TravelNurseSourceNewTravel Nurse RN - Utilization Review - $1,856 per week in Kansas City, MO TravelNurseSourceTravel Nurse RN - Utilization Review - $1,856 per week in Kansas City, MOKansas City, MO$1,856–$1,856Benefits: Day 1 Insurance Cigna medical, MetLife dental and vision insurance License reimbursement for new licenses needed for each assignment Discounts with hotels and rental cars A dedicated recruiter and support team that will help you every step of the way to sure you start on time and have an exceptional experience Referral bonus up to $700 About the Company: As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership.
MercyNewRN Care Manager Weekend MercyRN Care Manager WeekendJoplin, MOThe Care Management model provides effective transition planning and length of stay oversight while encompassing quality patient care, patient safety, and financial components; promotes integration of a seamless care model; coordinates patient throughput; encourages healthcare team collaboration and coordination as evidenced by metrics; and optimizes performance and adoption of best practice. See Mercy Terms & Conditions at https://www.mercy.net/about/legal-notices/ and Privacy Policy at https://www.mercy.net/about/legal-notices/ and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions.
MercyNewRN Care Manager II-IPCM MercyRN Care Manager II-IPCMCreve Coeur, MOSee Mercy Terms & Conditions at https://www.mercy.net/about/legal-notices/ and Privacy Policy at https://www.mercy.net/about/legal-notices/ and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions. The RN Care Manager II - IPCM, as part of the interdisciplinary team, assesses, plans, advocates, and coordinates care from admission to discharge ensuring a safe transition post-hospitalization.
MercyNewRN Care Manager II-IPCM (Exempt) MercyRN Care Manager II-IPCM (Exempt)Springfield, MOSee Mercy Terms & Conditions at https://www.mercy.net/about/legal-notices/ and Privacy Policy at https://www.mercy.net/about/legal-notices/ and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions. The Care Management model provides effective transition planning and length of stay oversight to maintain patient experience, safety, and quality of care utilizing performance metrics and adoption of best practices.
MercyNewNurse Navigator - Heart Failure Clinic, PRN MercyNurse Navigator - Heart Failure Clinic, PRNSaint Louis, MOThis position is designed to facilitate an effective process of the new care model; supporting quality patient care, safety, and financial components; promoting integration of a seamless care model; coordinating patient discharge planning for post-acute services, length of stay (LOS) management and utilization management; collaborating to include coordination as evidenced by metrics, optimizing performance and adoption of best practice. See Mercy Terms & Conditions at https://www.mercy.net/about/legal-notices/ and Privacy Policy at https://www.mercy.net/about/legal-notices/ and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions.
MercyNewNurse Navigator - Gastroenterology - FT MercyNurse Navigator - Gastroenterology - FTSpringfield, MOThis position is designed to facilitate an effective process of the new care model; supporting quality patient care, safety, and financial components; promoting integration of a seamless care model; coordinating patient discharge planning for post-acute services, length of stay (LOS) management and utilization management; collaborating to include coordination as evidenced by metrics, optimizing performance and adoption of best practice. See Mercy Terms & Conditions at https://www.mercy.net/about/legal-notices/ and Privacy Policy at https://www.mercy.net/about/legal-notices/ and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions.
SSM HealthNewRegistered Nurse - Case Manager SSM HealthRegistered Nurse - Case ManagerBridgeton, MOApplies the existing body of evidence-based practice and scientific knowledge in health care to nursing practice, ensuring that nursing care is delivered based on patient’s age-specific needs and clinical needs as described in the department's Scope of Service. May also be responsible for: utilization management process, ED case management process, admission process, and act as a case manager liaison with post acute providers (skilled nursing facilities, rehab, home health, etc.).
MercyNewSpecialty Clinic Nurse Navigator MercySpecialty Clinic Nurse NavigatorCreve Coeur, MOThis position is designed to facilitate an effective process of the new care model; supporting quality patient care, safety, and financial components; promoting integration of a seamless care model; coordinating patient discharge planning for post-acute services, length of stay (LOS) management and utilization management; collaborating to include coordination as evidenced by metrics, optimizing performance and adoption of best practice. See Mercy Terms & Conditions at https://www.mercy.net/about/legal-notices/ and Privacy Policy at https://www.mercy.net/about/legal-notices/ and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions.
MercyNewNurse Manager - Imaging - FT MercyNurse Manager - Imaging - FTSpringfield, MOSee Mercy Terms & Conditions at https://www.mercy.net/about/legal-notices/ and Privacy Policy at https://www.mercy.net/about/legal-notices/ and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions. The Nurse Manager works collaboratively and effectively with other administrative personnel, physicians and caregivers throughout the Ministry to enhance communication, share pertinent data and improve processes across the continuum.
