- Banner Health (Phoenix, AZ)
- …based with no budgetary responsibility. Internal customers: Patients, families, all levels of nursing management and staff, medical staff, and all other members ... networks, and regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained through the… more
- Banner Health (Mesa, AZ)
- …based with no budgetary responsibility. Internal customers: Patients, families, all levels of nursing management and staff, medical staff, and all other members ... networks, and regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained through the… more
- Bluestone Physician Services (Waukesha, WI)
- …with primary care teams to ensure high quality team-based care + Use utilization management tools to facilitate appropriate transitional care management ... as to acute settings with the goal of reducing utilization and unnecessary costs + Work to increase coordination...Nurse + 3-5 years of experience in case/care management or care coordination + Experience working directly with… more
- Molina Healthcare (Santa Fe, NM)
- …and recommendations to vendors as needed. * Assists in preparation of documents for utilization management , care management , state, CMS, NCQA and other ... Qualifications * At least 3 years of health care experience in a care management , utilization management , behavioral health, medical, and/or managed care… more
- Providence (Tarzana, CA)
- … management of the patient along the continuum of care, utilization activities, disease management appropriateness, discharge planning, patient education ... Degree Healthcare related field. + Upon hire: California Registered Nurse License + Management experience in a hospital/health care environment. + 3 years… more
- Banner Health (Casper, WY)
- …based with no budgetary responsibility. Internal customers: Patients, families, all levels of nursing management and staff, medical staff, and all other members ... networks, and regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained through the… more
- Virginia Mason Franciscan Health (Silverdale, WA)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing , physicians, ancillary departments, insurers ... two (2) years of acute hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of 1 year experience. Preferred Education and… more
- MVP Health Care (Tarrytown, NY)
- …healthcare procedures, and clinical guidelines. + Previous experience in clinical appeals, utilization management or managed care and LTSS is highly desirable ... license in good standing + Graduate of an Accredited nursing program required (BSN preferred) + Minimum 3-5 years...should be overturned + Collaborate with MVP Medical Directors, Utilization Management and Case Management … more
- Health Advocates Network (Harrisburg, PA)
- …as a Registered Nurse issued by the Pennsylvania State Board of Nursing ; or Possession of a non-renewable temporary practice permit issued by the Pennsylvania ... setting, behavioral health setting, drug and alcohol setting, managed care, quality management / utilization review or other related clinical experience; or An… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role Brighton Health Plan Solutions (BHPS) provides Utilization Review/Medical and Case Management services for Workers' Compensation. The Workers' ... and the evaluation of coverage under the Plan. The Nurse Case Manager reports to the Casualty Department Manager....services for timely return to work. + Provides case management , utilization review, continued stay reviews, and… more