Utilization Management Nurse Jobs in Mississippi
Yale New Haven Health
Oxford, MS
Demonstrates Competency In The Care Of The Neuro Patient Demonstrates Skill And Knowledge In Neuro Assessment Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient Demonstrates Skill And Understanding In Caring For A Trached Patient Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro Procedures Demonstrates Knowledge And Understanding Of Our 'Tia' Teaching Program Performs Pharynaeal, Endotracheal, Tracheostomy Suctioning According To Established Policy And Procedure: Pharynaeal, Endotracheal, Tracheastomy Demonstrates Skill And Understanding In The Use Of Equipment And Care Of Patient In A Halo Brace Demonstrates Skill And Understanding Of Nursing Responsibilities And Interventions For The Patient On A Ventilator Qualifications EDUCATION Graduate Of An Accredited School Of Nursing; BSN Preferred. EXPERIENCE N/A LICENSURE Valid State Of Connecticut Registered Nurse License SPECIAL SKILLS BLS Required Additional Information Med/Surg RN experience required.
Yale New Haven Health
Oxford, MS
Demonstrates Competency In The Care Of The Neuro Patient # Demonstrates Skill And Knowledge In Neuro Assessment # Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient # Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro Procedures # Performs Pharynaeal, Endotracheal, Tracheostomy Suctioning According To Established Policy And Procedure: Demonstrates Skill And Understanding In The Use Of Equipment And Care Of Patient In A Halo Brace # Demonstrates Skill And Understanding Of Nursing Responsibilities And Interventions For The Patient On A Ventilator Graduation from an accredited school of nursing. Heart and Vascular Cardiac ICU (5-1 SP) The Cardiac ICU is a fast paced, high acuity, 14-bed, critical care unit that cares for adult patients with complex cardiac, medical diagnoses such as myocardial infarction, cardiogenic shock, unstable arrhythmias, and heart failure.
Yale New Haven Health
Oxford, MS
Demonstrates Competency In The Care Of The Neuro Patient Demonstrates Skill And Knowledge In Neuro Assessment Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient Demonstrates Skill And Understanding In Caring For A Trached Patient Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro Procedures Demonstrates Knowledge And Understanding Of Our 'Tia' Teaching Program Performs Pharynaeal, Endotracheal, Tracheostomy Suctioning According To Established Policy And Procedure: Pharynaeal, Endotracheal, Tracheastomy Demonstrates Skill And Understanding In The Use Of Equipment And Care Of Patient In A Halo Brace Demonstrates Skill And Understanding Of Nursing Responsibilities And Interventions For The Patient On A Ventilator Qualifications EDUCATION: Graduation from an accredited school of nursing. Additional Information Heart and Vascular Cardiac ICU (5-1 SP) The Cardiac ICU is a fast paced, high acuity, 14-bed, critical care unit that cares for adult patients with complex cardiac, medical diagnoses such as myocardial infarction, cardiogenic shock, unstable arrhythmias, and heart failure.
Yale New Haven Health
Oxford, MS
Develops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process. The Registered Nurse (Rn) Assesses, Plans, Implements, Evaluates And Supervises Individual Patient Care On A Nursing Unit/Department According To Unit Policies And Procedures.
Yale New Haven Health
Oxford, MS
Demonstrates Competency In The Care Of The Neuro Patient Demonstrates Skill And Knowledge In Neuro Assessment Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient Demonstrates Skill And Understanding In Caring For A Trached Patient Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro Procedures Demonstrates Knowledge And Understanding Of Our 'Tia' Teaching Program Performs Pharynaeal, Endotracheal, Tracheostomy Suctioning According To Established Policy And Procedure: Pharynaeal, Endotracheal, Tracheastomy Demonstrates Skill And Understanding In The Use Of Equipment And Care Of Patient In A Halo Brace Demonstrates Skill And Understanding Of Nursing Responsibilities And Interventions For The Patient On A Ventilator Qualifications EDUCATION: Graduation from an accredited school of nursing. Additional Information Heart and Vascular Cardiac ICU (5-1 SP) The Cardiac ICU is a fast paced, high acuity, 14-bed, critical care unit that cares for adult patients with complex cardiac, medical diagnoses such as myocardial infarction, cardiogenic shock, unstable arrhythmias, and heart failure.
