Assists in identifying opportunities for alternative care options based on member needs and assessments. Documents all encounters with providers, members, and vendors in the appropriate system in accordance with internal and established documentation procedures; follows up as needed; and updates car...
Bachelor's degree in Nursing, or obtained within five (5) years from the initial date of hire; RN with 15+ years of service may be considered in lieu of education agreement. Advanced Degree in Nursing (MSN, PhD, DNP, ARNP) preferred. Washington state's largest community-based, locally governed healt...
Registered Nurse (RN) license in good standing in the state of residence. BSN degree, plus 2+ years of relevant RN experience; or. ASN degree, plus 5+ years of relevant RN experience; or. Nursing Diploma, plus 8+ years of relevant RN experience. ...
MUST have or be willing to obtain a Compact RN license. You’re required to use your own high-speed internet. You’ll access EMRs for charting and utilize our internal applications to perform job functions. MUST have or be willing to obtain a Compact RN license. ...
Active RN Compact State license. RN experience (any environment as long as they have a solid work history). ...
Revenue Cycle Clinical Support Office (RCCS) is an area within Access and Revenue Cycle Management Shared Services responsible for Clinical Pre-Certification, Case Reviews, Pre-billing edits, in-patient account validations, supporting Utilization Management, Peer to Peer processes, complex billing s...
The Registered Nurse (RN) is responsible for utilizing the nursing process (assessment, diagnosis, outcomes/planning, implementation and evaluation) to provide individualized nursing care to residents. Provides adequate assistance and support to delegates to ensure safe, reliable administration of r...
Utilize the online learning platform to enrich the learning experience. Be available within 48 hours (excluding weekends and holidays) by phone, email, and in the courseroom to ensure learners receive quality feedback in a timely manner to support their academic success. Establish high standards and...
The Quality Program Manager RN is responsible to develop and implement the Quality and Performance Improvement Program for the assigned services and location. Bachelor's degree in Nursing, or obtained within five (5) years from the initial date of hire; RN with 15+ years of service may be considered...
Current RN licensure required and required to be maintained throughout length of assignment. ...
For this position we are seeking a (RN) Registered Nurse with previous experience in Acute Care, Concurrent Review/ Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines. CALIFORNIA LICENSURE IS REQUIRED FOR THIS ROLE IMMEDIATELY UPON HIRE. CALIFORNIA IS NOT A COMPA...
Collaborate with sales team to ensure patient barriers are removed and internal and external resources are aligned to facilitate the implant process. Actively research, monitor, and identify VNS payer polices within assigned area and communicate information to internal customers. Education level: BS...
Teaches and counsels patients and families concerning heath assessment and care including prevention of disease and health maintenance. Skill at finding and providing solutions that are customized to meet customers’ needs and concerns. Ability to readily learn and apply information technology applic...
Matches these needs to a service site location or, if not available, look up and provide alternative services. Assist with clinical eligibility review for alternate services. RN license in a compact state is required. Ability to learn and master information related to locations and services of clien...
MUST have or be willing to obtain a Compact RN license. You’re required to use your own high-speed internet. You’ll access EMRs for charting and utilize our internal applications to perform job functions. MUST have or be willing to obtain a Compact RN license. ...
Identify related risk management quality concerns and report these scenarios to the appropriate resources. Interqual, NCCN) and government sponsored managed care programs. ...
Care Manager II (RN) - Field/Remote - McAllen, TXUSA TX. Care Manager II (RN) - Field/Remote - McAllen, TX in USA TX. Centene Corporation have an immediate need for Care Manager II (RN) - Field/Remote - McAllen, TX. If you happen to live in or around USA, TX or have the freedom to relocate yourself ...
Working collaboratively with all healthcare team members, internally and externally. Strong communication (written/verbal), interpersonal, organizational, and time management skills with a strong focus on customer service, including building and maintaining relationships with internal/external custo...
Strategic Staffing Solutions is currently looking for an RN Case Manager for a contract opportunity with one of our largest healthcare clients!. The Care Manager RN leads the coordination of a multidisciplinary team to deliver a holistic, person centric care management program to a diverse health pl...
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team.Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.Supervise the day to d...
Nurse Case managers are healthcare professionals, who serve as customer advocates to coordinate, support, and guide care for our customers, families, and caregivers to assist with navigating through the healthcare journey. I learn and adapt to meet evolving business needs. Active unrestricted Regist...
Identify related risk management quality concerns and report these scenarios to the appropriate resources. ...
Home Infusion Nurse RN (Accredo)- Part time, 32 hours a week. For RNs who want to grow their skills with new/specialty infusion therapies, while having greater flexibility, ownership, and serenity than what is experienced in more high-impact, high-stress environments, we encourage you to rethink wha...
The Case Manager RN directs the utilization review of patient charts, treatment plans, and discharge planning pertaining to the quality of care and treatment criteria for patients in a specific department. The Case Manager RN specializes in the review of information pertaining specifically to the as...
You will organize, plan, perform and supervise compliance internal audits and reviews. Bachelor's degree in Nursing, or obtained within five (5) years from the initial date of hire; RN with 15+ years of service may be considered in lieu of education agreement. Advanced degree in Nursing (MSN, PhD, D...