Care Manager RN: Elevate Care & Utilization
Highmark Health
Highmark Health is seeking a candidate for a role focused on implementing effective utilization management strategies within the healthcare sector. The responsibilities include reviewing health-care service appropriateness, educating providers and members, and analyzing data for improved performance and satisfaction. The ideal candidate should possess a Bachelor’s Degree in Nursing and have at least three years of progressive clinical experience. This role is office-based with an occasional travel requirement of 0% to 25%. #J-18808-Ljbffr Highmark Health
- ...a skilled Registered Nurse to ensure high-quality patient care while managing medical resources efficiently. This role requires conducting... ...significant acute hospital experience, including two years of utilization review experience. Adventist Health champions the wellbeing...Suggested
- ...healthcare provider in the United States is seeking an experienced RN for care management. The role involves implementing management strategies,... ...include monitoring healthcare services and utilizing data for quality improvement. This position offers a competitive...Suggested
- Ohio State University is seeking a Utilization Case Manager (RN) to implement and support the Utilization Management Program. This role requires in-depth knowledge of medical necessity guidelines and payer regulations, ensuring compliance with CMS and other requirements...SuggestedRemote job
- Ohio State University is seeking a dedicated Utilization Case Manager (RN) to support the Utilization Management Program remotely. This role requires an in-depth understanding of medical necessity guidelines and case management standards. The ideal candidate will hold...SuggestedRemote job
- Santa Barbara Cottage Hospital is seeking a qualified Registered Nurse to coordinate patient care and ensure quality services. The role requires effective communication with payers regarding medical necessities and monitoring patient resource use. The ideal candidate will...Suggested
- 1004 Lehigh Valley Hospital is seeking a Utilization Review Nurse to ensure appropriate use of hospital resources and compliance with payer... ...requirements. The role involves educating staff on patient care assignments, conducting timely reviews, and documenting activities...Remote jobMonday to FridayDay shift
- ...the NY area is seeking experienced REMOTE Care Managers CANDIDATES MUST RESIDE IN THE... ...member’s representatives, and specialis ts.Utilizes benefit structure and community-based resources... ...departmental workfl ow. Qualificati ons RN in the State o f NY2+ years of care...Remote work
$101.82k - $140.43k
...Position Summary The RN Care Manager performs the initial comprehensive assessment on admission in accordance with the Care Management Department policy, screening all patients by utilizing established tools for high risk indicators (i.e. AIMS, Geisinger, polypharmacy...Local area- ...The Clinical Coordinator / RN Care Manager performs the initial comprehensive assessment on admission in accordance with the Care Management Department policy, screening all patients by utilizing established tools for high-risk indicators to ensure high-risk patient populations...Local area
$66k - $100k
The Care Manager is responsible for completing a comprehensive assessment to determine the correct services and benefits based on medical... .... Completes documentation per company standards/policy utilizing an Electronic Medical Record (EMR) system. Participates in Marketing...Full timeShift work$134.9k - $168k
Care Manager (RN) - Bone Marrow Transplant (BMT) At NewYork-Presbyterian/Weill Cornell Medical Center, our Registered Nurse Care Managers... ...needs, identify risks, and support care planning. Conduct utilization review to ensure patients meet criteria for the appropriate...- ...healthcare staffing agency is seeking a local contract nurse RN Care Manager for a nursing position in New York, New York. The ideal... ...leadership experience. Responsibilities include care coordination, utilization review, and discharge planning. Required qualifications...Contract workLocal area
$80k - $95k
...RN Care Manager (DSNP) New York Hello, we're Belong. We partner with regional payers to deliver Medicare Advantage and Special Needs... ...basis to coordinate care and reduce barriers to care. Utilize population health, risk stratification and care management technology...Remote work- Job Overview As a Care Manager, you are the hub of the patient’s case management and care plan. You assure quality throughout the continuum... ...the best possible patient outcomes, efficient resource utilization, and effective communication with patients, families, and staff...ReliefShift work
- Inpatient Care Manager (RN)- Per-Diem, Days, Atlantic Health Chilton Medical Center Pompton Plains, NJ, United States Job Description The... ...for patients at the end‑of‑life. This role ensures effective utilization and monitoring of healthcare resources while managing...Hourly payDaily paidFull timeTemporary workPart timeFor contractorsFor subcontractorMonday to FridayFlexible hoursShift workDay shift
- ...Longitudinal Care Manager The Longitudinal Care Manager provides ongoing care coordination... ...optimal health outcomes, and appropriate utilization of services. This role supports patients... .... Qualifications: Current NYS RN license Experience in case management...Remote job
- ...Posted Monday, December 2, 2024 at 5:00 AM Care Solutions' goal is to create the... ...healthy living. Care Solutions is seeking RN Care Manager Join the excitement in support of our MLTC... ...such as complex case management and utilization management, the care manager will ensure...
