- Guthrie (Troy, PA)
- …years of experience in an acute care setting with strong care management, utilization review , and payer knowledge. A Case Management certification or obtaining ... levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care in collaboration...in addition to a degree in Nursing. A registered nurse with five (5) years relevant experience willing to… more
- Elevance Health (Los Angeles, CA)
- …members and providers. **How you will make an impact:** + Perform physician-level case review , following initial nurse review , of Medical Oncology regimens ... and supportive care. + Perform physician-level case review , following initial nurse review ,...regimens. + As necessary, assist pre-certification nurses and other staff in understanding the principles behind appropriate utilization… more
- Mount Sinai Health System (New York, NY)
- …Masters preferred. + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + ... are not limited to: 1. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will be needed using… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …and performance monitoring, oversees all Workers' Compensation (WC) Case Management and Utilization Review (UR) Programs. + Collaborates with the Chief Medical ... for the Casualty and Clinical Services departments which in turn includes Utilization Management, Case Management and Population Health divisions. The position can… more
- BronxCare Health System (Bronx, NY)
- …dates required for timely response by the department physician advisors and clinical staff . Qualifications - NYS Registered Nurse required - The Appeal Manager ... with the Department Denial and Appeals Coordinators, Physician Advisors, and the clinical staff , the Appeal Manager is responsible to develop a strong appeal letter… more
- HCA Healthcare (Dallas, TX)
- …related to the electronic health record (EHR) including: + standardization + utilization + integration + optimization The DCI is responsible for development, ... AND DUTIES:** + Implementation and support of facility-wide standardization, utilization , integration, and optimization activities related to the EHR and… more
- Molina Healthcare (Naperville, IL)
- …supporting one or more of the following functions: care management, utilization management, care transitions, long-term services and supports (LTSS), behavioral ... Duties * Provides level support to healthcare services department staff - devising/implementing delegation assignment strategies, facilitating healthcare services… more
- Constructive Partnerships Unlimited (Brooklyn, NY)
- …Operate office equipment. Supervises the scheduling of medical appointments by responsible staff . Monitors and track transportation utilization and convey all ... POSITION SUMMARY Under the Supervision of the VP of Nursing and Nurse Administrators, works collaboratively and assists in the management of medical care… more
- Houston Methodist (The Woodlands, TX)
- …Houston Methodist, the Case Manager PRN (CM) position is a licensed registered nurse (RN) who comprehensively plans for case management of a target patient ... EPIC and MIDAS + Serves as a preceptor, as appropriate, and implements staff education specific to patient populations and unit processes; coaches and mentors other… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Case Manager (CM) Certified position is a registered nurse (RN) responsible for comprehensively planning for case management of a targeted ... quality, efficient, and cost-effective. + Serves as a preceptor and implements staff education specific to patient populations and unit processes; coaches and… more