- Sharecare (Albany, NY)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more
- Truman Medical Centers (Kansas City, MO)
- …English, both spoken and written **Preferred Qualifications:** + RN experience in hospital utilization review, utilization management , or case management ... We are seeking a dedicated and detail-oriented Case Manager (CM)-a registered nurse committed to optimizing both patient outcomes and healthcare resources. In this… more
- Trinity Health (Livonia, MI)
- …experience in nursing and recent (within 2 year) experience in utilization review/ management /discharge planning or case management . Current knowledge of ... for all new nurses! Click here for more details (https://www.stjoeshealth.org/careers/ nursing -careers/ nurse -residency-program) + Retirement savings plan with employer… more
- Actalent (Cary, NC)
- …Triage skills + Acute care + Oncology nursing + RN license + Utilization management + Patient education Additional Skills & Qualifications + Registered ... Job Title: Telehealth NurseJob Description As a Telehealth Nurse , you will counsel and educate new and...Oncology and/or Hematology experience preferred + 3+ years of nursing experience with at least 1 year of acute,… more
- UCHealth (Aurora, CO)
- …cost-effective outcomes. Provides focused support to various areas such as utilization management , emergency department, acute, ambulatory and specialty care. ... UCHealth UCHlth Anschutz Inpt Pavilion, US:CO:Aurora Department: UCHA Care Management FTE: PRN, 0.0, 0.00 hours per pay period...less than 3 years' experience. Preferred: Bachelor's degree in Nursing . + State licensure as a Registered Nurse… more
- St. Luke's University Health Network (Allentown, PA)
- …for admission and/or referral to appropriate level of care. + May assist in the utilization management of psychiatric cases in the absence of the utilization ... and effective communication with patients, families, community agencies, physicians, nursing staff, department managers, ancillary departments, and the Manager… more
- Stanford Health Care (Palo Alto, CA)
- …trends within health care and academic medical centers that may impact product/service utilization or Value Based Management processes. + Collaborate with key ... analytics is essential for data-driven decision-making, along with proven project management skills to track and oversee initiatives from inception to completion.… more
- ChenMed (Louisville, KY)
- …informed decisions re: goals of care, palliative care and hospice. + Utilization /Financial Management -managing resource utilization and reimbursement for ... in the ambulatory health care center setting, or occasionally in acute care, nursing homes, skilled nursing facilities (SNF) and home settings depending on… more
- CVS Health (Albany, NY)
- …- 3+ years of acute experience as a Registered Nurse - 1+ years of Utilization Management experience - Must have experience using MS Office suites - Must be ... year - Occasional travel less than 5% to complete audits/meetings - Utilization Management is a 24/7 operation and work schedules will include weekends,… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- … experience. * 1+ years of managed care experience, eg case management /health coach, utilization management and/or auditing experience. Compensation ... US Minimum Experience Required 1+ years of managed care experience, eg case management /health coach, utilization management and/or auditing experience. Shift… more