RN Utilization & Case Management Leader - AI-Enhanced Care
Obsidian
Obsidian is seeking experienced Utilisation Management and Case Management leaders to shape AI tools that enhance clinical review and improve care coordination. The role involves leading operations, managing physician advisor programs, and ensuring compliance with healthcare regulations. Ideal candidates will have over 5 years of relevant experience and an active RN license. Join us to contribute to the development of next-generation AI systems in healthcare and collaborate with top-tier research teams. #J-18808-Ljbffr Obsidian
- ...Behavioral Health patient care • Manage Behavioral Health... ...with Care Coordination, Utilization review and discharge... ...Nursing is required -RN Licensed as a... ...Health clinical review and case management experience... ...professionals As a leader in the healthcare staffing...Suggested
- Arlo is seeking a Senior Case Manager to oversee the medical journeys... ...receive corresponding care promptly. In this role, you'll utilize your clinical experience... ...requires an active RN license and at least 5 years... ...businesses using innovative AI solutions. #J-18808-...Suggested
- ...Sciences University is seeking a full-time TH Utilization Review Quality Assurance Senior Coordinator / RN Case Manager in New York. The role focuses on hospital case... ...discharge planning to ensure smooth transitions of care. The position requires NY RN licensure, a...SuggestedFull time
- ...highly skilled health care professionals—UofL... ...Summary and Purpose The Utilization Review RN performs activities... ...support the Utilization Management functions. They are... ...communicates with physician and case managers regarding... ...projects or topics Enhances professional growth...SuggestedWork at officeShift work
$50.2k
...implements effective utilization management strategies including:... ...appropriateness of health care services, application... ...to a Health Coach/case management, and identification... ...outcomes might be enhanced by Health Coaching/... ...States Registered Nurse (RN) license Delaware RN...SuggestedRemote jobFor contractorsWork at officeLocal areaFlexible hoursWeekend work- ...daily oversight of clinical case management team to insure timely evaluation... ...of individualized plan of care that insures at risk and... ...improved clinical outcomes and enhanced quality of life.... ...experience in the areas of utilization management and/or case management...
- ...Description The Nurse Manager (NM) is... ...department or ambulatory care. This includes,... ...clinical activities to enhance Relationship... ...physicians, nursing, case management, OT/PT,... ...and operational leaders to monitor quality... ...improvement initiatives. 5. Utilizes the principles of...Hourly payFull timeWork at officeLocal areaMonday to FridayShift workDay shift
- ...uniting communities through care. We believe that health... ...York State Medicaid Managed Care, Medicare, Child... ...simple and complex medical cases to achieve high‑quality... ...MetroPlusHealth Utilization Management policies, procedures... ...Professional Nurse (RN), Licensed Practical...Shift work
$114k - $143k
Overview RN Clinical Care Manager/Case Manager - New York The RN Clinical Care Manager/Case Manager is responsible... .../partner business relationships to enhance Healthmap provider and member... ...Serve as Healthmap member advocate, utilize community resources and programs, and...Full timeTemporary workWork at office- ...Registered Nurse for the 3PM-11PM shift, Monday to Friday. You'll be responsible for guiding nursing staff while providing exceptional care in a supportive environment. Candidates must have a NYS Registered Nurse License, and experience in long-term care is preferred....Monday to FridayShift workAfternoon shift
- Cobble Hill Health Center, a not-for-profit facility in New York, is seeking an experienced Registered Nurse (RN) to join our team. The RN provides expert care in activities of daily living, supports residents’ independence, and mentors care staff. Responsibilities include...
- ...seeking a Registered Nurse to join our interdisciplinary team across inpatient, outpatient, and community settings. You will lead the care planning process, coordinate the interdisciplinary plan of care, and ensure alignment with the medical treatment plan while...
- ...Medical Center is a 342-bed, acute care, nonprofit hospital located... ...the Care Coordination staff utilizing evidence-based guidelines and... ...or a Masters degree in Case Management or Nursing field in lieu of 1 year experience. California RN license. AHA BLS Ability to pass...Remote work
- ...golden thread” of compassionate care that connects staff and... ...and Responsibilities As our Utilization Management Nurse, you will be a critical... ...authorize services, and prepare cases for physician review in partnership... ...Collaborates with facility RN Care Coordinators to ensure...
