- CareFirst (Baltimore, MD)
- …**Experience:** 8 years clinical practice experience. **Preferred Qualifications:** + Experience in utilization management or served as physician advisor for ... **Resp & Qualifications** **PURPOSE:** The Medical Director oversees all activities of utilization review, care management and quality to determine the medical… more
- AdventHealth (Orange City, FL)
- …of Nursing . + Health-related master's degree or MSN. + Prior Care Management / Utilization Management experience. + ACM/CCM Certification. This facility is ... Manager is under the general supervision of the Care Management Supervisor or Manager or Director of Nursing...need to succeed:** **Minimum qualifications** : + Associate's degree Nursing or RN Diploma degree. + Registered Nurse… more
- Catholic Health Initiatives (Plainview, NE)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing , physicians, ancillary departments, insurers ... hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management … more
- AdventHealth (Hinsdale, IL)
- …. BSN . Health-related Master's degree or MSN . Prior Care Management / Utilization Management experience **LICENSURE, CERTIFICATION OR REGISTRATION ... Manager is under the general supervision of the Care Management Supervisor or Manager or Director of Nursing...physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge… more
- HCA Healthcare (Houston, TX)
- …national standards for case management scope of services including + Utilization Management supporting medical necessity and denial prevention + Transition ... opportunity to make a real impact. As a(an) Registered Nurse Case Manager PRN you can be a part...and professional goals. Help to advance the practice of nursing and improve positive outcomes for your patients as… more
- UPMC (Washington, PA)
- …care/treatment, The Joint Commission Standards, Federal/State regulations relative to utilization /case management , discharge planning, Medicare, Medicaid, and ... The Manager oversees the day-to-day operations of the Case management department under the direction of the Director. The Manager is accountable for the following… more
- Corewell Health (Grand Rapids, MI)
- …of medical management + Provide clinical oversight to nurse case management and utilization management . + Promote and advocate for patient-centered ... education skills; evaluation of evidence-based standards of care and application of utilization management skills and strategies. Preferred + LIC-Physician (MD)… more
- Trinity Health (Troy, NY)
- …Friday - Samaritan HospitalIf you are looking for a position in RN (Registered Nurse ) Case Management in a dynamic hospital, this could be your opportunity. ... **Description:** We at St. Peter's Health Partners recognize that nursing is one of the most challenging careers and...in acute settingPreferred requirements:1+ year of experience in case management or utilization managementCase Management … more
- Centene Corporation (Salem, OR)
- …LPN/LVN with 5+ years of clinical nursing or case management experience. Managed care or utilization review experience preferred. **License/Certification:** ... nursing and/or case management experience or...or RN license. **Texas Requirements:** RN license required within Utilization Management at Superior HealthPlan or LPC,… more
- Nuvance Health (Danbury, CT)
- …patient-centric vision and strategy for system-wide care coordination, encompassing utilization review (UR), denials management , discharge planning, social ... *Education and Experience Requirements: * * Bachelor's degree in nursing (BSN) * Master's degree in nursing ,...of 5 years of progressive leadership experience in case management or utilization review * Proven leadership… more