Virtual Medical Management Nurse - Complex Case Reviewer
The Elevance Health Companies, Inc.
The Elevance Health Companies, Inc. is seeking a Medical Management Nurse (Virtual) responsible for reviewing complex cases and utilizing nursing judgment to assess medical necessity. This vital role requires collaboration with healthcare providers and consultation with Medical Directors on ambiguous cases. Candidates must have a minimum of an Associate's degree in nursing, an active RN license, and substantial care-management experience. This role is essential for ensuring quality outcomes for members across Georgia, providing an opportunity for impactful patient care improvement. #J-18808-Ljbffr The Elevance Health Companies, Inc.
$54.1k - $155.54k
...anywhere in the US with virtual training.... ...Holding, Inc (AHH) is a medical management company that is a... ...accredited in Case Management, Disease... ...barriers and address complex health and social... ...medical necessity reviews. Required... ...experience as a Registered Nurse, including at...VirtualHourly payFull timeLocal areaRemote workWork from homeFlexible hours- ...Telephonic RN Nurse Case Manager I - AmeriBen Location :... ...enables associates to work virtually full-time, with the... ...(TPA) of medical benefits, including medical... ...licensure for members with complex and chronic care... ...experience with utilization review and/or prior...VirtualFull timeTemporary workWork at officeLocal areaMonday to Friday1 day per week
$5,000 per month
...HOLIDAY Are you a Registered Nurse looking for a new... ...with a growing company As a RN Case Manager You will: Assess/monitor physical... ...nursing care: administering medications, treatments, and interventions... ...programs such as Noom, SkinIO (Virtual Skin Cancer Screening),...VirtualWork at officeLocal areaMonday to FridayFlexible hours- ...Telephonic RN Nurse Case Manager I - AmeriBen Location : This... ...enables associates to work virtually full-time, with the... ...for members with complex and chronic care needs... .... Interfaces with Medical Directors and other health... ...with utilization review and/or prior authorization...VirtualFull timeWork at officeLocal areaMonday to Friday
- ...Medical Management Nurse The Medical Management Nurse is responsible for review of the most complex or challenging cases that require nursing judgment, critical thinking, and holistic assessment... ...policies. Location Virtual: This role enables associates to work...VirtualFull timeTemporary workWork at officeLocal areaMonday to Friday1 day per week
- Medical Management Nurse Hours: Monday - Friday 9:30am-6pm This role... ...associates to work virtually full-time, with the exception... ...by understanding complex clinical concepts/... ...peculiar or complex cases as the nurse deems appropriate... ..., utilization review, or managed care...VirtualFull timeWork at officeLocal areaMonday to Friday
$79.46k - $124.87k
...Telephonic Nurse Case Manager II Sign on Bonus: $3000 Location: Virtual: This role enables associates to... ...licensure for members with complex and chronic care needs... .... Interfaces with Medical Directors and... ...under Florida law should review the education and awareness...VirtualFull timeTemporary workWork experience placementWork at officeLocal areaRelocation packageMonday to Friday1 day per week- Elevance Health is seeking a Telephonic RN Nurse Case Manager I to perform care management for members with complex needs. This role allows for virtual work while requiring occasional in-person training sessions. Key duties include assessing patients, developing care plans...VirtualRemote job
- ...Coordinator, Central Intake Case Manager to join our healthcare operations... ...is pivotal in ensuring that complex case management referrals are... ...-9/ICD-10, CPT coding, and Medical Terminology. Assessment: Demonstrated... ...candidates will undergo a virtual screening interview with the...VirtualPermanent employmentFull timeContract workCasual workWork at office
- ...Telephonic Nurse Case Manager II Location: This is a virtual position. Ideal candidates will reside... ...for members with complex and chronic care needs by... ...necessary. # Interfaces with Medical Directors and Physician... ...# Ability to manage, review and respond to emails/instant...VirtualWork at officeMonday to FridayAfternoon shift
- ...Emory Healthcare Registered Nurse Opportunity Be inspired. Be rewarded. Belong. At Emory... ...Unit at Emory University Hospital — a Complex Medicine unit that is part of our exciting... ...and specialty If completing virtual care activities that may include multi-state...VirtualFull timeRelocation packageShift work
- ...Behavioral Health Case Manager Title: Behavioral... ...I Location: Virtual- This role enables... ...field or a degree in nursing, and minimum of 3... ...experience with complex psychiatric and substance... ...abuse and/or medical disorders... ...Florida law should review the education and...VirtualFull timeTemporary workLocal areaMonday to FridayShift work1 day per week
- ...application process. RN- Case Manager/ Trainer Full Time... ...lives. Job Summary: The Medical Service Trainer / RN... ...a dual role as both a nurse case manager and... ...caregiving processes, reviews health and risk management... ...While onsite/during virtual training day ensure all...VirtualFull timeTraineeship
- ...Reliability Registered Nurse (RN)... ...Appendix G6) OR In cases of graduates of... ...with basic or complex An ADN or... ...goal setting for managing complex client... ...Veterans Affairs Medical Center (VAMC) personnel... ...reports Reviews quality -... ...Not available Virtual: This is not a...VirtualPermanent employmentTemporary workLocal areaImmediate startRemote workMonday to FridayFlexible hoursShift work
