- WellSpan Health (York, PA)
- …2 years of RN experience required + Field of Experience in Utilization Management , Case Management , or Clinical Nursing Specialty. Preferred ... **Essential Functions:** + Reviews assigned patients for medical necessity, utilization management , and appropriateness of setting for...**Licenses:** + Licensed Registered Nurse … more
- ERP International (Luke AFB, AZ)
- **Overview** ERP International is seeking a full time ** Registered Nurse - Case Management ** in support of the56th Medical Group at Luke AFB, AZ ... and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case...full, active, and unrestricted license to practice as a Registered Nurse , any state. Clinical Certification:** Certified… more
- Jennie Stuart Medical Center, Inc. (Hopkinsville, KY)
- Jennie Stuart Health is seeking a dedicated Case Management Nurse to join our healthcare team on a PRN basis. This role is integral to our patient care system, ... psychosocial support throughout the continuum of care. The Case Management Nurse will be based at our...teamwork + Experience with InterQual criteria + Understanding of utilization management + Knowledge of CMS regulations… more
- Sharp HealthCare (La Mesa, CA)
- …3 Years Recent acute care nursing experience or case management experience. + California Registered Nurse ( RN ) - CA Board of Registered Nursing ... Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA...and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge… more
- WellSpan Health (Lebanon, PA)
- …**Duties and Responsibilities** + Reviews assigned patients for medical necessity, utilization management , and appropriateness of setting for continued ... quality and cost of care efforts. + Liaisons between utilization management team, third party payers, and..., or Clinical Nursing Specialty. Preferred **Licenses:** + Licensed Registered Nurse Upon Hire Required or +… more
- Tenet Healthcare (Detroit, MI)
- …national standards for case management scope of services including: * Utilization Management supporting medical necessity and denial prevention * Transition ... b) leads the implementation and oversight of the hospital Utilization Management Plan using data to drive...in Nursing, Business Administration or Hospital Administration preferred. 2. Registered Nurse or LCSW/LMSW license. Must be… more
- Hartford HealthCare (Manchester, CT)
- … Management * **Organization:** **Manchester Memorial Hospital* **Title:** *Clinical Resource Management Nurse ( RN ) - Case Coordination* **Location:** ... timely and accurate information to payers. The role integrates and coordinates utilization management and denial prevention by focusing on identifying and… more
- Northwell Health (Staten Island, NY)
- …Nursing, required. + Current license to practice as a Registered Professional Nurse in New York State. + Case Management Certification, preferred. + Minimum ... another level of care according to regulatory standards. + * Performs concurrent utilization management using Interqual criteria. + Conducts chart review for… more
- Guthrie (Sayre, PA)
- …recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care in collaboration with ... degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant...admissions and short procedures by translating clinical information to Utilization Management requirements using pre ‐ determined… more
- Ventura County (Ventura, CA)
- …and patient-centered care. Under general direction, the Senior Medical Management Nurse is responsible for performing utilization review, case management ... Senior Medical Management Nurse - VCHCP Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5113983) Apply Senior Medical Management … more