- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) ... service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key... **Desired Licensing (nice to have):** + CCM (Certified Case Manager ) **Required Experience (must have):** +… more
- ERP International (Tinker AFB, OK)
- **Overview** ERP International, LLC is seeking a ** Registered Nurse - Case Manager ** for a full-time position supporting **SHG Clinic** in support of ... Medical Evaluation Unit (THMEU) in San Antonio, Tx. The Case Manager will be required to attend...or pending adverse actions) to practice nursing as a registered nurse in any US state/jurisdiction. Security**… more
- University Health (Seguin, TX)
- POSITION SUMMARY/RESPONSIBILITIES The nurse case manager coordinates, in collaboration with the patient and interdisciplinary team, the treatment/plan of ... nurse II or above). Work experience in case management, utilization review or hospital quality...quality is preferred. LICENSURE/ CERTIFICATIONS Current licensure as a Registered Nurse with the Texas State Board… more
- Stony Brook University (Stony Brook, NY)
- RN Case Manager **Position Summary**...required. **Qualifications** **Required** : A Bachelor's degree or a nurse working on their degree with an RN ... At Stony Brook Medicine, a ** RN Case Manager ** is a valuable member of...the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity… more
- Somatus (Utica, NY)
- …can leverage existing high-speed internet service Preferred Qualifications: - BSN - Certified Case Manager (CCM) - Diabetic educator experience - ICU, Cardiology ... utilizing basic nursing knowledge, experience and skills to ensure appropriate utilization of resources and patient quality outcomes. Performs care management… more
- University Health (Boerne, TX)
- …of clinical nursing experience is required. Data entry, referral management, utilization management experience is required. Case Management experience preferred. ... complications. EDUCATION/EXPERIENCE Graduation from an accredited school of nursing, RN or LVN is required. A minimum three years...EPIC EMR desirable. LICENSURE/CERTIFICATION Current licensure in the State of Texas as an RN or LVN is required.… more
- Commonwealth Care Alliance (Boston, MA)
- …procedures, and facilities under the provisions of CCA's benefits plan. The Manager , Utilization Management is responsible for overseeing and managing the ... daily operation of the Utilization Management Review Nurse and Specialist staff...decisions and organizational determinations. Essential Duties & Responsibilities: The Manager , Utilization Management reports to the Director… more
- Stanford Health Care (Palo Alto, CA)
- …affect the processes and outcomes of patient health care **Licenses and Certifications** + Nursing\ RN - Registered Nurse - State Licensure And/Or Compact ... and performance/quality improvement activities that lead to optimal patient outcomes. A Case Manager differs from other roles in professional nursing/health care… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …contractual, and legal requirements. **What you will bring** **:** **Required:** **?** + Registered Nurse - RN current state licensethat allows the ... (those who are facing medical, mental health and/or substance utilization disorders) and build a relationship that will support...potential lifestyle changes. + Create a space where a case manager and member can collaborate, along… more
- BlueCross BlueShield of Tennessee (Memphis, TN)
- …this position\. + This job requires digital literacy assessment\. **Job Qualifications** _License_ + Registered Nurse \( RN \) with active license in the state ... to meet their complex needs\. As a Care Transition Case Manager , you will play a vital...have you on our team\. **Job Responsibilities** + Supporting utilization management functions for more complex and non\-routine cases… more