$200k
...compassionate Registered Nurses to provide... ...disease, and manage acute and chronic... ...families. Administer medications and treatments as... ...OR, ER): Manages complex patient cases requiring... ...Not Available Virtual: This is not a virtual... ...office after review of the EDRP application...VirtualPermanent employmentFull timePart timeWork at officeRemote workRelocation package- ...Outpatient Staff Registered Nurse (RN) executes... ...creative approaches to management of complex primary care. This... ...- Appendix G6) OR In cases of graduates of foreign... ...of care Administers medications and procedures per established... ...: Not available Virtual: This is not a...VirtualPermanent employmentTemporary workImmediate startRemote workRelocation packageMonday to Friday
$200k
...program office after review of the EDRP... ...creative approaches to management of complex patient care.... ...acute and/or chronic medical, surgical, and... ...conditions. Nursing care ranges from... ...Tour: 1930-0800 Virtual: This is not a virtual... ...Appendix G6); OR In cases of graduates of...VirtualPermanent employmentTemporary workSeasonal workWork at officeLocal areaRelocation packageWeekend work- ...regarding the impact of nursing care on patient... ...employee conference, risk management and unit management reports... ...Completes performance reviews with Nurse Manager... ...within 60 days of hire if virtual care activities... ...University Hospital - a complex medicine unit that is...VirtualShift work
- ...foresight regarding the impact of nursing care on patient outcomes... .... Completes performance reviews with Nurse Manager input as appropriate.... ...and specialty; if completing virtual care activities that may include... ...University Hospital — a Complex Medicine unit that is part...VirtualRelocation packageShift work
- ...7am) CLICK HERE for virtual tour of Kennestone Hospital... ...* Performs the Nursing Process (assessment; diagnosis... ...rounds, case review, etc); completion of timely... ...collaboration with care managers and other members of the... ...records regarding medication or treatment * Ability...VirtualFull timeShift workNight shift
- ...as an expert of knowledge and nursing practice to define and... ...educator, consultant, researcher, manager, and collaborator. Primary Duties... ...skill in assessing the complex responses of individuals and... ...certifications. 2. If completing virtual care activities that may...VirtualTemporary workCasual workShift work
- ...Genetic Counselor Review Associate Genetic... ...Utilization Review Carelon Medical Benefits Management Virtual: This role enables... ...-care physicians, nurse practitioners,... ...clinical review and other case interactions in... ...reviewers/leaders on complex cases for utilization...VirtualFull timeWork at office
$200k
...The Outpatient PACT Registered Nurse is responsible for organizing... ...outcomes through day-to-day case management. The RN functions in the... ...Not available; this is not a virtual position. Permanent Change of... ...program office after complete review. Former EDRP participants are...VirtualPermanent employmentTemporary workWork at officeRemote workRelocation package- ...-based, compassionate medical advice to members of the... ...seeking experienced Nurse Practitioners (NPs) residing... ...role will conduct virtual Baseline Visits - 15... ...targeted medical history, review labs, and provide a... ...physicians regarding complex cases or urgent needs. Requirements...VirtualFull timeRemote workFlexible hours
$85k - $95k
...Overview RN / Registered Nurse, Home Health Location: Hapeville Position: RN Case Manager, Home Health Position Type: Full-Time Remote/Virtual Position: No Coverage Area: Hapeville... .... Our benefits include: Medical, dental, and vision coverage...VirtualFull timeRemote workFlexible hours$57.7k
...clinical needs. The incumbent assesses health management needs of the assigned member panel and... ..., the incumbent will manage an active case load of members in his/her panel that are... ...Substitutions None Preferred Bachelor's Degree in Nursing EXPERIENCE Required 7 years of any...Remote jobTemporary workFor contractorsWork at officeLocal area- ...accountable specialty care management organization focused on... ...lives of people with complex injuries and diagnoses.... ...clinical solutions, case management, specialty networks... ...to role of a nurse case manager at Paradigm... ...is responsible for the medical case management of work...Full timeContract workPart timeFor contractorsLive inLocal areaFlexible hours
$88.16k - $162.04k
...to uncover digital evidence Advise on complex matters involving employee misconduct, intellectual... ...Maintain regular contact with and manage expectations of stakeholders to... ...Total Rewards package includes a variety of medical and dental plans, vision coverage, disability...Full timeH1bLocal area- ...Full Time Registered Nurse, Occupational Health ,... ...clinical operations and manages required physical evaluations... ...work, and coordinates case management with the TPA... ...Performs and documents medical tests, screenings, and... ..., EAP, access to virtual primary care and virtual...VirtualFull timeContract workLocal areaShift work
$80.9k - $115.68k
...investigate and analyze complex coverage issues and... ...umbrella/excess handling and management of outside counsel.... ...California, New York and Texas case law, statutes and... ...discounts and free virtual fitness platformEmployee... ...WellnessComprehensive medical, dental and vision benefitsFlexible...VirtualWork at officeLocal area
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