• Clinical Appeals Supervisor (Hybrid)

    CareFirst (Baltimore, MD)
    …medical-surgical or similar clinical experience OR 5 years' experience in Medical Review, Utilization Management or Case Management at CareFirst BlueCross ... expected to work a portion of their week from home and a portion of their week at a...regulatory and accreditation requirements, understanding of appeals process and utilization management , and systems software used in… more
    CareFirst (10/15/25)
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  • Nursing Assistant and Unit Secretary - Cardiac ICU…

    WellSpan Health (York, PA)
    management , all components of advanced cardiac life support, pacemaker/ICD management , IABP management , CRRT utilization , and Impella. **General ... of various computer applications designed for functions such as patient management , patient census, acuity, composer, bed tracking, transport, etc.. Serves as… more
    WellSpan Health (11/04/25)
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  • RN Case Manager PRN

    Access Dubuque (Dubuque, IA)
    …MercyOne is committed to providing quality, personalized and safe health care close to home . The emergency department is staffed 24 hours a day, seven days a week ... the MercyOne Family! We are looking to hire a Nurse Case Manager. The Case Manager at MercyOne coordinates...delivery processes and quality improvement including tracking of resource utilization and outcome measures. The Case Manager is +… more
    Access Dubuque (10/11/25)
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  • Case Manager, Medicaid Long Term Support Program

    MVP Health Care (Rochester, NY)
    …every interaction **Your key responsibilities:** + Utilize the essentials of an integrated utilization management and case management model that includes ... **Qualifications you'll bring:** + Current New York State Licensure as a Registered Nurse required. + Certification in Case Management required within 24 months… more
    MVP Health Care (11/03/25)
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  • Director Of Clinical Practice (Hospice)

    BrightSpring Health Services (Springville, AL)
    utilization and hospital admission reduction + Provides survey management support/ follow-up/and coordination of corrective actions plans related to care ... and direction in performance improvement, provision of clinical services, survey management , documentation management , incident management , EMR/EHR… more
    BrightSpring Health Services (10/14/25)
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  • Physician Extender APP, Nephrology

    ChenMed (Glenwood, IL)
    …patient charts, provide assessments and recommendations for care plan. + Enhances home dialysis utilization for patients with emphasis on increasing de-novo ... and will help develop strategies for quality improvement and management . **ESSENTIAL JOB DUTIES/RESPONSIBILITIES:** + Works directly with the...start of home dialysis. + Works with transitional care team on… more
    ChenMed (11/05/25)
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  • Community Health Coordinator- Full-Time- (72 hours…

    Mille Lacs Health System (Onamia, MN)
    …clinic operations by integrating preventive health initiatives, population health management , and social support services into the clinical environment. The ... role may be filled by a Registered Nurse (RN), Licensed Practical Nurse (LPN), Licensed...LADC). Essential Duties and Responsibilities Care Coordination and Case Management + Conduct assessments to identify patients with complex… more
    Mille Lacs Health System (11/06/25)
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  • RN, Quality Assurance

    University of Rochester (Rochester, NY)
    …Serves as the primary internal contact for national and state registry data management questions, issues or concerns, but not limited to clinical data collection, ... validation, delivery, reconciliation, and data management activity timeliness. Concurrently and retrospectively reviews medical records and data to identify patient… more
    University of Rochester (11/06/25)
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  • RN Case Manager

    Prime Healthcare (Harlingen, TX)
    …Planning: c oordinate safe and appropriate discharge plans, including referrals to rehab, home health, or long-term care facilities + Utilization Review: m ... Case Manager , also referred to as a Registered Nurse Case Manager or RN Clinical Case Manager ....care transitions. RN Case Managers also conduct discharge planning, utilization review, and helping patients navigate insurance and healthcare… more
    Prime Healthcare (09/18/25)
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  • RN Case Manager

    University of Utah Health (Salt Lake City, UT)
    …integral to our mission. EO/AA_ + This position provides clinical case management services aimed at enhancing patient-centered care and maximizing outcomes across ... the patient care continuum from pre-admission through post-discharge. + Case management services include monitoring patient care to ensure progress toward desired… more
    University of Utah Health (10/28/25)
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