- Humana (Jackson, MS)
- **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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Cedars-Sinai (Beverly Hills, CA)
- …Angeles Fair Chance Initiative for Hiring. **Req ID** : 12949 **Working Title** : Registered Nurse - ISP Care Coordinator - PER_DIEM 8 Hour Days **Department** ... nurse practitioner and case manager assigned to the SNF 's for continued review and follow up. + Authorizes...TPL carrier of all injured worker cases receiving case management services. + Ensures appropriate utilization of… more
- CVS Health (Oklahoma City, OK)
- …and timely discharge, appropriate follow-up care, and next steps. + Coordinate with the Utilization Management team to review medical and payer records to ensure ... teams across various sites of care (eg ED, hospital, SNF , primary care clinics). This role prioritizes the relationship...stay and identify any barriers to discharge. + Assist Utilization Management team with access to external… more
- PeaceHealth (Bellingham, WA)
- **Description** PeaceHealth is seeking a RN Admissions/ Utilization Behavioral Health - Care Management for a Full Time, 1.00 FTE, Day position. The salary ... Review experience, someone who can talk to providers. **Credentials** + Required: Registered Nurse in state of practice + Preferred: Psychiatric/Mental Health… more
- AmeriHealth Caritas (Washington, DC)
- **$5,000.00 SIGN ON BONUS** **Role Overview** Our Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient services, ensuring ... in the least restrictive and most effective manner. The Utilization Management Reviewer must maintain a strong...of 3 years of diverse clinical experience as a Registered Nurse in an Intensive Care Unit… more
- Sharp HealthCare (La Mesa, CA)
- …3 Years Recent acute care nursing experience or case management experience. + California Registered Nurse ( RN ) - CA Board of Registered Nursing ... Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA...and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge… more
- CenterWell (San Juan, PR)
- … RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous… more
- CenterWell (Austin, TX)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous… more
- ChenMed (Philadelphia, PA)
- …RN with bachelor's degree in a related clinical field preferred + A valid, active Registered Nurse ( RN ) license in State of employment required + Compact ... the remaining hours. The Acute Care Manager, Complex Care ( RN ) is responsible for achieving positive patient outcomes, managing...required + A minimum of one (1) year of utilization review and/or case management , home health,… more
- ChenMed (Newport News, VA)
- …We're rapidly expanding and we need great people to join our team. The Nurse Case Manager 1 ( RN ) is responsible for achieving positive patient outcomes ... post-acute facilities, as well as, their home environments. The Nurse Case Manager 1 ( RN ) role also...preferred providers. + Coordinates the integration of social services/case management functions in the pre-acute, ER, acute and post-acute… more