Universal RN | Tues–Sat | Days InnovAgeUniversal RN | Tues–Sat | DaysAurora, Colorado$41.73–$54.28 / hourFull timeThis universal role supports participants in both clinic and in-home settings (as assigned), partners with the interdisciplinary team (IDT) to develop and execute individualized Plans of Care, and supports safe, efficient care delivery for frail and elderly participants. Conduct supervisory visits, care conferences, and periodic participant/caregiver check-ins; trend data and collaborate with the Home Care Manager and Nursing Services Director to ensure quality care delivery.
Behavioral Health Nurse-RN Signature HealthCARE of Monteagle Rehab & Wellness CenterBehavioral Health Nurse-RNMonteagle, TennesseeFull timeAbout Us: Signature HealthCARE of Monteagle Rehab & Wellness Center is a 150-bed skilled and intermediate nursing facility provides a safe, secure environment for those in need of medical care, and specializes in customized dementia and behavioral care for cognitively impaired residents. What you Need to make a Difference: Registered Nurse or Licensed Practical Nurse in good standing with state licensing board, or master’s degree specializing in Social Work and/or Licensed Social Worker with training in behavior, dementia and/or psychiatric care.
RN Case Manager Travel Integrated Resources, IncRN Case Manager TravelFairfield, CA$3,000–$3,500 / weekThe ideal candidate will be responsible for coordinating patient care across the continuum, ensuring appropriate utilization of healthcare resources, facilitating safe discharge planning, and collaborating with multidisciplinary teams to achieve optimal patient outcomes. We are seeking an experienced Travel RN Case Manager to join a leading acute care hospital in Fairfield, California.
Weekend RN - *Home Visits Interim HealthCareWeekend RN - *Home VisitsIndependence, KYTo qualify as a Registered Nurse Case Manager (RNCM) with us, you will need: · Licensure: Current unrestricted license to practice as a Registered Nurse (RN) in the state associated with this position. We take a patient-centric approach to address each individual’s mind, body, and spirit, our caregivers work tirelessly to help their patients and families find peace.
NewRN Case Manager - Home Health Interim HealthCareRN Case Manager - Home HealthCoraopolis, PA$80,000–$95,000 / yearTo qualify as a Registered Nurse Case Manager (RNCM) position with us, you will need: Licensure: Current unrestricted license to practice as a Registered Nurse (RN) in the state associated with this position. We take a patient-centric approach to address each individual's mind, body, and spirit, our caregivers work tirelessly to help their patients and families find peace.
RN Care Manager - Emergency Department (ED) - 26-00630 NavitasPartnersRN Care Manager - Emergency Department (ED) - 26-00630Bronx County, NY$52–$60 / hourThis role partners closely with physicians, nursing staff, and interdisciplinary teams to ensure safe, timely, and effective patient transitions across care settings while maintaining regulatory compliance and high-quality patient-centered care. About Navitas Healthcare, LLC certified WBENC and one of the fastest-growing healthcare staffing firms in the US providing Medical, Clinical and Non-Clinical services to numerous hospitals.
Case Manager RN Prime Healthcare Services IncCase Manager RNMission, TXRated one of the top hospitals in the country for clinical excellence in many services including maternity and orthopedic care, Mission Regional Medical Center has been offering quality healthcare, close to home, for over 60 years. Mission Regional Medical Center is a 297-bed, non-profit hospital that provides inpatient and outpatient hospital services to the people of the Rio Grande Valley.
RN Care Manager - Bilingual in Laotian AcuteCare Health System LLCRN Care Manager - Bilingual in LaotianFresno, CAProvide coordination and direct care as indicated to promote continued care in the community or promote optimal institutional care (Assisted Living, Nursing Home, Hospital, etc.) as needed. Teach participants, caregivers and families about self-care, medications, healthy lifestyles, infection control and safety to promote optimal health and safety.
