- Excellus BlueCross BlueShield (Rochester, NY)
- …varied clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, ... of consistent and quality health care services. Examples may include: Utilization Management, Quality, Behavioral Health, Pharmacy, Registered Dietitian and… more
- PruittHealth (Atlanta, GA)
- …years industry experience in a managed care setting focused on experience in utilization review /case management and at least two years case management, home ... with long-term care population **MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:** * Licensed Registered Nurse with current, unrestricted license in state of… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …coordination, and transition of care between settings. Required Skills and Experience * Registered Nurse licensure in the state of Minnesota with no ... legally protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: RN Case Manager - Commercial TOC Location: Remote Career Area: Health… more
- BrightSpring Health Services (Dunbar, WV)
- …Education: Degree from an accredited school of nursing Qualifications:* Must be a Licensed Registered Nurse ( RN ) in good standing and currently licensed by ... performance reviews* Responsible to ensure that there is a nurse on call after hours for all homes (and...State Health Services Director and Assigned Director, Clinical Practice* Review utilization report at least monthly to… more
- CareFirst (Baltimore, MD)
- …**Education Level:** High School Diploma or GED. **Licenses/Certifications Upon Hire Required:** + RN - Registered Nurse - State Licensure And/or Compact ... State Licensure RN - Registered Nurse in MD, VA or Washington....experience working in Care Management, Discharge Coordination, Home Health, Utilization Review , Disease Management or other direct… more
- Insight Global (Phoenix, AZ)
- …assurance processes, identify barriers, and report outcomes to management for continuous improvement. Previously a work from home Remote RN CA RN License ... are seeking 3 Patient Logistics RNs to work virtually in Phoenix. As the PL RN you will help with transfer center operations to ensure smooth patient placement and… more
- CareFirst (Baltimore, MD)
- …standards. **QUALIFICATIONS:** **Education Level:** High School Diploma or GED **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or ... Compact State Licensure RN - Registered Nurse in MD, VA or Washington,...experience working in Care Management, Discharge Coordination, Home Health, Utilization Review , Disease Management or other direct… 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, ... review of KPIs, improvement strategies and bi-directional feedback related...skills to make an impact** **Required Qualifications** + FL RN License + Must reside in the state of… more
- State of Colorado (Denver, CO)
- …Support NA 01 A requirement of the position is that you possess and maintain a VALID Registered Nurse ( RN ) License issued by the State of Colorado or any ... a license. As an example, if you are a registered nurse with a multistate license from...and other disciplines. + Directs and consults with other RN III's and subordinate staff in their provision of… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …help us transform healthcare? Bring your true colors to blue. The Role The RN Case Manager is responsible for facilitating care for members and families of members ... health, and any barriers to care. The Team The RN Case Manager is part of a highly dedicated...Mobile, and eWorker personas. This position can be fully remote with an expectation to work in our Hingham,… more