- Humana (Santa Fe, NM)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (Santa Fe, NM)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CVS Health (Santa Fe, NM)
- …clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
- CVS Health (Santa Fe, NM)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years post… more
- Sharecare (Santa Fe, NM)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
- Veterans Affairs, Veterans Health Administration (Albuquerque, NM)
- …expert consultant to mentor nursing staff, nursing leaders, and students in the utilization and dissemination of EBP. The EBP Nurse Coordinator provides ... (QS), quality management (QM), and quality assurance (QA) pertinent to nurse sensitive indicators and nurse competencies. Grade Determinations: The following… more
- Veterans Affairs, Veterans Health Administration (Albuquerque, NM)
- …knowledge of Fee federal regulations, VHA guidelines, medical review criteria, care management and utilization management processes, inter-facility transfer ... Summary Community Care is seeking Nurse Case Managers to join our team! Responsibilities...responsibilities that demonstrate leadership, experience and creative approaches to management of complex client care beyond the immediate practice… more
- Molina Healthcare (Roswell, NM)
- …reports submitted to the Eastern US Quality Improvement Collaborative (EQIC) and/or utilization management committees. + Participates as needed in joint ... **JOB DESCRIPTION** **Job Summary** The Delegation Oversight Nurse provides support for delegation oversight quality improvement activities. Responsible for… more
- Horizon Services, Inc. (Albuquerque, NM)
- …after 6 months, and $500 after 12 months of employment) JOB TITLE: Nurse Practitioner / Physician Assistant LOCATION: Gateway Medical Sobering - Albuquerque, New ... youth prevention, youth and adult outpatient, sobering programs, withdrawal management , and co-occurring capable residential programs to support the well-being… more
- Evolent (Santa Fe, NM)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are ... quality and cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on call… more