- Magellan Health Services (Albuquerque, NM)
- …including related correspondence. + Participates in Care Coordination team and utilization management activities, including collaboration with other staff on ... management and verbal and written communication skills. Knowledge of utilization management procedures, Medicaid benefits, community resources and providers.… more
- Centene Corporation (Little Rock, AR)
- …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
- Insight Global (Philadelphia, PA)
- …Active RN License or Active LPN License 2-3 years of clinical experience ( Utilization management or utilization review) Strong computer skills Ability ... looking for HEDIS RNs or LPNs for a partially remote contract position in PA and NJ. PARTIALLY ...of medical records assigned by a Clinical Quality Lead nurse . Miles will be reimbursed for any travel. Computer… more
- Veterans Affairs, Veterans Health Administration (Greenville, NC)
- …Greenville Specialty Procedures clinic. Demonstrates leadership, experience/ingenious approaches to management of complex patient care. Accountable for the ... care is achieved & a safe therapeutic environment. Responsibilities The Registered Nurse working in the Special Procedures departments in Greenville Clinic will… more
- Magellan Health Services (Somerset, PA)
- …Strong organization, time management and communication skills.* Knowledge of utilization management procedures, mental health and substance abuse community ... Strong organization, time management and communication skills. Knowledge of utilization management procedures, mental health and substance abuse community… more
- Veterans Affairs, Veterans Health Administration (Anchorage, AK)
- …knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ... https://www.va.gov/ohrm/QualificationStandards/. Preferred Experience: Three to five years of Registered Nurse Experience Case management experience Physical Requirements:… more
- State of Colorado (Denver, CO)
- Assistant Nurse Manager - Nurse III - Colorado Mental Health Hospital in Fort Logan (S. Denver) Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5012615) Apply Assistant Nurse Manager - Nurse III - Colorado Mental Health Hospital in Fort… more
- Veterans Affairs, Veterans Health Administration (Colorado Springs, CO)
- …responsibility for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care. Administers ... education and coaching on wellness, disease prevention, and chronic care management assisting in directing the provision of nursing education, orientation,… 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
- CVS Health (Austin, TX)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... each and every day. **Position Summary** **This is a remote work from home role anywhere in the US...or Specialty Pharmacy.** **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator… more