- CVS Health (Baton Rouge, LA)
- …per our company expense reimbursement policy. **Preferred Qualifications** + Managed care/ utilization review experience + Case management experience ... and/or face to face assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member… more
- MTC (Graceville, FL)
- …record or other forms as appropriate. + Practice basic cost containment and utilization management for inmate care and facility operations. + Maintain absolute ... improving people's lives. We are seeking an **On-Call Registered Nurse (RN)** to join our team. **Primary duties:** +...HIPAA rules. + Accurately and promptly chart medical care. Review medical files to determine all provided services are… more
- CVS Health (Atlanta, GA)
- …years clinical experience. **Preferred Qualifications** + Appeals, Managed Care, or Utilization Review experience. + Proficiency with computer skills including ... heart, each and every day. **Position Summary** CVS Aetna is seeking a dedicated **Appeals Nurse Consultant** to join our remote team. In this role, you will play a… more
- VNA Health (Santa Barbara, CA)
- …a $5,000 sign on BONUS! Job Description: VNA Health is looking for compassionate Registered Nurse Case Managers (RN CM) to join our Home Health care team. The RN CM ... organizes and directs home care services. Responsibilities: + Responsible for continuous review of all aspects of every patient on his/her caseload to include:… more
- Hospice of Michigan (Southfield, MI)
- …work with minimal supervision. + Requires knowledge of quality assessment and utilization review functions, principles and practices. + Theoretical and practical ... personnel on the QAPI plan, and team development. + Performs clinical record review activities for data collection. + Compiles, analyzes, trends and reports quality… more
- Dartmouth Health (Bennington, VT)
- …into a BSN program may be considered.Prior experience in utilization review , discharge planning and/or case management preferred.3-5years of recent clinical ... required. BSN preferred. Prior experience in utilization review , discharge planning and/or case management preferred....utilization review , discharge planning and/or case management preferred. VT Nursing License required by date of… more
- AdventHealth (Sebring, FL)
- …patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the interdisciplinary team ... core competencies of this role. The RN Care Manager facilitates the collaborative management of patient care across the continuum, intervening to remove barriers to… more
- Beth Israel Lahey Health (Cambridge, MA)
- …with Harvard Medical School. The Inpatient Case Manager (CM) performs utilization reviews and coordinates discharge planning for MAH inpatient admissions. Inpatient ... Case Manager Guidelines and audit tool. Reports to Inpatient Case Management Supervisor. **Job Description:** **Essential Duties & Responsibilities (including but… more
- Nuvance Health (Danbury, CT)
- *Description* Summary: Coordinates and performs utilization review and patient medical record audits according to State & Federal licensing regulations and Joint ... action plans to improve clinical documentation. Responsibilities: 1. Coordinates and performs utilization review and patient medical record audits according to… more
- Pine Rest Christian Mental Health Services (Grand Rapids, MI)
- …staff assignments and promoting staff development. + Responsible for the utilization and continued review of patient care protocols, standards ... to be a part of this incredible work. What Will You Do? As a Registered Nurse at Pine Rest, you'll be part of tight-knit team that believes in the healing power… more