- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …* 1+ years of medical call center or managed care experience; eg case management , utilization management * All relevant experience including work, education, ... Guide is a critical component of BCBSMs Integrated Health Management team. The position exists to provide member, provider...clinical and service availability. Required Skills and Experience * RN with MN license or LSW with no restrictions… more
- Elevance Health (Indianapolis, IN)
- …required. **Preferred Skills, Capabilities, and Experiences:** + Previous experience in case management / utilization management with a broad range of ... offers superior clinical mental health and substance use disorder management , a comprehensive employee assistance program, work/life support, specialty programs… more
- Diversicare Healthcare Services & Diversicare Ther (Sedgwick, KS)
- …nursing ( RN degree required). 2. Knowledge of healthcare reimbursement, utilization management , and discharge planning. 3. Experience providing strategic ... in and facilitate Engage/72 HR Admission meetings as part of the care management system. + Manage the restorative nursing program, integrating it with the activity… more
- Elevance Health (Nashville, TN)
- …services only, and there is licensed staff supervision. + Previous experience in case management / utilization management with a broad range of experience with ... managing Applied Behavioral Analysis behavioral health benefits through telephonic or written review . **How You Will Make an Impact** Primary duties may include, but… more
- Trinity Health (Westerville, OH)
- …in lieu of an RN . + Licensure/Certification: Current license to practice as registered nurse in the State of Ohio. Registered Health Information ... Minimum of 5 years acute care medical or surgical experience required; Utilization /Case Management , managed care, or Clinical Documentation and experience in… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Registered Nurse Care Manager, Continuum of Care Full Time, 80 Hours Per Pay Period , Day Shift M-F. May rotate weekend and minor holidays. Parkwest ... services within the scope of practice as a registered nurse meeting all required standards both...in area of assigned responsibility. Licensure Requirement: Current Tennessee RN License. Current certification in Case Management ,… more
- Highmark Health (Pittsburgh, PA)
- …advisor and third party payers. + Maintains a working knowledge of care management , care coordination changes, utilization review changes, authorization ... :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Registered nurse who is proficient in the...as an educational resource to all AHN staff regarding utilization review practice and governmental commercial payer… more
- Elevance Health (Cerritos, CA)
- …quickly learn and adapt to new technologies preferred. + Previous experience in utilization management with a broad range of experience with complex ... offers superior clinical mental health and substance use disorder management , a comprehensive employee assistance program, work/life support, specialty programs… more
- Villa of Hope (Rochester, NY)
- …JOB SUMMARY: Under the general direction of the Nurse Manager, the Intake Coordinator- RN is a Registered Nurse who will assist in supervising Clinical ... director of LHTC and administrative team, including billing and utilization review . + Triages potential admissions and...or leaving against medical advice. MINIMUM QUALIFICATIONS: + NYS Registered Nurse license + Bachelor degree preferred… more
- St. Bernard's Medical Center (Jonesboro, AR)
- …continuity of care and cost effectiveness through the integration and functions of case management and utilization review . The person in this position is ... Current Arkansas State RN license. + Experience + RN with previous case management experience preferred, but not necessary. Effective communication - both… more