- Highmark Health (Harrisburg, PA)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC) or WV or DE or...first 6 months of employment. **Preferred** + Certification in utilization management or a related field +… more
- Actalent (Austin, TX)
- …member care decisions + Document review findings, discharge plans, and actions in health management systems per utilization management policies + Work with ... Clinical Review Nurse - Concurrent Review Location: Remote ...Trucare Cloud preferred) + Knowledge of Medicaid regulations and utilization management processes preferred + Proficiency in… more
- Ochsner Health (New Orleans, LA)
- …of hospital-based experience in discharge planning, case management or utilization review. **Certifications** Required - Current registered nurse license in ... to develop and implement discharge plans based on patient's individualized needs. Registered Nurse (RN) Case Manager - Case Management OMC Jefferson Highway PRN… more
- State of Colorado (Pueblo, CO)
- …understood, actionable, and tied to CMHHIP's improvement goals. + Participate in utilization management and review activities when requested, applying clinical ... Nurse I - RN Critical Incident/Occurrence Reporter-CMHHIP-Pueblo Print...surveyors throughout the hospital) and/or provides assistance to Quality Management Leadership as directed during regulatory surveys. May perform… more
- Banner Health (Phoenix, AZ)
- …, acute care and/or home care environments, community resources and resource/ utilization management . Must demonstrate critical thinking skills, problem-solving ... networks, and regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained through the… more
- Centene Corporation (Indianapolis, IN)
- …findings, discharge plans, and actions taken on member medical records in health management systems according to utilization management policies and ... preferred. Knowledge of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. **License/Certification:** + LPN -… more
- Actalent (Orlando, FL)
- …EMR systems + Medicaid, Medicare or insurance-related knowledge + Prior utilization management experience What We Offer + Fully remote role with national ... Clinical Review Nurse - Concurrent Review Location: Remote ...preferred) + Knowledge of Medicaid or Medicare regulations and utilization management processes + Proficiency in Microsoft… more
- North Shore Community Health (Gloucester, MA)
- … management . + Pharmacy services. + Substance abuse disorder treatment. + Nurse care management . + Insurance enrollment assistance. NSCH operates service ... Primary Care Team Nurse Care Manager Gloucester, MA (http://maps.google.com/maps?q=302+Washington+Street+Gloucester+MA+USA+01930) Description Primary Purpose of… more
- Battelle Memorial Institute (Arlington, VA)
- …as a case manager by a recognized certifying organization, ie, Commission for Case Management Certification or American Nurse Credentialing Center + At least two ... Research and Analytics (HRA) business line is seeking a highly motivated, full-time ** Nurse Case Manager** to join our team in support of our government customer,… more
- State of Colorado (Denver, CO)
- Off Hours Nurse Supervisor - Nurse III (Internal Pool) - Colorado Mental Health Hospital Fort Logan Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5132944) Apply Off Hours Nurse Supervisor - Nurse III (Internal Pool) - Colorado Mental Health… more