- Humana (Lincoln, NE)
- **Become a part of our caring community and help us put health first** The Manager , Utilization Management Nursing (LTSS Utilization Management ... and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Nursing works within specific… more
- Molina Healthcare (Bellevue, NE)
- … RN or Clinical Social Worker/Counseling License. + Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified Professional ... licensing mandate. + At least 2 years in case, disease or utilization management ; managed care; or medical/behavioral health settings. + One year of training… more
- Fresenius Medical Center (Grand Island, NE)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Fresenius Medical Center (Omaha, NE)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. ... leading your business, and advanced leadership. As a Clinical Manager , you may advance your career into an Area...Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and… more
- CVS Health (NE)
- …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 with at least 1 year...or Specialty Pharmacy. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator… more
- Catholic Health Initiatives (Lincoln, NE)
- …timely and accurate information to payors. The role integrates and coordinates utilization management , care facilitation and discharge planning functions. + ... **Job Summary and Responsibilities** The purpose of the Case Manager position is to support the physician and interdisciplinary team in facilitating patient care,… more
- Molina Healthcare (Lincoln, NE)
- …of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. ... state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
- JBS USA (Grand Island, NE)
- …and rotating call for weekends and holidays or as needed. **POSITION SUMMARY** : The RN / LPN is responsible for direct care of employees of JBS under the direct ... supervision of the Occupational Health Manager . **SAFETY IS A CONDITION** : At JBS, _Safety...include the following. Other duties may be assigned + RN /LPN-Provide direct care for employees of the Complex according… more
- Sharecare (Lincoln, NE)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... program intervention guidelines. A Disease Management Nurse is supervised by an Operations Manager ...with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the… more
- Molina Healthcare (Lincoln, NE)
- …skills. * Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications * Registered Nurse ( RN ). License must be active and ... including design, development, implementation, and oversight of technology that drives core utilization management , care management , long-term services and… more
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