- 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
- 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
- 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
- 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
- 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
- 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
- Centene Corporation (Denver, CO)
- …and provide recommendations to senior management of process improvements within utilization management + Manages and oversees cases to ensure timely ... a fresh perspective on workplace flexibility. **Location: Position is remote . Prefer candidate to live in PST time zone.**...to the interdepartmental teams on training needed within the utilization management team based on trends +… 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