- CVS Health (Jackson, MS)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse (RN) with at least 1...or Specialty Pharmacy.** **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator… more
- Ochsner Health (Union, MS)
- …Contents are subject to change at the company's discretion. **Education** Required - Registered nurse diploma or bachelor's degree in related field Preferred - ... Health and discover your future today!** This job works with organizational management to implement and maintain a nationally recognized Diabetes Self- Management … more
- Sharecare (Jackson, MS)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the… more
- Prime Therapeutics (Jackson, MS)
- …**Education & Experience** + Associates - Nursing + Bachelors - Nursing + RN - Registered Nurse , State and/or Compact State Licensure - Care Mgmt + 5+ years ... for work visa or residency sponsorship. **Additional Qualifications** + Registered Nurse (RN). + 5 years of...experience. + Experience in managed care, specialty drugs, care management and utilization review. + Meets Credentialing… more
- Baptist Memorial (Jackson, MS)
- …demonstrated leadership skills. Knowledge of hospital policies and procedures, JCAHO, utilization management , infection control and performance tools and ... processes. Preferred/Desired Education Minimum Required + Registered Nurse , Associate Degree in Nursing or BSN preferred. TNCC, ACLS required within one year of… more
- United Therapeutics (Jackson, MS)
- …including ICU and critical care of PAH, cardiology or pulmonology patients + Registered Nurse (RN) - State Licensure and/or Compact State Licensure RN ... make a difference. The Regional Field Director, RNS Program Management serves as a director of all clinical field...- Registered Nurse - State Licensure and/or Compact… more
- Baptist Memorial (Jackson, MS)
- …Licensure Minimum Required + License/Certification/Registries (valid for the State of MS): Registered Nurse (RN) by the State Board of Nursing Required. ... plan of care. Assess and document the patient's care management and potential discharge needs. 20 % + Apply...plan to ensure safe discharge/transition. Coordinate with physician and nurse to make plan adjustments as patient condition indicates.… more
- Humana (Jackson, MS)
- …**Key Functions:** **Strategic Planning and Implementation:** + Develop and implement utilization management strategies that align with organizational goals. + ... care. **Cost Containment:** + Identify opportunities for cost savings through effective utilization management practices. + Monitor and analyze utilization … more
- Highmark Health (Jackson, MS)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... UM/CM/QA/Managed Care **LICENSES or CERTIFICATIONS** **Required** + United States Registered Nurse (RN) license + Delaware RN...is part of the compact **Preferred** + Certification in Utilization Management or a related field **SKILLS**… more
- STG International (Tupelo, MS)
- … management /coordination of the clinic's day-to-day activity, in conjunction with the Registered Nurse (RN)/CBOC Manager and VA Program's philosophy. + Comply ... to ensure compliance and patient safety. + Participates in quality improvement, care management , risk management , peer review, utilization review, clinical… more