- Veterans Affairs, Veterans Health Administration (Hines, IL)
- …Systems Specialist who's primary responsibility is provision of advisory service to the (ADPCS)/ Nurse Executive and top level management on the most complex ... aligned under the Office of the Associate Director for Patient Care Services (ADPCS)/ Nurse Executive at the Edward Hines Jr. VA Hospital. The primary purpose of… more
- CVS Health (Lansing, MI)
- …Sigma Black Belt or Lean Six Sigma Certification Preferred + Case Management Certification (CMC) **Education** + Registered Nurse (Masters preferred) ... and programs, and supportive technology and analytics to ensure appropriate utilization . This position provides leadership and direction in the execution of… more
- Centene Corporation (Austin, TX)
- …Licensure required or + NP - Nurse Practitioner - Current State's Nurse Licensure required + For Superior: Resource Utilization Group (RUG) certification ... including a fresh perspective on workplace flexibility. Performs care management duties to assess and coordinate all aspects of...plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay… more
- Veterans Affairs, Veterans Health Administration (Fredericksburg, VA)
- …service activities including visits, referrals, patient demographics, equipment utilization and patient satisfaction. Develops, implements, and evaluates clinical ... guidelines and protocols to establish appropriate utilization of services. The incumbent supervises a group of employees organized as an inter-professional team… more
- Guthrie (Corning, NY)
- …and autonomy in nursing practice. Preferred experience with PCMH process, care management / utilization review, and payer knowledge. Fast paced ambulatory care ... Coordinator has the responsibility and accountability for coordinating the medical management of patients, using an outcomes‐based approach. In collaboration with… more
- Praxis Health (OR)
- …Suite(Word, Outlook, Teams, Excel). + Expertise in chronic disease management , case management , utilization management , and adult acute care. + Hands-on ... Job Description Join Our Team as a Transitional Care Management (TCM) Coordinator! Location: Remote (Oregon residents only)...+ High school diploma or GED. + Licensed Practical Nurse (LPN) or Registered Nurse (RN) from… more
- CommonSpirit Health Mountain Region (Centennial, CO)
- …required Minimum Experience required: 4 years clinical experience as a Registered Nurse . 3 years with progressive experience in utilization review, preferred. ... your success. The RN Clinical Denials Appeals Specialist functions as a revenue management liaison for all care sites with external third-party payers to appeal… more
- Humana (Richmond, VA)
- …within the paradigm. . Analyze, monitor and provide periodic reports on the utilization of consumer directed services. Utilize the data to inform strategies and ... hands-on learning opportunities to partners, all levels of Member support management , and other divisions to support the development of organizational competencies.… more
- Veterans Affairs, Veterans Health Administration (Reno, NV)
- …Advanced MSA coordinates with the patient care team to review the clinic utilization by using various reports (eg, Clinic Utilization Statistical Summary). ... a manner that only minimal supervision is required Other duties as assigned by management . Requirements Conditions of Employment You must be a US Citizen to apply… more
- Hologic (Denver, CO)
- …create and implement innovative digital tools and field-level programs that increase utilization of the Fibroid ablation systems (Sonata, Acessa) and Novasure in ... educational outreach for patients and referring physicians, and leading our Nurse Advocate program. **Knowledge:** + Deep understanding of marketing principles and… more