RN Case Manager - Utilization Review
Healthcare Outcomes Performance Company
At The CORE Institute, we are dedicated to taking care of you so you can take care of business! Our robust benefits package includes the following: Competitive Health & Welfare Benefits Monthly $43 stipend to use toward ancillary benefits HSA with qualifying HDHP plans with company match 401 k plan with company match (Part-time employees included) Employee Assistance Program that is available 24/7 to provide support Employee Appreciation Days Free Lunch Fridays Closed Holidays Key Responsibilities: A Case Manager/ Utilization Review Nurse, in collaboration with patients/families, physicians and the interdisciplinary team, provides leadership and advocacy in the coordination of patient-centered care across the continuum to facilitate optimal transitions and progression in care. Conduct concurrent and retrospective reviews of patient medical records to verify the medical necessity of services provided. Assess admission criteria and length of stay, applying standardized clinical guideline...Case Manager, Manager, RN, Medical Equipment, Healthcare, Clinical
- ...Fridays ~ Closed Holidays Key Responsibilities: A Case Manager/Utilization Review Nurse, in collaboration with patients/families, physicians... ...A current and unrestricted Arizona Registered Nurse (RN) license. Certification in Health Care Quality and Management...SuggestedPart time
- ...is offering a remote internship opportunity for a Utilization Management Behavioral Health Registered Nurse (RN). This role is part of the DOW SkillBridge Internship... ...military spouses. Interns will conduct clinical reviews, communicate with providers, and document findings...SuggestedInternshipRemote work
- ...is looking for a Clinical Analyst to assess member utilization and predict future healthcare spending. The successful... ...in healthcare, with specific qualifications as an RN analyst in Utilization Review or Care Management. This position promotes a hybrid work environment,...Suggested
- Blue Cross Blue Shield of Arizona is seeking a Utilization Review Supervisor in Phoenix, AZ. This hybrid role requires coordination of medical... ...candidates must have 2 years of clinical experience and an active RN license in Arizona. The position entails evaluating department...Suggested
- ...Critical Illness Recovery Hospital (LTACH) Case Manager (PRN) Requires a current licensure in a... .... The Case Manager is responsible for utilization reviews and resource management, discharge... ...clinical discipline either as a Nurse (RN /LPN/ LVN)or a Respiratory Therapist OR...SuggestedDaily paidFull timePart timeReliefShift workWeekday work
- ...Case Management RN Great care starts with great people. (Like you.) At HonorHealth, you'll... ...determining the appropriate level of care, utilization of resources and length of stay (... ...coordination services. Performs concurrent review of patient treatment plans in...Work from home
$60.2k - $107.4k
...RN Care Coordinator Optum is a global organization... ...is responsible for managing patients attributed to... ...appropriate site-of-service utilization. This role includes... ..., including medication reviews, scheduling timely follow... ...years of experience in Case Management and/or Care...Minimum wageFull timeWork experience placementWork at officeLocal areaRemote workFlexible hoursAfternoon shift- A healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care.... ...Arizona and substantial experience in utilization review or case management. Strong communication skills and flexibility are essential...Contract workRemote work
$35 - $40 per hour
...Remote Position Summary The Utilization Review Nurse serves as a key liaison... ...guidelines. Refer cases outside of established guidelines... ...support to payer case managers, patients, and provider teams... ...Current, active nursing license (RN, LPN, or LVN) in good standing...Contract workRemote workFlexible hoursWeekend work$66.9k - $91k
...Financial Services, Inc. is seeking a Telephonic Medical Case Manager, RN to provide quality telephonic case management to ensure a... ...nursing, with responsibilities including care coordination, utilization review, and communication with injured employees and healthcare providers...$57.7k
...needs. The incumbent assesses health management needs of the assigned member panel and utilizing data/analytics in conjunction... ...incumbent will manage an active case load of members in his/her panel... ...Required ~ Current State of PA RN licensure OR Current multi-state...Temporary workFor contractorsWork at officeLocal areaRemote work- ...position. Candidates must have strong clinical documentation skills and be eligible for DoD background clearance. This role involves reviewing medical records, identifying quality issues, and supporting quality improvement initiatives while collaborating with Medical...Remote work
- Position: Remote Registered Nurse (RN) Case Manager Location: Scottsdale, AZ Remote Status:... ...preferred. Nurseline triage, Call Center Utilization Management, Call Center Case... ...promotion from within. Exceptions will be reviewed on a case-by-case basis to assess business...Remote jobTemporary workWork at officeImmediate startWork from homeHome officeMonday to FridayFlexible hoursShift work
