- Excellus BlueCross BlueShield (Rochester, NY)
- …and quality health care services. Examples may include: Utilization Management , Quality, Behavioral Health, Pharmacy, Registered Dietitian and Respiratory ... varied clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist,… more
- University of Southern California (Alhambra, CA)
- …InterQual guidelines, and Medicaid/Medicare contracts and benefit systems. Required Licenses/Certifications: + Req Registered Nurse - RN (CA DCA) + Req Basic ... populations. The role integrates the functions of complex case management , utilization management , quality ...status and processing of requests received from ambulatory care management nurse . 8. Assesses ongoing discharge planning… more
- LA Care Health Plan (Los Angeles, CA)
- …the ability to manage multiple training initiatives simultaneously. Licenses/Certifications Required Licensed Registered Nurse ( RN ) - Active, current and ... Lead Customer Solution Center Appeals and Grievances RN Job Category: Clinical Department: CSC Appeals &...clinical appeals and grievances experience in a managed care, utilization management and/or case management … more
- Sutter Health (Modesto, CA)
- …Case management OR Bachelor's in a related field **CERTIFICATION & LICENSURE:** RN - Registered Nurse of California **TYPICAL EXPERIENCE:** 5 years of ... Sutter Health philosophies and initiatives. Participates as a member of the utilization Management Committee (UMC). **Job Shift:** Days **Schedule:** Full Time… more
- Texas Health Resources (Bedford, TX)
- …role (ie Charge nurse , committee chair, preceptor) Required Licenses and Certifications * RN - Registered Nurse Upon Hire Required And * BCLS - ... Nursing Supervisor - Behavioral Health _Texas Health Bedford BU...career opportunities. Additional perks of being a Texas Health Registered Nurse : * Benefits include 401k, PTO,… more
- Nuvance Health (Danbury, CT)
- …Credentials: RN Company: Western CT Home Care Inc Org Unit: 607 Department: Registered Nurse Exempt: Yes Salary Range: $40.43 - $65.10 Hourly We are ... well being of the client within Agency policy. Supports utilization of medical resources through application of clinical expertise....or reported, and termination of care when goals of management are attained, or when termination of case is… more
- Ellis Medicine (Niskayuna, NY)
- …The Administrative Clinical Supervisor will work collaboratively with the DON and Nurse Managers to assure effective and efficient utilization of staff and ... our team and GROW with Ellis! The Administrative Clinical Supervisor functions as the administrative manager during the off-shift...+ Currently licensed in New York State as a Registered Nurse and a graduate of an… more
- Sutter Health (Roseville, CA)
- …+ Other: Graduate of an accredited School of Nursing **CERTIFICATION & LICENSURE:** + RN - Registered Nurse of California + BLS-Basic Life Support Healthcare ... Care at Home - Valley **Position Overview:** An experienced RN who is responsible for the overall management...the established plan of patient care and ensuring effective management of visit utilization and control of… more
- Sutter Health (San Francisco, CA)
- …+ Other: Graduate of an accredited School of Nursing **CERTIFICATION & LICENSURE:** + RN - Registered Nurse of California + BLS-Basic Life Support Healthcare ... Manager, the Primary Care Clinician (PCC) is an experienced RN who is responsible for the overall management...the established plan of patient care and ensuring effective management of visit utilization and control of… more
- Sutter Health (Santa Rosa, CA)
- …**EDUCATION:** Graduate of an accredited School of Nursing **CERTIFICATION & LICENSURE:** RN - Registered Nurse of California BLS-Basic Life Support Healthcare ... at Home - Outer Bay **Position Overview:** An experienced RN who is responsible for the overall management...the established plan of patient care and ensuring effective management of visit utilization and control of… more