$62.7k - $100.4k
CareSource is looking for a Community Based Care Manager to join their team in the United States.... ...teams and community organizations to enhance the quality of care provided to members... ...experience in nursing, social work, or case management. The position offers a competitive...$92.3k - $120k
Registered Nurse (RN), Home Health Utilization Management Remote - USA At Clover Health, we are committed to providing... ...s seniors. We prioritize preventive care while leveraging data and technology... ...home health agencies, physicians, case managers, and internal care...Work at officeLocal areaRemote workFlexible hours- ...the best primary care environment for patients... ...The Nurse, Care Management is a compassionate... ..., and enhancing overall quality of... ...encounters, progress, and case notes. Facilitate... ...case management, utilization management, or care... ...coordination. LPN required, RN preferred...Work at officeFlexible hoursWeekend work
- ...HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding... ...planners, MJHC, and in-house case management staff. managed care nurse, managed care rn, nursing, rn, nurse, care... ...preferred. Discharge Planning/Utilization Management experience preferred...
$60.2k - $107.4k
...a global organization that delivers care, aided by technology to help millions... ...Caring. Connecting. Growing together. Utilization Management & Clinical Validation RN Will accurately and efficiently review and extract pertinent case details from patient medical records;...Minimum wageFull timeWork experience placementLocal areaRemote work- Humana is seeking an experienced Utilization Management Nurse 2 to support medical necessity reviews, care coordination, and discharge planning for Kentucky Medicaid members... ...office a few times annually; requires Kentucky RN license, 2+ years clinical experience, and 1+...Remote jobWork at officeWork from homeShift work
- Netsmart is seeking a Registered Nurse with solid utilization management experience to perform ED utilization reviews and admissions screening... ...authorization. The successful candidate will bring 3+ years of acute care experience, knowledge of InterQual/MCG guidelines, and...Remote job
- ...Description RN/Case Manager MSH Case Management FT Weekdays... ...appropriateness of the Level of Care, assist in the... ...quality and resource utilization. Assignment will be by... ...At Mount Sinai, our leaders are committed to fostering... ...improvements that enhance patient care and workplace...Hourly payTraineeshipLocal areaWeekend workWeekday work
- ...Funds(“the Funds”)oversees and manages $11 billion of dollars in... ...Services Reports To Manager, CARE Team FLSA Status Exempt Union... ...issues, improve workflows, and enhance the participant counseling experience... ...results. Critical Thinking & Case Evaluation: Analyzes complex...
$101.82k - $140.43k
Position Summary The RN Care Manager performs the initial comprehensive assessment on admission... ...policy, screening all patients by utilizing established tools for high risk indicators... ...med/surg experience required Previous case management experience preferred Knowledge...Local area$39.78 - $42.36 per hour
...healthcare organization in New Jersey is seeking a Care Coordinator to provide care coordination... ...ideal candidate is a Registered Nurse (RN) or MSW with at least 3 years of... ...preferred. This part-time position is focused on enhancing the care and support for seniors and...Hourly payPart time- ...in New York, NY, seeks a qualified candidate to oversee the clinical case management team. The role involves ensuring timely evaluations and the development of care plans for at-risk members, enhancing their clinical outcomes and quality of life. Candidates must have a...Work at office
$34 - $35 per hour
Utilization Management - Clinical Nurse - Work from Home! Utilization... ...Work from Home! Get AI-powered advice on... ...Create case summaries for requests... ...appropriate continuity of care Meet regulatory timelines... ...Qualifications RN license in an eNLC (Enhanced Nurse Licensure Compact...Full timeWork at officeRemote workWork from homeNight shift- ProKatchers LLC is seeking a Registered Nurse Case Manager to coordinate patient care across the continuum and develop individualized care plans. The... ..., nurses, and multidisciplinary teams, perform utilization review, and drive discharge planning while ensuring timely...Day shift
- University of Miami Health System seeks a full-time Utilization Review Case Manager to work remotely. The role reviews patient charts for prior authorization... ...and retrospective utilization, coordinating with the care team for timely and appropriate care. You will manage a...Remote jobFull time
- CVS Health is seeking a Community Care Case Manager to coordinate care for patients and families... ...to meet health needs. The role requires RN licensure, 3-5 years of clinical... ...competitive base salary are offered. #J-18808-Ljbffr Hispanic Alliance for Career Enhancement
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