Care Manager - Appeals RN - Utilization Management
Providence
Care Manager AppealsRN - REMOTE position. This position is Per Diem and will work 8- hour, Day shifts. The Care Management Recovery Advocate (CMRA) is responsible for providing overall management and communication of clinically-based appeals between Providence Health and Services, California Region (PH&S) outside payers. Activities will be patient-focused, uniform, compliant, and support steadfast advocacy for reimbursement of services provided to patients served within the PH&S ministries. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence California Regional Services and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Required Qualifications: Associate's Degree in Nursing. California Registered Nurse License upon hire 4 yearsdirect patient care experience in an acute hospital setting. 4 yearsexperience as a case manager in an acute hospital setting. Preferred Qualifications: Bachelor's Degree in Nursing.-Or- Master's Degree in Nursing Case management certification upon hire Experience working with denials and appeals in/for an acute care setting. Experience in a multi-hospital and/or integrated healthcare system. Why Join Providence? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. #J-18808-Ljbffr Providence
- ...Care Manager Appeals RN - Remote Position This position is Per Diem and will work 8-hour, Day shifts. The Care Management Recovery Advocate (CMRA) is responsible for providing overall management and communication of clinically-based appeals between Providence Health...SuggestedDaily paidRemote workDay shift
- Providence California Regional Services is seeking a Care Manager Appeals RN for a remote per diem role. The position supports day shifts and focuses on managing and communicating clinically-based appeals with outside payers to ensure reimbursement for services to patients...SuggestedRemote jobDaily paidDay shift
- Providence Jobs is seeking a Care Manager RN for a remote, full-time position with day shifts in Torrance, CA. The role focuses on managing clinical appeals between Providence Health and Services and external payers, advocating for reimbursement and maintaining patient-...SuggestedRemote jobFull timeDay shift
- ...RN position for Care Managerin Torrance, California. This is a FT permanent position. Salary range: 106K-172K. Join an amazing team and let us help you find your purpose! Required qualifications: ~ Bachelor's Degree ~ Upon hire: California Registered Nurse...SuggestedPermanent employment
- ...appreciative and truly deserving community. We support our nurses with tools, training and best-in-class resources. Our fantastic new RN Residency Program launches recent graduates on a path to success. Our staff fellowships for experienced nurses open doors to new...Suggested
$47.2 - $63.45 per hour
...count on the hospital for high quality and compassionate medical care. St. Francis is recognized for its full range of diagnostic and... ...!ResponsibilitiesResponsible for the quality and resource management of all patients that are admitted to the facility from the point...Full timePart timeWork experience placementLocal area- ...Sonoma Valley Hospital is seeking a Registered Nurse Case Manager in California to lead care coordination across hospital levels of care. The role... ...collaborating with physicians and finance on resource utilization using medical necessity criteria. Responsibilities include...
- ...Registered Nurse (RN) Case ManagerThe Registered Nurse Case Manager is responsible for coordinating the management of care and ensuring optimal utilization of resources, service delivery, and compliance with external review agencies. This role involves ongoing support...Temporary workMonday to Friday
- ...RN Case ManagerCoordinates management of care and ensures optimum utilization of resources. Ensures service delivery and compliance with external review agencies. Provides ongoing support and expertise through comprehensive assessment. Conducts care planning, plan implementation...
- ...experienced Registered Nurse with expertise in Case Management to coordinate management of care and ensure optimum resource utilization. The ideal candidate will enhance the quality... ....QualificationsCurrent Registered Nurse (RN) license in California.Minimum of 2 years...Temporary workMonday to Friday
- ...RN Case ManagerPosition Duties: Discharge planningMinimum Required... ...:BLSCA licensePrevious case management experienceMinimum 2 years... ...experience as an RN in an acute care setting requiredPreferred Qualifications... ...ability to utilize/apply the general and specialized...Monday to Friday
- ...RN - Case ManagerAbout the Position Specialty: RN Case Manager Experience: 1+ year of recent case management or discharge planning... ..., discharge planning, and utilization review skillsDescription: The RN... ...Manager coordinates patient care plans and services across the continuum...