$100k - $135k
...Overview Job Summary: The Nurse Care Manager is responsible for providing care coordination including in-home assessment, planning, facilitation... ...only needed services at the most appropriate levels, utilizing network providers and ensuring that services are based on...Hourly payWork at officeLocal areaHome officeFlexible hoursWeekend workAfternoon shift$90k - $120k
...Overview Commonwealth Care Alliance® (CCA) is a nonprofit, mission... ...recognized nonprofit managed care organization with over 2... ...medical needs. Oversee enrollee utilization of long-term services and supports... ...Massachusetts as a Registered Nurse (RN), Licensed Clinical Social...Work at officeLocal areaWork from homeHome officeFlexible hoursWeekend workAfternoon shift- A healthcare organization is seeking an experienced Registered Nurse (RN) - Case Management for their New York location. The RN will be responsible for coordinating patient care, managing resources, and ensuring high-quality patient outcomes. Key responsibilities include...
- Equiliem is hiring a Care Manager in the Emergency Department to optimize patient care and facilitate discharge planning. The ideal candidate... ...Nurse and possess essential skills in care coordination and utilization review. This position offers comprehensive benefits including...
- Santa Barbara Cottage Hospital is hiring a Case Manager who is responsible for assessment, planning, and implementation of patient care. This role requires a Registered Nurse (RN) with a Case Management Certification (CCM) and three years of clinical experience. The successful...Hourly pay
- ...in New York. The role involves providing quality, cost-effective care by evaluating inpatient, outpatient, and specialty service... ...degree is preferred. The ideal candidate possesses knowledge of managed care regulations and excellent communication skills, and is licensed...
- A leading health management organization in the United States is seeking a Care Manager to implement effective utilization management strategies and enhance healthcare delivery. The ideal... ...will have a Bachelor's in Nursing, an RN license, and at least 3 years of relevant...Work at office
$134.9k - $168k
Care Manager RN Neurology Service Lines - Weill Cornell - Days At NewYork-Presbyterian/Weill Cornell Medical Center, our Registered Nurse... ...needs, identify risks, and support care planning. Conduct utilization review to ensure patients meet criteria for the appropriate...- Position Overview Empower. Unite. Care. MetroPlusHealth is committed to empowering New... ...of what you do every day. The Care Manager, under the direction of the Vice President... ..., following established MetroPlusHealth Utilization Management policies, procedures, and protocols...
$114k - $143k
RN Clinical Care Manager/Case Manager - New York Position Summary: The RN Clinical Care Manager/Case Manager is responsible for developing and... ...renal replacement therapy Serve as Healthmap member advocate, utilize community resources and programs, and serve as liaison...Temporary workWork at officeLocal area$85k - $110k
RN Care Manager, Population Health Programs at Duet About Duet: Duet is on a mission to transform primary care by empowering nurse practitioners... ...Value‑Based Program Support Support ACO quality and utilization goals (HEDIS, STARs, TCM, etc.) Document care management...$62.7k - $100.4k
## Community Based Care Manager RNApplylocations: Georgia Mobiletime type: Full timeposted on: Posted Todayjob requisition id: R13013**... ...monitoring of concerns or issues* Monitors and promotes effective utilization of healthcare resources through clinical variance and...Hourly payWork at officeLocal areaWork from homeHome officeFlexible hoursWeekend workAfternoon shift$78.5k - $90k
...position and join us in building on our legacy of world-class patient and family-centered care by taking your career - to the next level. Care Manager Behavioral Health - Utilization Management In this role, the Care Manager conducts managed care and utilization...Full timeMonday to FridayDay shift
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