Utilization Review Case Manager The University of Miami Health System Department of UMHC SCCC Business Operations has an exciting opportunity for a full time Utilization Review Case Manager to work to work remote. The incumbent conducts
POSITION SUMMARY: The RN Appeal Administrator will be responsible for the Pre-denial/ Denial and appeal process in addition to Utilization Review, to validate the patient’s placement to be at the most appropriate level of care based on
Population Health RN Case Manager - 40236 University Staff Description University of Colorado Anschutz Medical Campus Department: Community Practice Job Title: Population Health RN Case Manager Position #: 00849700 – Requisition #: 40236 Job Summary: The Population Health
Population Health RN Case Manager( Job Number: 40236) Description University of Colorado Anschutz Medical Campus Department: Community Practice Job Title: Population Health RN Case Manager Position #: 00849700 – Requisition #: 40236 Job Summary: The Population Health RN Case
Home Health Care, Hospice Care, Palliative Care, Long Term Care, Rehab No weekends, No afterhours support, No holidays Job Description Job Summary Are you seeking a unique nursing position that gives you a great work/life balance
JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired
Opportunity Overview: Cohere’s Service Operations team is responsible for ensuring that our healthcare partners are supported throughout their lifecycle of using the platform. The RN Supervisor, Clinical Operations position is a crucial role in our organization. In
Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united
City/StateHarrisonburg, VA Work ShiftFirst (Days) Overview: Sentara Health is looking to hire an Integrated Case Manager, RN. This is a remote position; however, candidates must reside in Virgina The Integrated Case Manager is responsible for case management
Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America’s heartland. Work Shift:8 Hours - Day Shifts (United
Job Summary: The Nurse Care Manager is responsible for providing care coordination including in-home assessment, planning, facilitation, advocacy and authorization of covered plan services to meet the members health needs while promoting quality cost effective outcomes. Essential
Job DetailsJob Location: Huntington Beach Office - Huntington Beach, CA 92647Position Type: Full TimeSalary Range: $34.98 - $42.85 HourlyRemote in California onlyAre you ready to make a lasting impact and transform the healthcare space? We are
RN Telephonic Nurse Case Manager Department: Claims Administration & Adjusting Employment Type: Permanent - Full Time Location: Home United States Reporting To: Vanessa Neuner Compensation: $75,000 - $80,000 / year Description Our Story Imagine being part of
JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired
Employment Type:Part time Shift: Description:The Utilization Review (UR) Nurse has well-developed knowledge and skills in areas of utilization management (UM), medical necessity, and patient status determination. This individual supports the department by developing and/or maintaining effective
JOB DESCRIPTION Fully remote opportunity requiring an active Illinois nursing license. The role operates Monday through Friday from 9:30 AM to 6:30 PM CST and requires prior experience in Utilization Management (UM) and the application of
Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nations leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part
JOB DESCRIPTION This RN will act as a Care Review Clinician supporting our Medicare members who have recently been admitted to this hospital. The Medicare will support them to ensure a successful transition from inpatient to discharge
As an Authorization Management Clinical Reviewer, you’ll play a vital role in ensuring patients receive the right care at the right time. Your primary responsibility will be reviewing acute and post-acute authorizations before submission to the payer and
Summary We are currently hiring for an RN Case Management Coordinator to join BlueCross BlueShield of South Carolina. In this role as an RN Case Management Coordinator, care management interventions focus on improving care coordination and reducing the