- US Tech Solutions (RI)
- …HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE 1 YEAR OF UTILIZATION ... + Must have experience with Medcompass + Must have prior authorization utilization experience. + Managed Care/Medicare experience preferred. **Skills:** + MUST HAVE… more
- CVS Health (Columbus, OH)
- …heart, each and every day. **Position Summary** CVS Aetna is seeking a dedicated **Appeals Nurse Consultant ** to join our remote team. In this role, you will be ... clinical experience. **Preferred Qualifications** + Appeals, Managed Care, or Utilization Review experience. + Pre Certification or Pre Authorization experience… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …concerns Key Qualifications + Strong clinical skills and understanding of HMM's Utilization Management , Case Management and operational procedures, Medical ... your true colors to blue. The RoleThe Clinical Business Consultant for Cost and Trend Management is...concerns that may require additional attention. + Partner with Utilization and Care Management to provide clinical… more
- Carle Health (Normal, IL)
- …Lactation Consultants (IBCLC) within 2 years - International Board of Lactation Consultant Examiners (IBCLE); Licensed Registered Professional Nurse (RN) - ... Overview The staff Registered Nurse (RN) is a professional caregiver who assumes...frame and provides care to these patients via the utilization of the nursing process, nursing trends, technology, financial… more
- CVS Health (Austin, TX)
- …for continuous learning and passion to improve population health. Clinical Program Consultant (CPC) plays a key role in delivering strategic clinical insights to ... As a CPC, you will collaborate closely with account teams, care management , Regional Analytic Consulting, and key enterprise partners to support customer objectives.… more
- Carle Health (Urbana, IL)
- …for a designated timeframe and provides care to these patients via the utilization of the nursing process, nursing trends, technology, financial, and human resources ... Heart Association (AHA)American Heart Association (AHA); Licensed Registered Professional Nurse (RN) - Illinois Department of Financial and Professional Regulation… more
- Trinity Health (Mishawaka, IN)
- …for quality care. **JOB SUMMARY:** The inpatient **Certified Wound Ostomy Continency Consultant (CWOCN Consultant ), Registered Nurse ** will provide clinical ... and their family members to assist them in the management of their individual wound care needs. Ultimate responsibility...for the patient, unit based resource nurses and the Nurse Manager of each unit. The CWOCN Consultant… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Job Title: Clinical Nurse -WoundCare-WOCN-Mount Sinai Hospital-FT/Days** The Nurse Clinician is a registered professional nurse who ... skills in an area of clinical nursing specialization. The nurse clinician is able to guide and promote the...Patient/Family education 3) D/C planning and follow-up 4) Case management 5) Research + Maintains clinical expertise in area… more
- Albany Medical Center (Albany, NY)
- …works proactively with the Quality Improvement Teams, patient care standards, and utilization management to coordinate the appropriate use of resources to ... appropriate LOS and financial constraints. + Provides collaborative care management with the primary nurse in assessing...assigned service - required + Recent experience in case management , utilization management and/or discharge… more
- Veterans Affairs, Veterans Health Administration (Salem, VA)
- …Come Join Our Team! The Salem Veterans Medical Center is seeking a Registered Nurse for the Emergency Department. Responsible and accountable for all elements of the ... patient care. The coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care. Responsibilities… more