- Fallon Health (Worcester, MA)
- … Nurse in a clinical setting required. + 2 years' experience as a Utilization Management /Prior Authorization nurse in a managed care payer preferred. + ... in nursing required** **License/Certifications** + Active and unrestricted licensure as a Registered Nurse in Massachusetts. **Experience** + A minimum of three… more
- Billings Clinic (Billings, MT)
- …care. * Maintains respectful and professional communication skills. Insurance and Utilization Management *Maintains working knowledge of CMS requirements and ... * 1 Experience working in Billings Clinic, preferred. License and Certification * Current Registered Nurse license in the state of Montana, at hire Billings… more
- Cedars-Sinai (Beverly Hills, CA)
- …be Doing** The RN Care Coordinator is responsible for the case management of patient while hospitalized and upon discharge from various care settings. In ... nurse practitioner and case manager assigned to the SNF 's for continued review and follow up. + Authorizes...TPL carrier of all injured worker cases receiving case management services. + Ensures appropriate utilization of… more
- Arnot Health (Bath, NY)
- …of all duties that may be assigned. EDUCATION: Current New York State Registered Nurse Licensure. BSN preferred. Certification in nursing specialty desirable. ... with care team and therapies. + Demonstrates effective time management , flexibility and priority setting. + Promotes and ensures...of the Long Term Care Department. + Ensures the utilization of the nursing process in maintaining quality of… more
- UNC Health Care (Hendersonville, NC)
- …visibility and oversight on areas at risk within the CJR program including SNF utilization , discharge status to home and home health, post-acute spending, ... a liaison between surgeons/surgical practices, Pardee Surgical Services, Care Management and other ancillary services to ensure the needs...Required + Must be licensed to practice as a Registered Nurse in the state of North… more
- Cedars-Sinai (Beverly Hills, CA)
- …Facilities, refer to nurse practitioner and case manager assigned to the SNF 's for continued review and follow up. + Authorize all appropriate services based ... of acute nursing experience required + 3 years of previous experience in case management , discharge planning, utilization review, and HMO in the acute inpatient… more
- Actalent (Atlanta, GA)
- …+ Active RN license in GA or compact + 3+ years of case management experience + SNF /LTAC/AIR utilization review experience + Knowledge of CMS skilled ... or home. Collaborates with physicians, telephonic care coordinators, inpatient case management /social workers, telephonic to create a safe discharge plan for… more
- Tufts Medicine (Haverhill, MA)
- …our High Pointe House Facility in Haverhill, MA, and Skilled Nursing Facility management and oversight. Hours: Full Time 40 Hours Location: Lowell MA and Haverhill ... **Minimum Qualifications:** 1. Bachelor's degree in Nursing (BSN). 2. Massachusetts RN Licensure. 3. Five (5) years of palliative, hospice, complex care… more
- Sharp HealthCare (San Diego, CA)
- …**Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered ... or equivalent experience in the healthcare setting. + California Registered Nurse ( RN ) - CA...and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge… more
- Stony Brook University (Stony Brook, NY)
- …the following but are not limited to:** + Responsible for addressing Utilization management , denials and appeal, discharge and transition planning activities, ... Management leadership and staff functions regarding care management and utilization management activities....Qualifications:** * Possession of license to practice as a registered nurse in New York State. *… more