- Highmark Health (Jackson, MS)
- …**Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides ... to appropriate resources for additional support. + Implement care management review processes that are consistent with established industry, corporate, state, and… more
- Veterans Affairs, Veterans Health Administration (Las Vegas, NV)
- Summary The Revenue Utilization Review (RUR) nurse is...Must have ability to report to Las Vegas, NV Remote : This is not a remote position. Must ... and analytical review of clinical information. Responsibilities The Revenue Utilization Review (RUR) Registered Nurse is under the supervision of a… more
- Molina Healthcare (Austin, TX)
- JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for verifying ... cost-effective member care. The candidate must have Medicare Appeals and/or Utilization Management knowledge. Work hours are Monday-Friday 8:00am- 5:00pm PST. This… more
- Molina Healthcare (Spokane, WA)
- JOB DESCRIPTION Job Summary The Care Review Clinician (RN) provides support for clinical member services review assessment processes. Responsible for verifying ... and critical care experience, ie ER or ICU. Candidates with Utilization Management and med/surge experience are highly preferred. Exceptional time management… more
- State of Colorado (Denver, CO)
- Assistant Nurse Manager - Nurse III (Internal Pool) - Colorado Mental Health Hospital in Fort Logan Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5132944) Apply Assistant Nurse Manager - Nurse III (Internal Pool) - Colorado Mental Health… more
- Ochsner Health (New Orleans, LA)
- …hospital-based experience in discharge planning, case management or utilization review . **Certifications** Required - Current registered nurse license in ... implement discharge plans based on patient's individualized needs. Registered Nurse (RN) Case Manager - Case Management OMC Jefferson...of the conditions of participation as it relates to utilization review and discharge planning. + Maintains… more
- CVS Health (Austin, TX)
- …with heart, each and every day. **Position Summary** This Case Manager - Registered Nurse (RN) position is with Aetna's National Medical Excellence (NME) team and is ... a fully remote position. Candidates from any state are welcome to...apply, however, preference is for candidates in compact Registered Nurse (RN) states. This role is a blended role… more
- US Tech Solutions (Columbia, SC)
- …**Responsibilities:** + May provide any of the following in support of medical claims review and utilization review practices: Performs medical claim reviews ... **Location: Columbia, SC 29229** **( Remote after training)** **Duration: 3+ Months** **(Possible temp...indicated protocol sets or clinical guidelines. Provides support and review of medical claims and utilization practices.… more
- Battelle Memorial Institute (Colorado Springs, CO)
- …within legal and professional parameters + Knowledge and skill in using pre-established utilization review criteria to recognize and report actual or potential ... (HRA) business line is seeking a highly motivated, full-time ** Nurse Case Manager** to join our team in support...model allows you to work 60% in-office and 40% remote , with Monday and Tuesday as common in-office days,… more
- North Shore Community Health (Gloucester, MA)
- Primary Care Team Nurse Care Manager Gloucester, MA (http://maps.google.com/maps?q=302+Washington+Street+Gloucester+MA+USA+01930) Description Primary Purpose of ... in exceptional community healthcare delivery. The Primary Care Team Nurse Care Manager (PC team RN CM) is a...PC team RN CM coordinates the overall health care utilization for NSCH's most vulnerable patients. The Organization North… more