- ...Case Manager OpportunityVIBRA TRAVELS is seeking a Case Manager to join our expanding network... ...coordinate clinically complex patient's care across a continuum; ensuring and... ...material from medical records.Knowledgeable in utilization review, medical terminology, appropriate...Hourly payLocal areaImmediate start
- ...RN Case Manager Per Diem - Weekends (Floater for Gardena Hospital & Coast Plaza Hospital) Job... ...case manager manages clinical resource utilization and documentation affecting... ...collaborate with members of the health care team in removing barriers to discharge...Daily paidShift workWeekend work
- ...RN Case Manager Position Duties: Discharge planning Minimum Required Qualifications: BLS... ...experience as an RN in an acute care setting required Preferred Qualifications... ...Interqual Knowledge Demonstrated ability to utilize/apply the general and specialized...Monday to FridayShift work
- ...and integrity that you truly deserve. Job Description Minimum of recent 2 years combined case management or clinical experience providing direct patient care and utilization review/case management experience in an acute care environment Working knowledge in the use of...Daily paid
- ...part-time Registered Nurse Case Manager to support discharge planning, resource utilization, and documentation that affects reimbursement... .... You will coordinate with the care team to assess medical, financial... ...have at least two years of RN or Case Manager experience,...Daily paidPart time
- RN - Case Manager Profession: Registered Nurse Specialty: Case Management Duration: 13 weeks Shift... ..., with experience in a long-term acute care or short-term acute care setting... ...management of care and ensures optimum utilization of resources.Ensures service delivery and...Temporary workMonday to FridayShift work
$26.41 - $51.49 per hour
...JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities... ...of relevant education and experience. - Registered Nurse (RN). License must be active and unrestricted in state of practice...Hourly payWork experience placementWork at officeLocal area- ...Job Description Job Description Senior Living Memory Care Director, LVN Are you passionate about working with seniors? Are... ...significant changes in resident behavior and health to the General Manager, physician, and family per state regulations. Conducts...Full timeTemporary workPart timeLocal areaImmediate startFlexible hoursShift work
- ...Los Angeles is seeking a seasoned Case Manager Nurse to oversee admission and care coordination. You will manage quality and resource utilization for all patients from admission through... ...graduation nursing experience with an active RN license and experience in case...
$139.3k - $160.09k
...Nurse Director of Case Management Utilization Review —ignite an impact-driven leadership career in a high-acuity Southern California hospital... ...Director of Case Management Utilization Review will champion care coordination excellence, operational efficiency, and patient...Full timeRelocation packageWeekend work- ...RN - Case ManagerOur client is currently seeking RN - Case Manager positions in GARDENA, CA for a 5x8 Days shift. You must have current State Licensure and at least... ...friend and earn extra cash!At THP Healthcare Staffing, we take care of you - work with us, not for us!...Extra incomeContract workDay shift
- ...Job Description The Case Management Nurse reviews, evaluates and... ...necessity and efficiency of health care services proposed or provided... ...and clinical case appeals for members who have psychiatric... ...This role focuses on performing utilization and concurrent reviews of inpatient...Daily paidLocal areaShift work
- ...RN Case ManagerQualifications for RN Case Manager:The Case Manager is responsible for managing a continuum of care from admission through discharge for assigned patients.Partners with medical staff, utilizes scientific evidence for best practices, relevant data and compliance...Temporary work
- ...Case Manager RnGetMed Staffing is searching for a strong Case Manager RN to assist our traveler-friendly client. A minimum of 1-2 years of experience is required. Traveling with GetMed Staffing offers the unique opportunity to gain diverse experiences, both personally...
$41 - $55 per hour
...RN Case Manager - Position Highlights Remote CKD/ESKDLocation: The teammate must be based in Northern California, Salem/Portland, Oregon, or... ...healthcare team to coordinate and facilitate quality, cost-effective care while minimizing fragmentation of the healthcare delivery...Hourly payMinimum wageWork at officeRemote workMonday to Friday- ...required•Duration: 13 weeksResponsibilities:• Provide case management for patients in a Level 1 trauma center Emergency Department• Coordinate care for acute inpatient cases, ensuring efficient and quality outcomes• Utilize EPIC documentation system for accurate record-...Shift workWeekend work
- ConVerdia Health StaffingStaffing temporary and permanent jobs across the nation, ConVerdia Health Staffing assists RNs, LPNs, CNAs, Allied Healthcare professionals, Therapists, Physicians, and more. Work one on one with one of our committed recruiters to find the best...Permanent employmentTemporary work
- ...Case ManagerCase managers work to facilitate patient care by assessing patient needs, evaluating treatment options, creating treatment plans, coordinating care, and gauging progress. The overall goal for case managers is to improve clinical outcomes, increase patient...
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