Reviews, assesses, and evaluates clinical information used to support Utilization Management (UM) decisions based on established clinical criteria and applies intermediate knowledge of coding and medical record research. IHN) is designated as a regional Coordinated Care Organization (CCO) for Medica...
This position is perfect for a professional looking for supplemental income or a flexible schedule to balance work and life commitments. Job Title: PRN OR Circulating Registered Nurse (R. Minimum of 1 year of experience as an OR Circulating RN. Ideal for those seeking a flexible schedule to enhance ...
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability ...
The Primary Care Nurse completes triage and identifies abnormal patient symptoms, laboratory findings and notifies physician or provides treatment according to standard Primary Care developed protocols. Associate of Applied Science in Registered Nursing, Graduation from registered nursing program, B...
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability ...
PASSION FOR CHRONIC DISEASE, DEVELOPING TRUSTFUL RELATIONSHIPS AND ADVOCATE FOR AMBULATORY CONTINIUM OF CARE. Provide and coordinate nursing care for the patient in collaboration with the Health Care team. Collaborates with managers in completing the process for self and colleague/team performance r...
Mission Statement: To provide superior quality healthcare services that: PATIENTS recommend to family and friends, PHYSICIANS prefer for their patients, PURCHASERS select for their clients, EMPLOYEES are proud of, and INVESTORS seek for long-term returns. All resumes submitted by search firms to any...
Mission Statement: To provide superior quality healthcare services that: PATIENTS recommend to family and friends, PHYSICIANS prefer for their patients, PURCHASERS select for their clients, EMPLOYEES are proud of, and INVESTORS seek for long-term returns. All resumes submitted by search firms to any...
As a Utilization Management Nurse/Social Worker, you'll play a crucial role in our multidisciplinary team, ensuring that patients progress seamlessly through their care journey according to appropriate admission statuses. Proficient in Utilization Review processes, you'll maintain effective procedur...
As a Government Solutions Autism Care Navigator reporting to a Clinical Steward, you will be a trusted go-to resource for beneficiaries in the Autism Care Demonstration. In this role, you will collaborate and oversee the assessment, planning, facilitation, care coordination, evaluation, and become a...
Must be comfortable traveling to Medford Oregon, including Klamath Falls to Roseburg. In this role, you’ll work independently to make decisions and execute them for the best possible outcome for your patients, while feeling the impact you’re making every single day. Accredo, Evernorth Health Service...
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability ...
Bachelor's degree in Nursing or a Master's degree in Social Work or Health Education. Active, unrestricted State Registered Nursing license or Licensed Clinical Social Worker (LCSW) or Advanced Practice Social Worker (APSW) in good standing. As a Case Manager at the National Healthcare Organization,...
You will perform retrospective clinical case reviews and draft appeals that focus on establishing the Medical Necessity of diagnosis in question by the payor or 3rd party audit firm. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant i...
Mission Statement: To provide superior quality healthcare services that: PATIENTS recommend to family and friends, PHYSICIANS prefer for their patients, PURCHASERS select for their clients, EMPLOYEES are proud of, and INVESTORS seek for long-term returns. All resumes submitted by search firms to any...
PASSION FOR CHRONIC DISEASE, DEVELOPING TRUSTFUL RELATIONSHIPS AND ADVOCATE FOR AMBULATORY CONTINIUM OF CARE. Provide and coordinate nursing care for the patient in collaboration with the Health Care team. Collaborates with managers in completing the process for self and colleague/team performance r...
Bachelor's degree in Nursing or a Master's degree in Social Work or Health Education. Active, unrestricted State Registered Nursing license or Licensed Clinical Social Worker (LCSW) or Advanced Practice Social Worker (APSW) in good standing. As a Case Manager at the National Healthcare Organization,...
Mission Statement: To provide superior quality healthcare services that: PATIENTS recommend to family and friends, PHYSICIANS prefer for their patients, PURCHASERS select for their clients, EMPLOYEES are proud of, and INVESTORS seek for long-term returns. All resumes submitted by search firms to any...
Mission Statement: To provide superior quality healthcare services that: PATIENTS recommend to family and friends, PHYSICIANS prefer for their patients, PURCHASERS select for their clients, EMPLOYEES are proud of, and INVESTORS seek for long-term returns. All resumes submitted by search firms to any...
Evaluates the needs of the member, barriers to accessing the appropriate care, social determinants of health needs, focusing on what the member identifies as priority and recommends and/or facilitates the plan for the best outcome. Coordinates as appropriate between the member and/or family/caregive...
Support for you and your family: Family resources, EAP counseling sessions, access Headspace®, backup child and elder care, maternity/paternity leave and more. As such, individuals are recruited, hired, assigned and promoted without regard to race, national origin, religion, age, color, sex, sexual ...
Evaluates the needs of the member, barriers to accessing the appropriate care, social determinants of health needs, focusing on what the member identifies as priority and recommends and/or facilitates the plan for the best outcome. Coordinates as appropriate between the member and/or family/caregive...
Mission Statement: To provide superior quality healthcare services that: PATIENTS recommend to family and friends, PHYSICIANS prefer for their patients, PURCHASERS select for their clients, EMPLOYEES are proud of, and INVESTORS seek for long-term returns. All resumes submitted by search firms to any...