MercyNewNurse Manager - Surgical ICU MercyNurse Manager - Surgical ICUSaint Louis, MOEffectively managing the delivery of nursing care requires creating and promoting a professional practice environment at the unit level that exemplifies a vision and goals congruent with the Medical Center and the respective clinical service line as well as high levels of coworker engagement, patient satisfaction, safe and quality clinical outcomes, financial performance and physician satisfaction. See Mercy Terms & Conditions at https://www.mercy.net/about/legal-notices/ and Privacy Policy at https://www.mercy.net/about/legal-notices/ and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions.
MercyNewNurse Manager - Surgical Stepdown MercyNurse Manager - Surgical StepdownCreve Coeur, MOEffectively managing the delivery of nursing care requires creating and promoting a professional practice environment at the unit level that exemplifies a vision and goals congruent with the Medical Center and the respective clinical service line as well as high levels of coworker engagement, patient satisfaction, safe and quality clinical outcomes, financial performance and physician satisfaction. See Mercy Terms & Conditions at https://www.mercy.net/about/legal-notices/ and Privacy Policy at https://www.mercy.net/about/legal-notices/ and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions.
MercyNewRN Supervisor of GIG Caregivers, Full Time MercyRN Supervisor of GIG Caregivers, Full TimeNixa, MOSee Mercy Terms & Conditions at https://www.mercy.net/about/legal-notices/ and Privacy Policy at https://www.mercy.net/about/legal-notices/ and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions. Works collaboratively with the healthcare team with open communication; serving as a clinical resource for coworkers, patients and visitors.
MercyNewNurse Manager - IR/Cath Lab MercyNurse Manager - IR/Cath LabCape Girardeau, MOSee Mercy Terms & Conditions at https://www.mercy.net/about/legal-notices/ and Privacy Policy at https://www.mercy.net/about/legal-notices/ and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions. Responsible for assisting the Chief Nursing Officer in the delivery of safe, quality and cost efficient care by having competent staff members in the Med Surg and Outpatient Departments.
MercyNewRN - Supervisor, General Surgery MercyRN - Supervisor, General SurgerySaint Louis, MOSee Mercy Terms & Conditions at https://www.mercy.net/about/legal-notices/ and Privacy Policy at https://www.mercy.net/about/legal-notices/ and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions. From day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period.
MercyNewRN - Home Health Case Manager - Full Time - Saint Louis MercyRN - Home Health Case Manager - Full Time - Saint LouisSaint Louis, MOProvides day- to-day patient care in the home setting which includes, but is not limited to: case management and total care of multiple patients with different levels of acuity, admissions to home care services, post-hospitalization assessments, recertifications, discharges, patient teaching, dressing changes, IV therapy administration, access site care and general skilled nursing according to policy and procedure, assists with other needs that may be apparent in the home to assure safety and appropriate care i.e. lifeline, meals on wheels, and instruction on public programs availability. See Mercy Terms & Conditions at https://www.mercy.net/about/legal-notices/ and Privacy Policy at https://www.mercy.net/about/legal-notices/ and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions.
OptumNewRegistered Nurse $10,000 Bonus - Creve Coeur MO OptumRegistered Nurse $10,000 Bonus - Creve Coeur MOSaint Louis, MO$75,450–$113,174 / yearQualityMakes initial and/or comprehensive nursing evaluation visits, ensures patients meet home health eligibility and medical necessity guidelines, determines primary focus of care, develops the plan of care within State guidelines with the physician, and submits accurate documentation. Actively participates in survey/survey readiness activities and performance improvement plans, works to reduce unnecessary patient hospitalizations, improve patient safety, and implements processes and best practices to ensure positive patient outcomes.
OptumNewRN $10,000 bonus - Jefferson City MO OptumRN $10,000 bonus - Jefferson City MOArgyle, MO$30.82–$68.03 / hourQualityMakes initial and/or comprehensive nursing evaluation visits, ensures patients meet home health eligibility and medical necessity guidelines, determines primary focus of care, develops the plan of care within State guidelines with the physician, and submits accurate documentation. Actively participates in survey/survey readiness activities and performance improvement plans, works to reduce unnecessary patient hospitalizations, improve patient safety, and implements processes and best practices to ensure positive patient outcomes.
