- Amergis (Los Angeles, CA)
- …or service + Performs other duties as assigned/necessary Minimum Requirements: + Registered Nurse or Licensed Practical Nursing license required + Certified ... + Audits medical records and monitors performance measures for health care risk management , sentinel events and trends + Oversees and monitors the development and… more
- Insight Global (Philadelphia, PA)
- …healthcare insurance company local to the Philadelphia area is looking for to hire a fully remote Case Management RN to join their Care management team. ... 100% remotely and have own equipment to work from home 3+ years of case management and utilization management experience Post acute Care experience Discharge… more
- CVS Health (Harrisburg, PA)
- …care more personal, convenient and affordable. **Position Summary** This is a fulltime remote Utilization Management Nurse Consultant opportunity. ... external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working...of residence + 3+ years of experience as a Registered Nurse + Must possess 1+ years… more
- AmeriHealth Caritas (Philadelphia, PA)
- **Long Term Services & Support Utilization Management Clinical Educator, RN ** Location: Remote , United States Primary Job Function: Medical Management ... www.amerihealthcaritas.com. As part of the Community Health Choices LTSS Utilization Management (UM) Review Team, the [...and contract adherence. **Education/Experience:** + Bachelor's Degree required. + Registered Nurse required. + 1 to 3… more
- Dartmouth Health (Lebanon, NH)
- Overview The Manager of Utilization Management is responsible for day to day operations of the utilization review program at multiple Dartmouth Health system ... preferred. This position has the option to be Fully Remote ! These are just a few highlights of being...communication and computer skills desired. Required Licensure/Certifications - Licensed Registered Nurse with NH eligibility - BLS… more
- Ascension Health (Birmingham, AL)
- …AL ( remote ) At least 3 years of acute care experience and utilization management experience **Benefits** Paid time off (PTO) Various health insurance options ... and coordinate compliance to federally mandated and third party payer utilization management rules and regulations. **Requirements** Licensure / Certification… more
- Humana (Louisville, KY)
- **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 ... benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the… more
- Veterans Affairs, Veterans Health Administration (St. Louis, MO)
- …Louis Health Care System (VASTLHCS), St. Louis, Missouri. The Registered Nurse Case Manager ( Utilization Management ) demonstrates leadership, experience, ... and creative approaches in providing complex patient management in delivering and improving holistic care through collaborative...Nurse Total Rewards The primary purpose of this Registered Nurse Case Manager (RNCM) is to… more
- Mayo Clinic (Rochester, MN)
- …and inclusion, and provides the resources you need to succeed. **Responsibilities** The Registered Nurse ( RN ) Case Manager works within an interdisciplinary ... by ensuring appropriate utilization management , care coordination, resource utilization , and clinical documentation. The RN Case Manager will function… more
- Banner Health (Gilbert, AZ)
- …include working in an acute care setting within the past 12 months as a Registered Nurse in the specialty area. Banner Registry and Travel physician practice ... (HUC). Clinical Care Operations is the hub of patient management for the campus, including: bed assignment, unit staffing...require a minimum of one year experience as a Registered Nurse in a physician practice or… more