- Elevance Health (Grand Prairie, TX)
- ** Telephonic Nurse Case Manager II** **Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person ... complete the assessment within 48 hours of receipt and meet the criteria._** The ** Telephonic Nurse Case Manager II** is responsible for care management within… more
- Elevance Health (Las Vegas, NV)
- ** Telephonic Nurse Case Manager II** **Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person ... complete the assessment within 48 hours of receipt and meet the criteria._** The ** Telephonic Nurse Case Manager II** is responsible for care management within… more
- Humana (Hallandale Beach, FL)
- …ensure interaction between the company and members are optimized. The Telephonic Behavioral Health Care Manager Internship provides transitioning service members ... requirements to achieve and/or maintain optimal wellness state in a remote telephonic environment. The Behavioral Health Care Manager guides members and/or families… more
- Trinity Health (Fort Lauderdale, FL)
- …Care Plans to ensure authorization for hospital stay. Hybrid Position **_Position Purpose:_** ** Utilization Review (UR) Nurses play a vital role in healthcare by ... hospital clinical experience is required.** Recent experience in case management, utilization review , discharge planning, ongoing monitoring and evaluation of… more
- Sharecare (Columbia, SC)
- … utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification ... To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and objectives of the… more
- CVS Health (Austin, TX)
- …with transferring patients to lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred. + ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
- Luke Staffing (Montgomery, AL)
- …Case Management Society of America (CMSA); American Accreditation Healthcare Commission/ Utilization Review Accreditation Commission (URAC); CAMH; (AAAHC); Health ... **REGISTERED NURSE - CASE MANAGER** **SITE OF SERVICE** **:**...and implement local strategies using inpatient, outpatient, onsite and telephonic CM . Develop and implement tools to support… more
- Baystate Health (Springfield, MA)
- **RN, ACO Nurse Care Manager, Community Health Center** The **ACO Nurse Care Manager i** s responsible for the management of care for a defined group of patients ... face visits, home visits if necessary, as well as telephonic interactions. In addition, they will assist with advance...room, or from a skilled nursing facility. Responsible to review the discharge summaries, follow up on testing that… more
- Nuvance Health (Poughkeepsie, NY)
- …or BSN preferred. Must have current RN license. Preferred experience in Utilization Review /Management.Company: Vassar Brothers Medical Center Org Unit: 1190 ... affiliates, Position Summary: Under the general supervision of the Director, The Nurse Case Manager role provide clinically-based case management to support the… more
- NJM Insurance (Trenton, NJ)
- …Workers' Compensation line of business by performing prospective and retrospective Utilization Review of pharmaceutical/medication requests in accordance with ... and causally related. + Evaluate requests that are routed for clinical review based upon established criteria to issue appropriate and timely determinations on… more