Issuing Body, Certified Case Manager (CCM) - EV Accredited Issuing Body, Registered Nurse (RN) - EV Accredited Issuing Body...
of clinical experience and/or utilization review experience. Current active, valid and unrestricted LPN/LVN license or RN license...Anticipated End Date: 2026-02-13 Position Title: Medical Management Clinician Job Description: Medical Management...
. Professional certification in Case Management, Nursing, or Utilization Review preferred. Responsibilities Perform comprehensive... utilization management reviews and communicate clinical information to third-party payors. Serve as a liaison among patients...
in on-call and weekend rotation as needed to meet patient needs Adheres to and participates in the agency's utilization... management model You'll be rewarded and recognized for your performance in an environment that will challenge you and give...
effectively and efficiently. Reports directly to the Senior Director of Case Management in the Utilization Management Department... experience in case management- including as an RN, medical, mental health care manager or a related job experience Excellent...
in on-call and weekend rotation as needed to meet patient needs Adheres to and participates in the agency's utilization... management model You'll be rewarded and recognized for your performance in an environment that will challenge you and give...
at home. If you’re a licensed RN with proven home health experience and a heart for helping others, this is your opportunity... accountability and teamwork Utilize the available tools to enhance effectiveness of coding, service utilization and clinical...
standing. URAC-recognized certification in case management (CCM, CDMS, CRC, CRRN or COHN, COHN-S, RN-BC, ACM, CMAC, CMC... Health, Patient Care, Utilization Management, Acute Care, Orthopedics, Rehabilitation, Rehab, CCM, Certified Case Manager...
Job Description: Ensures the surgical program creates high patient satisfaction, maintains/increases surgical utilization, meets surgeon needs..., and provides experienced, knowledgeable staff. Assumes 24-hour accountability for the management and delivery of daily patient...
/supervision of an RN, with overall responsibility for the member's case, as required by applicable state law and contract..., assisting the responsible RN with telephonic or face-to-face assessments for the identification, evaluation, coordination...
services, including Care Management (CM), Utilization Management (UM) and Complaints, Appeals & Grievances (CAG). This role... or Healthcare Licensed clinician preferred (RN, RPh, or equivalent) with deep experience in Care Management, UM, and CAG...
Anticipated End Date: 2025-11-17 Position Title: Med Mgmt Nurse (US) Job Description: Medical Management Nurse... and will include weekends. The Medical Management Nurse will be responsible for review of the most complex or challenging cases...