- Cleveland Clinic (Cleveland, OH)
- …of Professional Nursing + Current state licensure as a Registered Nurse (RN) + Basic Life Support (BLS) Certification through the American Heart Association ... ideal future caregiver include: + Bachelor's of Science in Nursing (BSN) + CTM, ACM, CCM or AHA Certification...approved entity + Two years of recent experience in utilization review, quality or care management +… more
- Corewell Health (Royal Oak, MI)
- …coordinating patient discharge planning for post-acute services, length of stay (LOS) management and utilization management ; collaborating to include ... into clinical practice. This position reports to the Clinical Nurse Manager and/or the Director of Nursing ....Clinical Nurse Manager and/or the Director of Nursing . + Determine the appropriate appointment scheduling, by assessing… more
- Diversicare Healthcare Services & Diversicare Ther (Oxford, AL)
- …current license in respective field. 2. Knowledge of healthcare reimbursement, utilization management , and discharge planning. 3. Experience providing strategic ... Engage/72 HR Admission meetings as part of the care management system. + Manage the restorative nursing ...care management system. + Manage the restorative nursing program, integrating it with the activity department. +… more
- Diversicare Healthcare Services & Diversicare Ther (Hartford, AL)
- … nursing 2. RN License 3. Knowledge of healthcare reimbursement, utilization management , and discharge planning. 4. Experience providing strategic leadership, ... Engage/72 HR Admission meetings as part of the care management system. + Manage the restorative nursing ...care management system. + Manage the restorative nursing program, integrating it with the activity department. +… more
- HCA Healthcare (Gainesville, FL)
- …and improve the patient flow program effectiveness as it relates to utilization review, resource management , and discharge planning and care coordination. ... location._** It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential...and professional goals. Help to advance the practice of nursing and improve positive outcomes for your patients as… more
- Dignity Health (Santa Maria, CA)
- …RN is responsible for providing telephonic clinical assessment, health education and utilization management services to a variety of patients. **Job ... One or more years of telephone/ call center triage nurse experience preferred + Registered Nursing /... / BSN + Familiarity with an electronic practice management system is preferred **Where You'll Work** Dignity Health's… more
- Centene Corporation (Trenton, NJ)
- …Knowledge of NCQA, Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. **License/Certification:** + LPN - ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
- Centene Corporation (Jefferson City, MO)
- …Knowledge of NCQA, Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. **License/Certification:** + LPN - ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
- MD Anderson Cancer Center (Houston, TX)
- …avenues of appeal. * Contact third-party payers, insurance medical directors, case management , and utilization review to request reconsideration and/or appeal of ... *WORK EXPERIENCE* * Required: 5 years Experience in clinical nursing and 1 year Experience in utilization ...preferred degree for two years of the five clinical nursing experience. * Preferred: Nurse Defense Audit… more
- Magellan Health Services (Carlsbad, NM)
- …Magellan Credentialing criteria. 2+ years' post-licensure clinical experience. Experience in utilization management , quality assurance, home or facility care, ... with care coordination goals. Other Job Requirements Responsibilities Associate's Degree in Nursing required for RNs, or Master's Degree in Social Work or… more