TravelNurseSourceNewTravel Nurse RN - Case Manager - $1,732 to $1,924 per week in Kansas City, MO TravelNurseSourceTravel Nurse RN - Case Manager - $1,732 to $1,924 per week in Kansas City, MOKansas City, MO$1,732–$1,924Works in collaborative practice with Physicians and Physician extenders to actively support the delivery of cost effective, outcome oriented, quality care in the appropriate health care setting to meet patient specific, age and cultural needs. Works in collaborative practice with the physician and other members of the health care team to meet patient specific and age-related needs linking cost and quality to patient care.
MercyNewManager-Nursing Level IV (Exempt) MercyManager-Nursing Level IV (Exempt)Saint Louis, MOEffectively managing the delivery of nursing care requires creating and promoting a professional practice environment at the unit level that exemplifies vision and goals congruent with the Medical Center and the respective clinical service line as well as high levels of coworker engagement, patient satisfaction, safety and quality clinical outcomes, financial performance and physician satisfaction. See Mercy Terms & Conditions at https://www.mercy.net/about/legal-notices/ and Privacy Policy at https://www.mercy.net/about/legal-notices/ and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions.
MercyNewManager-Nursing - Heart Hospital - FT MercyManager-Nursing - Heart Hospital - FTNixa, MOEffectively managing the delivery of nursing care requires creating and promoting a professional practice environment at the unit level that exemplifies a vision and goals congruent with the Hospital and the respective clinical service line as well as high levels of coworker engagement, patient satisfaction, safe and quality clinical outcomes, financial performance and physician satisfaction. See Mercy Terms & Conditions at https://www.mercy.net/about/legal-notices/ and Privacy Policy at https://www.mercy.net/about/legal-notices/ and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions.
Medline IndustriesSenior Clinical Solutions Specialist Medline IndustriesSenior Clinical Solutions SpecialistSt. Louis, MO$92,000–$138,000 / yearFull timeContribute to the development of new products along with the modification and improvements of existing products by providing customer (end user) insight for process enhancement and improvement opportunities. Medline Industries, LP, and its subsidiaries, offer a competitive total rewards package, continuing education & training, and tremendous potential with a growing worldwide organization.
MercyNewClinical Supervisor (Non-Exempt) MercyClinical Supervisor (Non-Exempt)Springfield, MOSee Mercy Terms & Conditions at https://www.mercy.net/about/legal-notices/ and Privacy Policy at https://www.mercy.net/about/legal-notices/ and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions. From day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period.
CenterWell Home HealthNewHome Health Clinical Manager CenterWell Home HealthHome Health Clinical ManagerColumbia, MO$77,200–$106,200 / yearOur care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives. As the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients.
MercyNewClinical Pharmacist-Hospital - $10K Sign-on Bonus MercyClinical Pharmacist-Hospital - $10K Sign-on BonusSpringfield, MOFrom day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period. This role serves as a key drug information resource for physicians, nurses, and patients while supporting high-quality patient care.
MercyNewClinical Pharmacist - Hospital - Full Time - $10K Sign-on Bonus MercyClinical Pharmacist - Hospital - Full Time - $10K Sign-on BonusSpringfield, MOFrom day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period. This role serves as a key drug information resource for physicians, nurses, and patients while supporting high-quality patient care.
MercyNewClinical Pharmacist-Hospital Overnights 7 on/7 off - $10K Sign-on Bonus MercyClinical Pharmacist-Hospital Overnights 7 on/7 off - $10K Sign-on BonusSpringfield, MOFrom day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period. This role serves as a key drug information resource for physicians, nurses, and patients while supporting high-quality patient care.
MercyCare Manager II-IP, PRN - Mercy Jefferson MercyCare Manager II-IP, PRN - Mercy JeffersonFestus, MOThe Care Management model provides effective transition planning and length of stay oversight to maintain patient experience, safety, and quality of care utilizing performance metrics and adoption of best practices. From day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period.
Compass Health NetworkBehavioral Health Consultant Compass Health NetworkBehavioral Health ConsultantLebanon, MissouriFull timeThis is a great opportunity for someone who enjoys collaborative care, thrives on variety in their work, and is passionate about improving health outcomes through behavioral interventions and patient support. Provide in-person and remote consultation to patients and primary care providers on a range of health concerns, including mental health, chronic conditions, and wellness management.
Advocates For A Healthy Community Inc.PACE Medical Director, Jordan Valley Senior Care Advocates For A Healthy Community Inc.PACE Medical Director, Jordan Valley Senior CareSpringfield, MOExperience: Must have experience working in a managed care environment and working with peers and other health providers to resolve utilization, quality management, performance improvement, pharmacy and therapeutics, peer review, credentialing, and physician leadership issues. Medical and Prescription Drug Coverage: Three comprehensive plan options (Buy-up, Base, and High Deductible) through UnitedHealthcare's Choice Plus network, covering various deductibles and out-of-pocket limits.
