- AmeriHealth Caritas Health Plan (Philadelphia, PA)
- …and meaningful collaboration. Lead with Clinical Insight. Whether you're an experienced utilization review nurse, a sharp case manager, or a behavioral health ... impact behind the scenes, this is your moment. As a Clinical Care Reviewer , you'll evaluate inpatient, outpatient, pediatric, or behavioral health services to ensure… more
- Optum (San Juan, PR)
- …for further review in a production environment. Primary Responsibilities: Clinical Case Reviews -75% Perform clinical review of professional (or facility) ... claims vs. medical records to determine if the claim is supported or unsupported Maintain standards for productivity and accuracy. Standards are defined by the department Provide clear and concise clinical logic to the providers when necessary Examine, assess,… more
- VNA of the Treasure Coast (Vero Beach, FL)
- …within the client's admission Identify high risk cases that require interdisciplinary case conferencing Review clinical records for accuracy and completeness on ... Several local and national discounts The VNA is seeking a part time Quality Reviewer . This position supports the efforts of VNATC Home Health in managing quality of… more
- Riverside County, CA (Moreno Valley, CA)
- …Riverside - Riverside University Health System-Medical Center is seeking an Assistant Director of Case Management and Utilization Review to join our UR Case ... nurse in an accredited acute care hospital. Professional experience in case management and utilization review in a hospital is preferred. Schedule: 9/80 after 90… more
- Medical Solutions (Omaha, NE)
- Ready to Plant Roots? This Permanent Case Management (Utilization Review )/RN (Registered Nurse) Position in White Plains, NY Has Your Name on It! A top-tier ... facility is looking for a dedicated Case Management (Utilization Review )/RN (Registered Nurse) to join their team. If you've been craving the stability to stay… more
- American Traveler (Washington, DC)
- American Traveler is seeking an experienced RN Case Manager with a DC license and case management or utilization management background for a day shift position. ... Job Details *Work in a case management department with primary focus on care coordination,...at time of consideration, *Minimum 2 years of recent case management experience required (will consider utilization management experience),… more
- American Traveler (Boston, MA)
- American Traveler is seeking an experienced RN Case Manager with acute case management experience and an active MA RN license. Job Details *Position is based in ... a hospital setting within the case management department, *Day shift schedule from 08:00 to...pending licenses accepted), *Minimum of 2 years of acute case management experience required, *Current BLS certification from the… more
- North Carolina Specialty Hospital (Durham, NC)
- …a resource for routine and complex problem solving as it relates to utilization review and case management. Anticipate the needs of customers and work ... minimum of 1 year previous Medical and/or Surgical nursing experience preferred. Utilization Review and Case Management experience required . Skills & Abilities:… more
- Medical Solutions (Omaha, NE)
- …in Santa Ana, CA is seeking its next amazing RN (Registered Nurse) to work in Case Management (Utilization Review ). Read on if this sounds like your perfect fit! ... Nurses and allied healthcare professionals are in high demand nationwide, and our team of industry-leading, traveler-favorite recruiters can get you where you want to go - personally and professionally. Wherever you may roam, travel healthcare helps you hone… more
- Fort Duncan Regional Medical Center (Eagle Pass, TX)
- …(CCM, ACM, CCM-RN) preferred. Proven leadership experience in acute care, utilization review , case management. Strong working knowledge of hospital billing, ... Position Summary Lead and oversee the hospital's case management department, ensuring patients receive high-quality, efficient, and coordinated care from admission… more
Related Job Searches:
Case,
Case Reviewer Physician Non,
Complex Medical Case Reviewer,
EIS Case Reviewer,
NCA Pert Case Reviewer,
Physician Case Reviewer AIM,
Quality Control Case Reviewer,
Reviewer,
Senior Case Reviewer