Methodist Le Bonheur Healthcare
Hernando, MS
Working at MLH means carrying the mission forward of caring for our community and impacting the lives of patients in every way through compassion, a deliberate focus on service expectations and a consistent thriving for excellence. The Associate is required to have close visual acuity including color, depth perception, and field of vision to perform an activity, such as assessing patients, preparing and analyzing data and figures; transcribing; viewing a computer terminal; or extensive reading.
Humana
$71100 - $97800
Jackson, MS
The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for members. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it.
Humana
$71100 - $97800
Jackson, MS
As a Utilization Management RN working on the OneHome/Home Solutions UM Team, you will have the opportunity to use your clinical knowledge, communication skills, and independent critical thinking skills to ensure value-based care for members who desire to heal at home. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it.
Dane Street
Meridian, MS
Our organization is a URAC accredited leader in IME and Record Review services, currently working with over 170 Work Comp, Disability, Group Health, Auto Liability Carriers, Third Party Administrators, Managed Care Organizations, Employers, Pharmacy Benefit Managers, and Medicare Set-Aside providers to provide customized peer review and IME programs which assist their RN's and adjustors in reaching appropriate medical determinations as part of the claims management process. We process over 200,000 insurance claims annually for leading national and regional Workers’ Compensation, Disability, Auto and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers and Pharmacy Benefit Managers.
Dane Street
Hattiesburg, MS
Our organization is a URAC accredited leader in IME and Record Review services, currently working with over 170 Work Comp, Disability, Group Health, Auto Liability Carriers, Third Party Administrators, Managed Care Organizations, Employers, Pharmacy Benefit Managers, and Medicare Set-Aside providers to provide customized peer review and IME programs which assist their RN's and adjustors in reaching appropriate medical determinations as part of the claims management process. We process over 200,000 insurance claims annually for leading national and regional Workers’ Compensation, Disability, Auto and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers and Pharmacy Benefit Managers.
Baptist Memorial Health Care
Jackson, MS
Has direct supervisory accountability for all positions, employees, operations, and activities within the assigned patient care area; including coordination staff training, assigning and reviewing work, and evaluating performance independently or in conjunction with a higher-level supervisor/manager. Acts as a change agent, evaluating present systems and creating efficient, effective systems as necessary.
Baptist Memorial Health Care
Jackson, MS
Assumes accountability for the overall financial management of the department including but not limited to capital and operational budgeting, variance analysis as well as management of resources. Assists in creating a culture of optimism that focuses on serving as the patient’s advocate, providing patient-centered care and prudent resource utilization.
Dane Street
Gulfport, MS
Our organization is a URAC accredited leader in IME and Record Review services, currently working with over 170 Work Comp, Disability, Group Health, Auto Liability Carriers, Third Party Administrators, Managed Care Organizations, Employers, Pharmacy Benefit Managers, and Medicare Set-Aside providers to provide customized peer review and IME programs which assist their RN's and adjustors in reaching appropriate medical determinations as part of the claims management process. We are currently recruiting board certified physicians with an active/unrestricted license for the following services: Anesthesia/Pain Management or Physical Medicine/Pain licensed in Mississippi (Retrospective Record Reviews for Auto and Work Comp Claims).
Baptist Memorial Health Care
Southaven, MS
Manages the care for a specific group of patients; facilitates the safe movement of patients through the continuum of care, ensures optimal utilization of resources, service delivery and compliance with external review agencies, local, state, and federal requirements. Build on the discharge planning assessment in developing, coordinating, implementing and revising a care plan to ensure good transition management and continuity of care (LOS, discharge delays), cost reduction and patient self-management (patient activation).
Baptist Memorial Health Care
Jackson, MS
Provide individual patient/family education and self-management support that is appropriate based on language, cognitive abilities, literacy level, learning style, cultural norms, patient preference, readiness for change and resources available. Assist with and facilitate the transition of care from inpatient settings such as hospital, rehabilitation facilities and skilled nursing facilities to home.