MercyNewPharmacy Resident II (Exempt) MercyPharmacy Resident II (Exempt)Springfield, MOPGY2 competency areas, goals, and objectives in advanced areas of pharmacy practice are differentiated from those from PGY1 by specialization and the expectation of PGY2 residents for greater work competence and proficiency in the specialty area. PGY2 residencies provide residents with opportunities to function independently as practitioners by conceptualizing and integrating accumulated experience and knowledge and incorporating both into the provision of patient care or other advanced practice settings.
University Health.Utilization Management RN Hourly (PRN) - Care Continuity - UH Truman Medical Centers (varied days per week; 7:00a-3:30p) University Health.Utilization Management RN Hourly (PRN) - Care Continuity - UH Truman Medical Centers (varied days per week; 7:00a-3:30p)MOJoin our dedicated Utilization Management team and help shape smarter, more effective care delivery across the healthcare continuum. As a UM Nurse, you'll play a critical role in supporting interdisciplinary collaboration, resource stewardship, and positive patient outcomes.
CVS Health CorpNewUtilization Management Nurse Consultant CVS Health CorpUtilization Management Nurse ConsultantWork At Home, MO$29.10–$62.32 / hourUtilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do.
Navitus Health Solutions, LLCRN, Utilization Case Manager - Archimedes Navitus Health Solutions, LLCRN, Utilization Case Manager - ArchimedesEarth City, MissouriFounded with the goal of transforming the PBM industry to provide the necessary ingredients for the sustainability of the prescription drug benefit – alignment, value and transparency – Archimedes achieves superior results for clients by eliminating tightly held PBM conflicts of interest including drug spread, rebate retention and pharmacy ownership and delivering the most rigorous clinical management at the lowest net cost. M-F 8am to 5pm): Our Core Business Hours-Hybrid Work Schedule 3 Days In Office Overview: The RN, Utilization Case Manager will coordinate care between physicians, patients, and pharmacies, facilitating access to specialty medications for patients with complex disease states.
Southeast Alabama Medical CenterUtilization Review Nurse Southeast Alabama Medical CenterUtilization Review NurseSoutheast Health Hospital, MOThe Utilization Review case manager collaborates with all components of the healthcare system, managing appropriate use of acute care to aid in the achievement of quality outcomes, fiscal responsibility, and patient satisfaction. Demonstrates responsibility for educational requirements as evidenced by reading all assigned related references, and attending all required educational meetings, or webinars, and completing annual Symplr requirements.
TriWest Healthcare AllianceUtilization Clinical Reviewer TriWest Healthcare AllianceUtilization Clinical ReviewerKansas City, MORemoteFull timeApplies clinical knowledge to make determinations for preauthorization, inpatient and continued stay reviews for Behavioral Health and Medical/Surgical requests to establish medical necessity, benefit coverage, appropriateness of quality of care, and length of stay or care plan. The Utilization Management Clinical Review nurse reviews and makes decisions about the appropriateness and level of beneficiary care being provided in an effort to provide cost effective care and ensure proper utilization of resources.
Elevance Health IncNewMedical Management Nurse (US) Elevance Health IncMedical Management Nurse (US)St. Louis, MOThe Medical Management Nurse is responsible for review of the most complex or challenging cases that require nursing judgment, critical thinking, and holistic assessment of member's clinical presentation to determine whether to approve requested service(s) as medically necessary. Utilizes nursing judgment and reasoning to analyze members' clinical information, interface with healthcare providers, make assessments based on clinical presentation, and apply clinical guidelines and/or policies to evaluate medical necessity.
North Kansas City HospitalNewLactation Consultant/Case Management, RN North Kansas City HospitalLactation Consultant/Case Management, RNNorth Kansas City, MOThe role advocates for breastfeeding as a global health imperative, creating supportive environments for breastfeeding families, while also focusing on care management to ensure high-quality, cost-effective healthcare across the continuum of care. The role requires close collaboration with interdisciplinary teams, including physicians, nurses, and external providers, to improve patient outcomes and ensure efficient healthcare delivery.