- ...pain and develop an individualized pain management plan. Assess the ability of the caregiver... .../family needs. Implement the care plan utilizing appropriate preventative and rehabilitative... ...of the interdisciplinary team. Use the case management approach, referring to other...Immediate start
- ...Lead Case Manager The position manages the continuum of care for assigned patients and... ...patients and families, discharge planning and utilization review. The position serves as the department... ...and annual InterQual training for RN Case Managers. Responsibilities include...16 hoursWork at officeFlexible hours
$59.5k - $116.6k
UnitedHealth Group is seeking a Utilization Management Nurse RN to work remotely from anywhere in the U.S. This role involves ensuring efficient health services and requires an active RN license and 3+ years of Managed Care or Clinical experience. The successful candidate...Remote jobWeekend work$108.2k - $162.41k
...and Research in Phoenix, Arizona, is seeking a dedicated RN Manager for Care Management. This leadership role involves overseeing case managers and social workers, resolving issues related to utilization review, and ensuring safe discharge planning. Successful candidates...$55 per hour
...Job Description Job Description RN Chronic Case Manager Scottsdale, Arizona Our client is NOW hiring for an RN Chronic Case Manager... ...providers, patients and the community Conduct admission reviews, post-discharge calls, and discharge planning Provide...Hourly payPermanent employmentFull timeContract workTemporary workWork at officeImmediate startMonday to Friday$85k - $92k
...to identify a Clinical Quality Reviewer. This role focuses on reviewing clinical cases, identifying potential quality... ...experience in clinical review, utilization management, or healthcare quality within health... ...license as a Registered Nurse (RN) or Licensed Clinical Social...Hourly payWork at officeRemote workHome office- ...Description Assisteo is looking for a Hospice RN to connect and care for our patients.... .... Provides professional nursing care by utilizing all elements of nursing process. 3.... ...optional comfort care. 10. Acts as Case Manager when assigned by Clinical Supervisor and...
- Sedgwick is seeking a Physical Therapy Utilization Review Advisor to enhance patient care by counseling providers and reviewing treatment plans. Ideal candidates should have a Master's degree in Physical Therapy and a minimum of eight years of relevant experience. The...
- ...RN Pediatric Clinical Case Manager Duties and Responsibilities Ensures supervision of all home care personnel, as assigned: Enforces/demonstrates... ...per agency policies and State regulations. Reviews clinical documentation to ensure it is complete and reflects...Work at officeFlexible hours
- ...Phoenix area. Job Summary The Care Manager RN Heart Failure Coordinator plans, organizes... ...PCP is aware of patient's admission Review discharge instructions with patient including... ...key healthcare providers involved in the case. Facilitates a smooth and timely transition...
- ..., compassionate care while loving your job! Position Profile RN case managers have the primary responsibility to provide and coordinate hospice... ...patient care. Creates timely and accurate documentation. Utilizes resources effectively and efficiently. Adheres to scope of practice...Flexible hours
$80k
...can focus on what truly helps people. About This Role The RN Case Manager serves as the primary clinical point of contact for employer... ...supporting chronic condition management, and reducing unnecessary utilization. Advocate for members by navigating the healthcare system,...Remote work- ...SUMMARY The Prior Authorization RN is responsible for reviewing and processing medical... ...standards. CORE FUNCTIONS Manages health Plan consumer/... ...determinations, concurrent review, and case management functions... ...to prior authorization, utilization management, and/or case...
- ...family atmosphere where your voice is heard! Position Summary The RN is experienced in planning, organizing, and directing home care... ...and implements prior to discharge of the patient. Acts as Case Manager and assumes responsibility to coordinate patient care for assigned...Weekly payFull timeWork at officeLocal area
$57.7k - $107.8k
...healthcare services organization based in Arizona is seeking a Case Manager to oversee the health management of assigned members. This role... ...least 7 years of clinical or case management experience and an RN license. The position offers a salary range of $57,700 to $107,...$83k - $94k
...Overview Make a Lasting Difference as a Hospice Registered Nurse Case Manager (RNCM)! Are you a compassionate Registered Nurse (RN) who finds purpose in supporting patients and families through meaningful moments of care? Hospice of the West is seeking a Full Time Hospice...Full timeMonday to Friday- ...yourcommission in Phoenix, Arizona is looking for a dedicated Case Manager to provide comprehensive patient care coordination. This role includes... ...experience. Necessary certifications include a current Arizona RN license and BLS certification. Strong communication and...
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