A company is looking for a Case Manager - Utilization Management.Key ResponsibilitiesReview patient admissions to evaluate appropriateness and ensure compliance with third-party payer requirementsCollaborate with care managers and other departments to facilitate patient class assignments and maximize reimbursementParticipate in performance improvement processes to enhance departmental efficiency and effectivenessRequired QualificationsSpecialized Diploma in nursing2 years of previous utilization review experience2 years of knowledge of utilization management related to third-party payersRN - Licensed Registered Nurse in the state of Pennsylvania upon hireKnowledge of evidence-based clinical decision support criteria
Travel Nurse - RN - Case Manager - $2097.24 / Week
Cynet Health is seeking an experienced Case Manager Registered Nurse for an exciting Travel Nursing job in New York, NY. Shift: 5x8 hr days Start Date: 11/18/2024 Duration: 9 weeks Pay: $2097. Ranked #5 Best Travel Nursing Companies 2022 by BluePipes. We offer the most competitive pay for every posi...
RN Case Manager Care Coordination Part Time Day
Expectations: achieve ANCC case management certification within two years (effective 2016), or when requirements for sitting for the exam case management exam, as stated by the ANCC, are met, whichever comes first. Minimum five years experience in utilization review management and/or case management...
Utilization Management Specialist - RN
A company is looking for a Utilization Management Specialist (Home-Based) - Prior Authorization. ...
RN Utilization Case Manager Care Coordination Full Time
Performs concurrent utilization review activities on all patients within the assigned caseload. Monitors and intervenes on LOS, resource utilization and denial management/ prevention within the assigned caseload. Minimum 5 years experience in clinical nursing, minimum of 3 years in case management/ ...
California Licensed Case Manager RN
A company is looking for a Case Manager RN for a fully remote position. ...
Director of Utilization and Case Management
The Director of Utilization and Case Management will spearhead the strategic direction, management, continuous improvement, and overall maintenance of the Utilization and Case Management Services Unit. Lead the Utilization and Case Management Department at University Hospital, a prestigious healthca...
Bilingual Spanish RN Case Manager
Key Responsibilities:Coordinate care for patients, families, and physiciansAssess and develop care plans for members with complex and chronic care needsMonitor and evaluate the effectiveness of care management plans and modify as necessaryRequired Qualifications:Minimum of 1 year clinical experience...
staff - Registered Nurse (RN) - Case Management - $93K-117K per year
Certified Case Manager - Commission for Case Manager Certification within 1 year of employment required. VNS Health is seeking a Registered Nurse (RN) Case Management for a nursing job in West New York, New Jersey. Provides telephonic clinical care management services using evidence-based practices ...
RN Case Manager Care Coordination Part Time Day
Expectations: achieve ANCC case management certification within two years (effective 2016), or when requirements for sitting for the exam case management exam, as stated by the ANCC, are met, whichever comes first. Minimum five years experience in utilization review management and/or case management...
Case Manager RN - Field (Hudson County, NJ) at CVS Health
As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Utilizes case management processes in compliance with regulatory and company policies and procedures. CVS Health also offers numerous well-being programs, education ...