- Commonwealth Care Alliance (Boston, MA)
- …member experience. * Address provider inquiries related to care coordination, utilization management , and program participation, collaborating with internal ... does not have direct reports. Essential Duties & Responsibilities: Provider Relationship Management * Serve as the primary relationship manager and point of contact… more
- Evolent (Springfield, IL)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... work with a group of nurses, providing appeal intake review for one dedicated client. They interact with coordinators...Be Doing:** + Practices and maintains the principles of utilization management and appeals management … more
Recent Jobs
-
Occupational Health and Safety Coordinator
- Austin Energy (Austin, TX)
-
Equipment Engineer and Process Engineer - Veterans and Transitioning Military
- Micron Technology, Inc. (Boise, ID)
-
Assistant Teacher II (K-8/Fairmount Campus)
- Kennedy Krieger Institute (Baltimore, MD)
-
Product Planning Program Manager
- Carnival Cruise Line (Miami, FL)