- CareFirst (Baltimore, MD)
- …preferred. **Experience:** 5 years clinically related experience working in Care Management , Discharge Coordination, Home Health, Utilization Review, Disease ... School Diploma or GED **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or Compact State Licensure RN-...CCM/ACM or other RN Board Certified certification in case management . Incumbents not certified at the time of hire… more
- Baylor Scott & White Health (College Station, TX)
- …for assessing and coordinating patient care across the continuum to include case management , social work, utilization review and care coordination to achieve ... SUCCESS FACTORS** Knowledge of Care Coordination, discharge planning, case management and utilization review. Knowledge of human...level **QUALIFICATIONS** - EDUCATION - Bachelor's - MAJOR - Nursing - MAJOR - Nursing - EXPERIENCE… more
- PruittHealth (Atlanta, GA)
- …three years industry experience in a managed care setting focused on experience in utilization review/case management and at least two years case management , ... **JOB PURPOSE:** Responsible for the oversight of clinical care management of community based long-term care population for PruittHealth Premier Dual Eligible… more
- Banner Health (Fallon, NV)
- …the operations of the unit to ensure smooth and efficient patient care management and resource utilization . 2. Leads change by developing, implementing and ... Fallon, Nevada **Department Name:** Med/Surg-Hosp **Work Shift:** Day **Job Category:** Nursing The future is full of possibilities. At Banner Health, we're… more
- HCA Healthcare (Wichita, KS)
- …or 2 years of critical care experience is preferred + Certification in case management or utilization review is preferred + InterQual experience is preferred ... 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
- UNC Health Care (Rocky Mount, NC)
- …Summary: Facilitates effective and cost-efficient care of patients through such case management functions as utilization review and discharge planning. May ... the continuum of care, or may concentrate on one aspect of case management , depending on the area assigned. In collaboration with the Interdisciplinary Patient Care… more
- Providence (WA)
- …retain the best people, we must empower them. **Required Qualifications:** + Degree in Nursing + Oregon Registered Nurse License + 5+ years clinical experience ( ... + Dual RN License: Oregon and Washington + 1 year Quality management /quality improvement/ utilization review auditing experience, including experience in auditing… more
- Banner Health (Tucson, AZ)
- …the operations of the unit to ensure smooth and efficient patient care management and resource utilization . 2. Leads change by developing, implementing and ... Arizona **Department Name:** Emergency Ctr-Hosp **Work Shift:** Day **Job Category:** Nursing Banner Health believes leadership matters. We look for people who… more
- Wellpath (Franklin, TN)
- …you make a difference** The Regional Care Manager (RCM) is responsible for utilization review, care coordination, and daily care management across multiple sites ... **Qualifications & Requirements** EDUCATION + Graduation from an accredited School of Nursing or Care Management Certification + RN preferred EXPERIENCE +… more
- HCA Healthcare (Portsmouth, NH)
- …experience in case management OR 3+ years experience in clinical nursing Required InterQual experience Preferred Registered Nurse license for New Hampshire ... throughput while supporting a balance of optimal care and appropriate resource utilization . Provides case management services for both inpatient and observation… more