Intermountain Health IncRN Hospital Care Manager - PRN Intermountain Health IncRN Hospital Care Manager - PRNSaint Joseph, MO$40.39–$60.96 / hourFrequent interactions with providers, colleagues, customers, patients/clients, and visitors that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately. We care about your well-being - mind, body, and spirit - which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
HCA Healthcare IncRN Case Manager HCA Healthcare IncRN Case ManagerKansas City, MOReferral services for child elder and pet care home and auto repair event planning and moreConsumer discounts through Abenity and Consumer DiscountsRetirement readiness rollover assistance services and preferred banking partnershipsEducation assistance tuition student loan certification support dependent scholarshipsColleague recognition programTime Away From Work Program paid time off paid family leave long- and short-term disability coverage and leaves of absenceEmployee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income. Education is key to excellence As a majority owner of Galen College of Nursing which joins Research College of Nursing and Mercy School of Nursing as educational facilities within the HCA Healthcare family we make it easier and more affordable to gain certifications and job skills.
Prime Healthcare Services IncNewCase Manager Registered Nurse Prime Healthcare Services IncCase Manager Registered NurseBlue Springs, MOThey assess patients' needs, develop care plans, and collaborate with physicians, nurses, social workers, and other providers to manage care transitions. Care Coordination: develop and implement individualized care plans in collaboration with the healthcare team to ensure effective treatment and timely interventions.
MTC CareNewPsychiatric Mental Health Nurse Practitioner (PMHNP) - In Person - Columbia/Jefferson City, Missouri MTC CarePsychiatric Mental Health Nurse Practitioner (PMHNP) - In Person - Columbia/Jefferson City, MissouriColumbia, MOOur clinical team includes trained psychiatry and psychology providers with a focus on tailored interventions to ensure quality of life for patients, a supportive environment that promotes mental well-being, interdisciplinary collaboration, and compliance with regulatory organizations. Advance your career to a whole new level providing much-needed healthcare services to underserved communities as a Psychiatric Mental Health Nurse Practitioner (PMHNP) with MTC Care, the nation's largest telehealth company!
Elevance Health IncNewNurse Care Manager I Elevance Health IncNurse Care Manager ISt. Louis, MORequires 3 years full-time equivalent of direct clinical care experience to the consumer, 5 years full-time equivalent of direct clinical care experience to the consumer preferred or any combination of education and experience, which would provide an equivalent background, Multi-state licensure is required if this individual is providing services in multiple states. The Nurse Care Manager I will be responsible for performing care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum.
Actalent IncNewClinical Review Nurse - Concurrent Review Actalent IncClinical Review Nurse - Concurrent ReviewSt. Louis, MORemote$34–$40 / hourIf you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market.
TriWest Healthcare AllianceProgram Integrity Clinical Specialist (RN or PA Req'd) TriWest Healthcare AllianceProgram Integrity Clinical Specialist (RN or PA Req'd)Kansas City, MORemoteFull timeTechnical Skills: Knowledge of TRICARE policies and procedures, knowledge of Case Management, Utilization Management, and Quality Management practices and principles, and knowledge of Managed Care concepts, alternative care treatments, and community resources. • Research and investigate medical issues as they relate to potential fraud and abuse cases, to include perform anti-fraud and abuse pre-payment reviews or post-payment reviews.
Elevance Health IncNewTransplant Nurse II Elevance Health IncTransplant Nurse IISt. Louis, MO$83,248–$104,060 / yearWithin the case management role will within the scope of licensure assess, develop, implement coordinate, monitor, and evaluate care plans designed to optimize member health care across the care continuum and ensuring member access to services appropriate to their specific health needs. Within the medical management role will collaborate with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources for more complex medical transplant issues.
Elevance Health IncNewNurse Case Manager II (US) Elevance Health IncNurse Case Manager II (US)St. Louis, MOThe Telephonic Nurse Case Manager II is responsible for care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
Elevance Health IncNurse Case Manager II Elevance Health IncNurse Case Manager IISt. Louis, MOThe Telephonic Nurse Case Manager II is responsible for care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
CVS Health CorpCase Manager, Registered Nurse - Fully Remote CVS Health CorpCase Manager, Registered Nurse - Fully RemoteMORemote$54,095–$155,538 / yearBenefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues.
Agape Care GroupNewRN Clinical Supervisor - Remote Agape Care GroupRN Clinical Supervisor - RemoteKansas City, MO, MissouriRemoteAs a regional leader in hospice and palliative care, Agape Care Group proudly serves patients through its family of care providers — Agape Care South Carolina, Georgia Hospice Care, Hospice of the Carolina Foothills in North Carolina, and ACG Hospice in Alabama, Kansas, Louisiana, Missouri, Oklahoma, and Virginia. We are looking for strong, compassionate clinical leaders to join our hospice team who are committed to creating meaningful patient experiences while supporting clinical excellence behind the scenes.
St. Mary's Medical CenterNewCase Manager Registered Nurse St. Mary's Medical CenterCase Manager Registered NurseBlue Springs, Missouri