- Trinity Health (Mishawaka, IN)
- …and detail-oriented ** RN ** **Case Manager** to coordinate patient care, utilization management , and discharge planning. This role ensures quality outcomes, ... + Provide education and support to patients and families + Maintain compliance with healthcare regulations and documentation standards **Requirements:** + RN … more
- Blue KC (MO)
- …Lead cross-functional efforts to embed behavioral health principles into population health management , product design, and beyond + Perform as a strategic advisor to ... behavioral health services, programs, and vendor relationships to ensure compliance with regulatory requirements, performance guarantees, and accreditation standards… more
- Actalent (Des Moines, IA)
- …and familiarity with HEDIS measure specifications. * Prior work in utilization management , quality management /review, accreditation, outpatient clinic ... into company's electronic HEDIS application Ensure Health & Care Management are in compliance with HEDIS audit...and consistent with the standards pertinent to the Quality Management team Qualifications * Active and Unrestricted RN… more
- Urbandale Community School District (Urbandale, IA)
- …performance appraisal, education, collegiality, ethics, collaboration, research, resource utilization , communication, program management and health education. ... Job ID: 5227365 Job Description JOB TITLE - Substitute Nurse PURPOSE OF THE POSITION - We are seeking...to interpret federal, state and local codes and maintain compliance . + Ability to use computer software. Education +… more
- Medtronic (Greenville, SC)
- …experience in healthcare access (ie., prior authorization, patient support, case management , practice operations, and utilization review) + Demonstrated ... delivery (TDD), and interventional pain therapies-while upholding the highest standards of compliance and patient privacy. This is a **field-based** position. We are… more
- Trinity Health (Albany, NY)
- …they remain current with advancements in Oncology care and clinical best practices. ** Compliance & Risk Management :** + Support operational leaders in ensuring ... to strengthen patient and provider access across THNY oncology services. **Financial Management :** + Manage a regional service line dashboard, including oversight of… more
- Atrius Health (Newton, MA)
- …. Minimum 5 years nursing experience, which includes a minimum of 3 years in utilization management or case management . . Minimum of 3-5 years clinical ... Case Management (CCM) or CCM eligible preferred. Current unrestricted RN licensure to practice professional nursing in the Commonwealth of Massachusetts… more
- UCLA Health (Los Angeles, CA)
- …The Home Health ICM Coordinator plays a key role in supporting our Utilization Management team to ensure safe, high-quality, and cost-effective care for ... patients enrolled in UCLA Medicare Advantage and Intensive Case Management programs. Under the supervision of the RN Assistant Director, you will coordinate… more
- McLaren Health Care (Mount Pleasant, MI)
- …education sessions to maintain competency and knowledge of regulations in denials, utilization management , care management , clinical documentation, and ... other related duties as required and directed. **Qualifications:** **_Required:_** + Registered Health Information Technician (RHIT), Licensed Practical Nurse … more
- HCA Healthcare (Englewood, CO)
- …shift. The House Supervisor participates as an active member of the nursing management team and assumes authority to manage all activities and personnel in ... the designated shift. Makes decisions regarding patient care and staff management using established policies/procedures. + Participates in the monitoring,… more