• Telephonic Nurse Case Manager I

    Elevance Health (GA)
    ** Telephonic Nurse Case Manager I** **Location: Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... must complete the assessment within 48 hours of receipt and meet the criteria._** The ** Telephonic Nurse Case Manager I** is responsible for telephonic care… more
    Elevance Health (05/01/25)
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  • Utilization Management Nurse

    LA Care Health Plan (Los Angeles, CA)
    Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
    LA Care Health Plan (03/27/25)
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  • Acute Care Nurse , HCT (RN)

    ChenMed (New Orleans, LA)
    …assess and record patients' progress and adjust and plan accordingly. + Understanding utilization review and how to leverage with inpatient staff for possible ... we need great people to join our team. The Nurse Case Manager 1 (RN) is responsible for achieving...experience required. + A minimum of 1 year of utilization review and/or case management, home health,… more
    ChenMed (02/22/25)
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  • Community Care Nurse , HCT (RN)

    ChenMed (Houston, TX)
    …years' clinical work experience required. + A minimum of 1 year of utilization review and/or case management, home health, discharge planning experience ... we need great people to join our team. The Nurse Case Manager 1 (RN) is responsible for achieving...with patient and family. + Facilitates patient/family conferences to review treatment goals and optimize resource utilization ;… more
    ChenMed (03/28/25)
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  • Acute Care Nurse , HCT (RN)

    ChenMed (Norfolk, VA)
    …healthcare setting experience is preferred. + Minimum of two (2) years of utilization review , case management, home health and/or discharge planning experience ... of communication. + Introduce self to patient/family and explain nurse case manager role and process to contact ...patients' progress and adjust and plan accordingly. + Understanding utilization review and how to leverage with… more
    ChenMed (05/02/25)
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  • Acute Care Nurse , HCT (Registered…

    ChenMed (Lakeland, FL)
    …assess and record patients' progress and adjust and plan accordingly. + Understanding utilization review and how to leverage with inpatient staff for possible ... we need great people to join our team. The Nurse Case Manager 2 (RN) is responsible for achieving...experience required. + A minimum of 1 year of utilization review and/or case management, home health,… more
    ChenMed (04/15/25)
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  • PAC Nurse

    Actalent (Tampa, FL)
    Actalent is hiring Remote PAC Nurses!Job Description Actalent is looking for PAC Utilization Review Nurses that will work remote! Qualified candidates must have ... experience working in the managed care/insurance industry. The PAC Nurse is a telephonic position responsible for... experience and/or discharge planning. + 2 years of utilization review /management experience. + 1 year of… more
    Actalent (05/02/25)
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  • Community Care Nurse (RN)

    ChenMed (Philadelphia, PA)
    …engagement with patient and family. + Facilitates patient/family conferences to review treatment goals and optimize resource utilization ; provides family ... people to join our team. The Community Care RN ( Nurse Case Manager) is responsible for achieving positive patient...achieving desired clinical outcomes within specific timeframe. + Conducts review for appropriate utilization of services from… more
    ChenMed (03/08/25)
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  • Nurse Care Manager

    Spectrum Health Services (Philadelphia, PA)
    …from the hospital, specialty care practices, health plan staff, and others, the Nurse Care Manager identifies and proactively manages the needs of patients with high ... health and/or psychosocial problems through practice and home-based visits and telephonic support on a care management or case management basis appropriate… more
    Spectrum Health Services (03/19/25)
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  • Case Manager, registered Nurse - Oncology…

    CVS Health (Denver, CO)
    …with transferring patients to lower levels of care - 1+ years' experience in Utilization Review - CCM and/or other URAC recognized accreditation preferred - 1+ ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
    CVS Health (04/30/25)
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