- Humana (Lincoln, NE)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Emory Healthcare/Emory University (Duluth, GA)
- …review of medical necessity for all inpatients, concurrent stay documentation per utilization management plan, verification and correction of patient status, ... educational opportunities to enhance health care teams knowledge of case management services; + Participates in and facilitates patient/family education and… more
- HCA Healthcare (Houston, TX)
- …service organizations, agencies and healthcare facilities. **What qualifications you will need:** + ( RN ) Registered Nurse + Associate Degree, or Bachelors ... from any other healthcare provider. We are seeking a(an) Registered Nurse Case Manager to join our...and overall evaluation of individual patient needs. Care coordination, utilization review and management , as well as… more
- Sutter Health (San Francisco, CA)
- …in nursing, case management or related field. **CERTIFICATION & LICENSURE** + RN - Registered Nurse of California (required) + CCM-Certified Case Manager ... Manager is responsible for Care Coordination, Care Transitions, Discharge Planning and Utilization Management throughout the acute care patient experience. The … more
- Beth Israel Lahey Health (Exeter, NH)
- Registered Nurse Case Manager + Full Time + Exeter, NH 03833 ... the patient's health care needs following the current phase of illness. **Requirements** + Registered Nurse - NH State or Compact State + BSN Preferred +… more
- Sharp HealthCare (La Mesa, CA)
- …3 Years Recent acute care nursing experience or case management experience. + California Registered Nurse ( RN ) - CA Board of Registered Nursing ... Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA...and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge… more
- AmeriHealth Caritas (Washington, DC)
- …Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... overtime, and weekends based on business needs. **Responsibilities:** + Conduct utilization management reviews by assessing medical necessity, appropriateness of… more
- ChenMed (Philadelphia, PA)
- …RN with bachelor's degree in a related clinical field preferred + A valid, active Registered Nurse ( RN ) license in State of employment required + Compact ... the remaining hours. The Acute Care Manager, Complex Care ( RN ) is responsible for achieving positive patient outcomes, managing...required + A minimum of one (1) year of utilization review and/or case management , home health,… more
- Centene Corporation (Austin, TX)
- …4-6 years of related experience. Bachelor's degree in Nursing preferred **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact ... days of hire required + **Preferred Experience:** + Clinical Registered Nurse with experience in Acute Care...Medicine, LTC, SNF , or Nursing Rehab + RN Case Management and/or RN … more
- Accura Healthcare (Toledo, IA)
- …to ensure complete, current, and accurate medical records. QUALIFICATIONS: + Hold current Registered Nurse ( RN ) license with applicable state, without ... an Assistant Director of Nursing (ADON) - LPN or RN to join our team! We're seeking a skilled...join our team! We're seeking a skilled and compassionate registered nurse to manage and oversee the… more