- ChenMed (Metairie, LA)
- …and exercise of independent judgment **EDUCATION AND EXPERIENCE CRITERIA:** + A valid, active Registered Nurse ( RN ) license in State of employment plus one ... closely with facility-based healthcare providers (acute care providers, case, and utilization management departments), local payor partners and our PCP-led… more
- ChenMed (Morrow, GA)
- … management programs, clinical meetings and other meetings. The Nurse Practitioner will adhere to strict departmental goals/objectives, standards of performance, ... role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education and identify post- SNF needs. +… more
- ChenMed (Bradenton, FL)
- … management programs, clinical meetings and other meetings. The Nurse Practitioner will adhere to strict departmental goals/objectives, standards of performance, ... role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education and identify post- SNF needs. +… more
- Crouse Hospital (East Syracuse, NY)
- …and communication skills. + Desirable Qualifications: + Current NYS Licensure as a Registered Nurse or Licensed Practical Nurse . + Bachelor's degree ... stability within a fast-growing Medical Practice + Longevity and consistency of management + Tuition reimbursement program + Affiliation with Crouse Hospital Other… more
- Elevance Health (Grand Prairie, TX)
- …preferred. + BA/BS degree preferred. + Previous utilization and/or quality management preferred. + Post acute ( SNF , IRF, LTACH) clinical experience ... ** Nurse Reviewer I** **Location:** Virtual: This role enables...hospital setting or minimum of 1 year of prior utilization management , medical management and/or… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role BHPS provides Utilization Management (UM) services to its clients, ensuring high-quality, clinically sound decision-making. The Clinical Appeal ... and Grievance Nurse is responsible for conducting daily clinical and benefit...accurate decisions + Ensure strict adherence to Appeals and Utilization Management (UM) processes and regulatory and… more
- UNC Health Care (Apex, NC)
- …a Staff RN . 5. Collaborates with other team leaders and management to ensure optimal efficiency throughout the department. Notifies Clinical Manager, as ... **Description** **Commitment Incentive** -$15,000 may be offered to an RN who has already earned an associate's, bachelor's, or master's nursing degree. Three (3)… more
- Hartford HealthCare (Wethersfield, CT)
- …professional position, working as a member of the ICP Community Care Management team. The ICP Community Care Manager facilitates transitions as patients move ... uninterrupted quality care, as well as providing ongoing education and diseased management for ICP attributed patients with chronic conditions. They are responsible… more
- Elderwood (Waverly, NY)
- …Overview Mon-Fri 8am-4pm The Managed Care Coordinator assists and supports the LPN/ RN MDS Coordinator with case management responsibilities. The candidate is ... the primary liaison between the SNF and the HMO Managed Care Insurance Companies. This...as applicable and with clinical oversight provided by the LPN/ RN MDS Coordinator. Attends team meetings at the discretion… more
- University of Virginia (Charlottesville, VA)
- …assessments and interventions during all client contacts. + Collaborate with Risk Management , Patient Relations, Utilization Management , the Ethics Committee ... to the strategic plan. + Works collaboratively with the RN Case Manager and the treatment team members to...post-acute discharges for complex patients in collaboration with Care Management Discharge Manager. + Identifies the need for and… more