Highmark Health
Jackson, MS
This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate resource utilization, identification of opportunities for referral to a Health Coach/case management, and identification and resolution of quality issues. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy._.
United Therapeutics
$168000 - $220000
Jackson, MS
Serve as an educational resource deployed to help ensure that physicians, nurses and other allied healthcare professionals are educated on PAH disease state and identify educational gaps that exist in the PAH space (e.g disease progression, risk stratification, therapies, clinical considerations etc.) and work to increase awareness around those identified gaps. + Ability to work independently and efficiently with minimal oversight; experience using time management skills such as prioritizing/organizing and tracking details while meeting deadlines of multiple projects without varying completion dates while traveling.
Baptist Memorial Health Care
Southaven, MS
Communicates with Case Managers and Social Workers to optimize the utilization/case management processes. Participates in discharge planning activities in collaboration with Case Managers/Social Workers.
Manhattan NRC LLC
Jackson, MS
Perform various duties to provide quality nursing care to residents to maintain or attain the highest practical level of functioning and to coordinate total nursing care for the residents as illustrated by the following: Assesses residents who have had an accident or incident that results in injury or any unusual event; documents findings as per Resident Care Manual Policy. Makes daily rounds in areas of nursing care under his/her supervision, visiting each unit to evaluate overall unit performance, and to receive comments relating to the residents needs and problems, and implement necessary changes.
Evolent
$32 - $37
Jackson, MS
Tasks are performed within the RN/LVN/LPN scope of practice, under Medical Director direction, using independent nursing judgement and decision-making, physician-developed medical policies, and clinical decision-making criteria sets. We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router.
Community Health Systems
Vicksburg, MS
If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to http://www.chs.net/serving-communities/locations/ to obtain the main telephone number of the facility and ask for Human Resources. + Collaborates with interdisciplinary teams (IDT) to ensure effective communication and coordination of patient care, including identifying avoidable days and resolving care transition issues.
Community Health Systems
Vicksburg, MS
If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to http://www.chs.net/serving-communities/locations/ to obtain the main telephone number of the facility and ask for Human Resources. + Collaborates with interdisciplinary teams (IDT) to ensure effective communication and coordination of patient care, including identifying avoidable days and resolving care transition issues.
Intermountain Health
$18.81 - $27.45
Jackson, MS
Ongoing need for employee to see and read information, labels, assess patient needs, operate monitors, identify equipment and supplies.- and -Frequent interactions with patient care providers, patients, and visitors that require employee to verbally communicate as well as hear and understand spoken information, alarms, needs, and issues quickly and accurately, particularly during emergency situations.- and -Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy. 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.
Lakeland NRC LLC
Jackson, MS
Provides hands on nursing care to residents as needed as a registered professional nurse, consistent with the state’s Nurse Practice Act. Certified Nursing Assistant, Licensed Practical Nurse and Registered Nurse, as needed.
Cardinal Health
$91400 - $130600
Jackson, MS
Clinical Operations is responsible for supporting the timely and quality sale, installation and monitoring of Cardinal Health products and services may also provide product and service education to facilitate technology adoption and workflow change management. Support Customers Clinically to Drive Competitive Differentiation:Conduct state of the art Live/Virtual trainings for external/internal customers and provide relevant clinical knowledge tools/support.
Monogram Health
Greenville, MS
Provide clinical guidance and direction to Market teams to drive Population Health Management activities, including identifying and intervening on High-Risk Patients, formulating strategies to reduce admissions/readmissions, complete quality post hospital discharge visits, and improving the quality of visits. Reporting to the Region President, the Market Physician Executive (MPE) is a key clinical leader within Monogram Health who contributes to the development and oversight of clinical strategies, policies, programs, processes, protocols, guidelines, and operations that drive improved patient health outcomes within the market.
Baptist Memorial Health Care
Southaven, MS
Manages the care for a specific population; facilitates the safe transition of patients throughout the continuum of care for appropriate utilization of resources, service delivery and compliance with federal and other payer requirements. For two consecutive years, Baptist has won a Best in Benefits award for offering the best benefit plans compared with their peer groups.