A company is looking for a Manager, Clinical Finance Case Management-RN.Key ResponsibilitiesOversee daily operations of Clinical Pre-Certification, Peer to Peer Clinical Appeals, and Denial AnalysisUtilize clinical knowledge to interpret medical necessity guidelines and determine appropriate levels of careDevelop and implement policies, procedures, and workflows related to clinical financial case managementRequired QualificationsBachelor's degree in nursing with a current licenseMinimum of 5 years of clinical care experienceExperience collaborating with physicians and their designeesExtensive knowledge of clinical operations and patient flowProficient in Microsoft Office products and various technology applications
Bilingual Telephonic Case Manager - CA Compact RN
A company is looking for a Bilingual Telephonic Case Manager with compact and CA RN licenses. ...
Clinical Case Manager
Health, Dental, Vision, PTO, Internet Stipend. Must have reliable high-speed internet. Please note there are no evening, overnight or weekend hours available. ...
Travel Nurse RN - Case Manager - $1,010 to $1,160 per week in Irving, TX
Host Healthcare is an award-winning travel healthcare company with an immediate opening for this .Passionate and transparent team members have made Host Healthcare the agency of choice for new and experienced travelers looking for opportunities far away and close to home.Starting the day you apply, ...
Certified Case Manager (RN) - Transition in Care (Medical Center - On-site)
At Houston Methodist, the Case Manager (CM) Certified position is a registered nurse (RN) responsible for comprehensively planning for case management of a targeted patient population on a designated unit(s) and/or service line. Identifies when services no longer meet InterQual/Milliman l criteria, ...
Clinical Care Coordinator- Case Manager
Clinical Care Coordinator- Case Manager -(STA013492)Clinical Care Coordinator. The CCC will also provide selected clinical services, primarily in these areas: access/intake, assessment, crisis response, bridging care toward other services, brief individual counseling, and external referral resources...
Case Manager (RN) PRN
At Houston Methodist, the Case Manager PRN (CM) position is a licensed registered nurse (RN) who comprehensively plans for case management of a target patient population on a designated unit(s). Identifies when services no longer meet InterQual/Millman l criteria, initiates discussion with attending...
Field Nurse Case Manager RN - Kidney Resource Services - North Houston, TX
Must reside in a location that can receive a UnitedHealth Group approved high speed internet connection or can leverage existing high-speed internet service (Broadband Cable, DSL or Fiber). Current, unrestricted RN license in the state of Texas. Telephonic case management experience. ...
Travel Nurse RN - Case Manager - $1,783 to $1,932 per week in San Antonio, TX
TravelNurseSource is working with Host Healthcare to find a qualified Case Manager RN in San Antonio, Texas, 78251!. Different regions may incorporate alternative medicine practices into healthcare. ...
RN Case Manager - Baytown
At Houston Methodist, the Case Manager (CM) position is a registered nurse (RN) responsible for comprehensively planning for case management, which includes care transitions and discharge planning of a targeted patient population on a designated unit(s) and/or service lines. Consults with Social Wor...
Complex Case Manager RN - Oncology (Remote)
In addition to identifying the appropriate clinical interventions and referrals, the incumbent will manage an active case load of members in his/her panel that are enrolled in case management. The incumbent assesses health management needs of the assigned member panel and utilizing data/analytics in...