- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …a difference, join us. The Impact You Will Have This job implements effective utilization management strategies including: review of appropriateness of pre ... performance and member satisfaction. Required Skills and Experience * Registered nurse or licensed behavioral health clinician...* 1+ years of managed care experience (eg case management , utilization management and/or auditing… more
- Veterans Affairs, Veterans Health Administration (Ann Arbor, MI)
- …RN ) - Community Care, aligned under Chief of Staff. Responsibilities The Community Care (CC) RN Registered Nurse ( RN ) is responsible for executing a ... intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards,...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Aspirus Ironwood Hospital (Wausau, WI)
- …Coordination is responsible for system-wide Care Coordination functions ( Utilization Review , Social Work, Navigation, and Case Management ) including the ... A minimum of five years of experience in care management or utilization review +...Click here (https://www.aspirus.org/about) to learn more. Credentials: Essential: * REGISTERED NURSE LICENSE Position DIRECTOR - SYSTEM… more
- Kaleida Health (Buffalo, NY)
- …preferred. RN licensure required.** **Experience** **10 years of care management / utilization management experience required in hospital and/or ambulatory ... **VP Care Management Post-Acute Care Transition** **Location:** **Buffalo General Medical...daily oversight of operations, the VP will partner with Utilization Review , Revenue Cycle, and Clinical leadership… more
- Rochester Regional Health (Rochester, NY)
- …BLS - Basic Life Support - American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse - New York State Education Department ... holiday every other year. Sign-On Bonus: Yes SUMMARY:As a Registered Nurse - Care Manager, your excellent...+ Three (3) years of acute hospital care, case management or utilization management experience… more
- McLaren Health Care (Bay City, MI)
- …and to be obtained within three years of accepting position + State licensure as a Registered Nurse ( RN ) + Minimum experience of three years in acute ... Association or equivalent through the Military Training network (MTN) **_Preferred:_** + Utilization management ( review ) and discharge planning experience. +… more
- UNC Health Care (Raleigh, NC)
- …of care and cost effectiveness through the integrating and functions of case management , utilization review and discharge planning. The Care Manager ... Management Team is seeking an experienced full time RN Care Manager for Emergency Department patients. This role...date. **Licensure/Certification Requirements:** * Licensed to practice as a Registered Nurse in the state of North… more
- Henry Ford Health System (Detroit, MI)
- …community partners to support patient needs beyond the hospital setting. Qualifications: + Registered Nurse ( RN ) with active licensure + Minimum [number] ... with computers, electronic health records (EHR), database systems, and utilization review /case management documentation systems....work in a fast-paced environment. Licenses and Certifications: + Registered Nurse ( RN ) with a… more
- MTC (Graceville, FL)
- …medical team who are dedicated to improving people's lives. We are seeking an **On-Call Registered Nurse ( RN )** to join our team. **Primary duties:** + ... forms as appropriate. + Practice basic cost containment and utilization management for inmate care and facility...HIPAA rules. + Accurately and promptly chart medical care. Review medical files to determine all provided services are… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …true colors to blue. The Role:The Compliance Program Consultant will focus on utilization management compliance and audit readiness activities such as evaluating ... Medical Management 's (HMM) and delegate's compliance with the applicable NCQA utilization management standards and state and federal regulations. The Team:… more