CARE MANAGER RN - REMOTE (DAYLIGHT WEEKENDS & 3 WEEKDAYS)
Care Manager RN - Remote (Daylight Weekends & 3 Weekdays) at Highmark Health in Boise, Idaho, United States Job Description Company : Highmark Inc.
Job Description : JOB SUMMARY This job implements effective utilization management strategies including : review of appropriateness of health care services, application of criteria to ensure appropriate resource utilization, identification of opportunities for referral to a Health Coach / case management, and identification and resolution of quality issues.
Monitors and analyzes the delivery of health care services; educates providers and members on a proactive basis; and analyzes qualitative and quantitative data in developing strategies to improve provider performance / satisfaction and member satisfaction.
Responds to customer inquiries and offers interventions and / or alternatives. ESSENTIAL RESPONSIBILITIES + Implement care management review processes that are consistent with established industry and corporate standards and are within the care manager's professional discipline.
- Function in accordance with applicable state, federal laws and regulatory compliance. + Implement all care management reviews according to accepted and established criteria, as well as other approved guidelines and medical policies.
- Promote quality and efficiency in the delivery of care management services. + Respect the member's right to privacy, sharing only information relevant to the member's care and within the framework of applicable laws.
- Practice within the scope of ethical principles. + Identify and refer members whose healthcare outcomes might be enhanced by Health Coaching / case management interventions.
- Employ collaborative interventions which focus, facilitate, and maximize the member's health care outcomes. Is familiar with the various care options and provider resources available to the member.
- Educate professional and facility providers and vendors for the purpose of streamlining and improving processes, while developing network rapport and relationships.
- Develop and sustain positive working relationships with internal and external customers. + Utilize outcomes data to improve ongoing care management services.
- Other duties as assigned or requested. EDUCATION Required + None Substitutions + None Preferred + Bachelor's Degree in Nursing EXPERIENCE Required + 3 - 5 years of related, progressive clinical experience in the area of specialization + Experience in a clinical setting Preferred + Experience in UM / CM / QA / Managed Care LICENSES AND CERTIFICATIONS To view full details and how to apply, please login or create a Job Seeker account
Registered Nurse (RN) - Home Health Case Manager, Acute Care Case Management - $35-55 per hour
Luke's Health System is seeking a Registered Nurse (RN) Home Health Case Manager, Acute Care Case Management for a nursing job in Meridian, Idaho. Join our care council teams and shared governance committees to help improve our processes and quality of care. We care about you and have fantastic ...
Registered Nurse (RN) - Home Health Case Manager, Acute Care Case Management - $35-55 per hour
Luke's Health System is seeking a Registered Nurse (RN) Home Health Case Manager, Acute Care Case Management for a nursing job in Meridian, Idaho. Join our care council teams and shared governance committees to help improve our processes and quality of care. We care about you and have fantastic fina...
Care Manager Rn
Care Manager RN at Highmark Health in Boise, Idaho, United States Job Description Company : Highmark Inc. ESSENTIAL RESPONSIBILITIES + Implement care management review processes that are consistent with established industry and corporate standards and are within the care manager's professional disci...
Care Manager (UM/UR) - Remote, Idaho Licensed
CEAP - Certified Employee Assistance Professional - Care Mgmt, LCSW - Licensed Clinical Social Worker - Care Mgmt, LMFT - Licensed Marital and Family Therapist - Care Mgmt, LMSW - Licensed Master Social Worker - Care Mgmt, LPC - Licensed Professional Counselor - Care Mgmt, LSW - Licensed Social Work...
Care manager (LMFT or LCSW) - Remote
CEAP - Certified Employee Assistance Professional - Care Mgmt, LCSW - Licensed Clinical Social Worker - Care Mgmt, LMFT - Licensed Marital and Family Therapist - Care Mgmt, LMSW - Licensed Master Social Worker - Care Mgmt, LPC - Licensed Professional Counselor - Care Mgmt, LSW - Licensed Social Work...
Psych Registered Nurse Night Shift - Now Hiring! - Urgently Hiring!
We are seeking talented Registered Nurses to join our team!. As a Registered Nurse you will conduct patient assessments and provide nursing interventions to patients while maintaining a safe and efficient working and treatment environment. Two years of experience as a Registered Nurse with one year ...
Travel Registered Nurse - Med/Surg - $1,812 per week in Boise, ID
A Clinic Registered Nurse, (RN) provides primary care, treatments, and simple procedures to patients of all ages. A Clinic Nurse is to screen each patient for the degree of medical needs and provide the information to the treating physician. ...
Travel Registered Nurse - Telemetry - $2,097 per week in Idaho
Travel Nursing: Telemetry Meridian.Location: Meridian.Start Date: 9/16/2024.Shift Details: 12H Nights (12:00 AM-12:00 PM).Length: 26 WEEKS 26 weeks.Apply for specific facility details....
Travel Registered Nurse - Labor/Delivery - $1,964 per week in Idaho Falls, ID
Advantis Medical, the #1 rated travel nurse agency, is currently seeking an experienced Labor/Delivery Registered Nurse (RN) for an exciting new travel job in Idaho Falls, ID 83404. If you are an experienced Labor/Delivery Registered Nurse (RN) with a passion for providing exceptional patient care, ...
Travel Registered Nurse - Labor/Delivery - $2,124 per week in Twin Falls, ID
GetMed Staffing is searching for a strong L&D RN to assist our traveler-friendly client.A minimum of 1-2 years of experience is required.Traveling with GetMed Staffing offers the unique opportunity to gain diverse experiences, both personally and professionally....