and skills to ensure appropriate utilization of resources while ensuring high quality outcomes. Performs care management..., or Managed Care Organization Experience related to case management, utilization management, quality assurance, discharge...
clinical care to the consumer. *Utilization management, discharge planning or managed care experience. *Customer service... support services). *Provider side insurance experience. *Familiarity with Utilization Management or Case Management...
Job Description: The Associate Clinical Operation Director is a clinical leadership role dedicated to the Utilization Management and Case.... Education: Bachelors Degree in Nursing (RN), master’s level preferred Certification Case Management (CCM) preferred...
Anticipated End Date: 2025-09-29 Position Title: Medical Management Clinician Job Description: The MyCare Ohio... Management Clinician Location: This role requires associates to be in-office [1] days per week, fostering collaboration...
Care Management Social Worker AdventHealth PHSO Resources All the benefits and perks you need for you and your family... we are even better. Schedule: Monday-Friday Shift: 8:00AM-5:00PM Location: Remote The role youll contribute: Promotes the psychosocial...
study tips, time management and test taking strategies, and HESI data review and coaching. This role is part of a dynamic... and creative team of nurse educators dedicated to student success. A well-suited candidate needs to be creative and solution...
. Must possess one of the below: Current Registered Nurse (RN) License Registered Health Information Administrator (RHIA...Employment Type: Full time Shift: Day Shift Description: POSITION PURPOSE Work Remote Position Responsible...
, COLA, TJC). Build consultative relationships with customers to optimize product utilization and technical workflows. Lead... in Medical Technology, Nursing, or equivalent accredited degree. Registered Medical Technologist or Registered Nurse in the...
. Strong organization, time management and communication skills. Knowledge of utilization management procedures, mental health... - Care MgmtCare Mgmt, LSW - Licensed Social Worker - Care MgmtCare Mgmt, RN - Registered Nurse, State and/or Compact State...
management and communication skills. Knowledge of utilization management procedures, mental health and substance abuse community... Social Worker - Care Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt License...
Administration. California Registered Nurse (RN) - CA Board of Registered Nursing -REQUIRED Preferred Qualifications Master... to ensure timely submission of required Utilization, Case Management and Disease Management Work plans to Health plans...
preferred. License/Certifications: Active and unrestricted Registered Nurse (RN) license or Compact State RN license... as a Registered Nurse (RN). Experience in home-based care settings, including home health, hospice, or palliative care is highly...
as a Registered Nurse (RN). Home health experience is required. Management and people leadership experience is strongly preferred... preferred. License/Certifications: Active and unrestricted Registered Nurse (RN) license or Compact State RN license...
Bachelor's degree in Nursing preferred License/Certification: RN - Registered Nurse - State Licensure and/or Compact State... Licensure required or NP - Nurse Practitioner - Current State's Nurse Licensure required For Superior: Resource Utilization...
Summary Job Description: RN Case Manager - Case Management Full-time, M-F, 8:00a-4:30p (rotation in weekends... as a Registered Nurse in the state of Kentucky required. Three years of job-related experience required. Case Management...
to perform the Case Management process by utilization of approved clinical guidelines and following Medical Management Policy... medical necessity, utilization management reviews, and review of benefits as part of the pre-determination process...
Minimum Qualifications: Registered Nurse (RN) with active compact state licensure, 3+ years of experience Must hold... Diabetes Self-Management Education and Support Program as well as clinical oversight for NationsNutrition programming...
Employment Type Full Time Hours/Pay Period 80 Remote No Category Cath Lab Nursing Weekly Schedule varies Shift Day... of practice), including knowledge and integration of available standards, resources and data, and in the efficient utilization...
/Certification: RN - Registered Nurse - State Licensure and/or Compact State Licensure required or NP - Nurse Practitioner... - Current State's Nurse Licensure required For Superior: Resource Utilization Group (RUG) certification must be obtained...
as assigned. Legally Required License: Registered Nurse RN Job Experience: 5 to 7 years Preferred Knowledge, Skills... and Abilities: 4 year/ Bachelors Degree 2 years of denials, utilization review, or case management experience strongly preferred...