- Sharecare (Orem, UT)
- …cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification of those ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting the goals and… more
- ChenMed (North Miami Beach, FL)
- …RN with bachelor's degree in a related clinical field preferred. + A valid, active Registered Nurse ( RN ) license in State of employment required. + A ... great people to join our team. The Acute Care Nurse ( RN ) is responsible for achieving positive...patients' progress and adjust and plan accordingly. + Understanding utilization review and how to leverage with… more
- Matrix Providers (Fairfield, CA)
- Registered Nurse - Disease Management Location: Fairfield, CA, United States Healthcare Provider Type : Nursing START YOUR APPLICATION ... lower provider-to-patient ratios and fair, reliable schedules. Matrix Providers is hiring a Registered Nurse - Disease Management to join our team of talented… more
- Option Care Health (Austin, TX)
- …and/or Experience Requirements:** + Graduate of an accredited school of nursing + Current Registered Nurse ( RN ) licensure in the state of practice + ... telephonic nursing support and management. + Provide excellent communication to nurse colleagues regarding patients on service with review of current status,… more
- CVS Health (St. Paul, MN)
- …care. - Perform medical necessity reviews. **Required Qualifications** - 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... in a hospital setting. - A Registered Nurse that holds an active, unrestricted...lower levels of care. - 1+ years' experience in Utilization Review . - CCM and/or other URAC… more
- CVS Health (Charleston, WV)
- …2+ years CM, discharge planning and/or home health care coordination experience * Registered Nurse with active unrestricted state license in good standing within ... Overview** This is a Hybrid role. The Care Manager RN will be responsible to work from home as...coordination of psychosocial wrap around services to promote effective utilization of available resources and optimal, cost-effective outcomes. **What… more
- CVS Health (Annapolis, MD)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- Access Dubuque (Dubuque, IA)
- …consumers, ensuring quality outcomes and cost-effective treatment. **Key Responsibilities:** + Provide telephonic case management and utilization review for ... Bilingual RN Case Manager **Cottingham & Butler/ SISCO** 1...Minimum 2 years of clinical practice. Case management or utilization review experience strongly preferred. + **Skills:**… more
- ICW Group (Las Vegas, NV)
- …providing direct clinical care required. **CERTIFICATES, LICENSES, REGISTRATIONS** Current unrestricted Registered Nurse ( RN ) or Licensed Vocational ... evaluate needs for treatment in worker's compensation claims. The Telephonic Nurse Case Manager will negotiate and...+ Interfaces with external agencies in relation to the utilization review process including, Third-Party Payers, Insurance… more
- US Tech Solutions (Columbia, SC)
- …mental health/chemical dependency, orthopedic, general medicine/surgery. Or, 4 years utilization review /case management/clinical/or combination; 2 of the 4 ... and determine medical necessity criteria and contract benefits. Provides telephonic support for members with chronic conditions, high risk...the state of hire OR, active compact multistate unrestricted RN license as defined by the Nurse … more
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