RN Westchester Medical Center Health NetworkRNKingston, NY$48.49–$73.58 / hourJob Category Job Category Advanced Clincial Providers Advanced Practice Providers Allied Health Prof/Technical Clerical/Administrative Support clerical/Administrative Supportc Executive/Management Finance/Info Systems Nursing Support Nursing/Nursing Management Physicians Professional/Non-Clinical Service/Trades. Company Company Bon Secours Charity Medical Group Bon Secours Community Hospital Good Samaritan Hospital HealthAlliance Hospital Margaretville Hospital MidHudson Regional Hospital Mountainside Residential Care Center NorthEast Provider Solutions Inc.
Licensed Practical Nurse (LPN), Rehab, Evenings Beacon Health SystemLicensed Practical Nurse (LPN), Rehab, EveningsMILicensed Practical Nurse (LPN), Rehab, Evenings in Three Rivers, MI - Careers at Beacon Health System - Jobs in Healthcare Licensed Practical Nurse (LPN), Rehab, Evenings in Three Rivers, MI - Careers at Beacon Health System - Jobs in Healthcare. As a Licensed Practical Nurse (LPN), you'll bring a high level of knowledge and competency in performing nursing care procedures, assessments, treatment, and techniques and your advanced analytical skills are necessary to solve complex problems and make decisions related to patient care.
RN Care Manager - Exempt AcuteCare Health System LLCRN Care Manager - ExemptOceanport, NJPass a comprehensive criminal background check that may include, but is not limited to, federal and state Medicare/Medicaid exclusion lists, criminal history, education verification, license verification, reference check, and drug screen. Provide coordination and direct care as indicated to promote continued care in the community or promote optimal institutional care (Assisted Living, Nursing Home, Hospital, etc.) as needed.
Regional Infusion Nurse Manager ARCARERegional Infusion Nurse ManagerFayetteville, ARWhether caring for patients in the clinic, supporting operations behind the scenes, or serving communities through outreach and education, our teams are united by a shared purpose: delivering compassionate, accessible care that improves lives. Eligible clinical team members may qualify for federal loan repayment programs through HRSA, including the National Health Service Corps Loan Repayment Program and the Nurse Corps Loan Repayment Program.
Lead Primary Care Nurse - Coatesville Children's Hospital of PhiladelphiaLead Primary Care Nurse - CoatesvilleCoatesville, PA$44.25–$56.45 / hourPlans for and institutes practices that promote the organizations capacity to provide resources that ensure continuity of care among primary care, specialties, other disciplines and across health care systems. Partners with Nurse Manager to identify an execute annual unit-based quality improvement initiatives that result in a measurable impact on quality, cost and resource utilization.
RN Case Manager Mercy Medical Center IncRN Case ManagerBaltimore, MDThe RN Case Manager applies case management strategies to assess, plan, implement, coordinate, monitor and evaluate options and services to meet an individual's healthcare needs, through communication and the use of available resources to promote quality, cost effective outcomes. The RN Case Manager responsibilities include assessing clients needs, developing individualized care plans, coordinating with physicians, social workers and ancillary staff, and advocating for clients' rights and access to resources.
Behavioral Health Nurse-RN Signature HealthCARE LLCBehavioral Health Nurse-RNTNSignature HealthCARE of Monteagle Rehab & Wellness Center is a 150-bed skilled and intermediate nursing facility provides a safe, secure environment for those in need of medical care, and specializes in customized dementia and behavioral care for cognitively impaired residents. Registered Nurse or Licensed Practical Nurse in good standing with state licensing board, or master's degree specializing in Social Work and/or Licensed Social Worker with training in behavior, dementia and/or psychiatric care.
Psychiatric Nurse Practitioner - PRN- Watauga FRONTIER HEALTHPsychiatric Nurse Practitioner - PRN- WataugaJohnson City, TNMaintains knowledge of agency policy and procedures, especially as they relate to functions of this position in timely documentation, necessary assessments, patient medication education, lab work, and sample medicating. SUMMARY: Psychiatric Nurse Practitioner performs in an expanded role and practices based upon protocols that are established and approved by a physician who serves as a supervisor for the mid-level practitioner.
Specialty Reg Nurse (BMG) Beacon Health SystemSpecialty Reg Nurse (BMG)South Bend, INPerforms nursing functions specific to the specialty practice and as directed by the physician by: Assisting physicians with procedures specific to the specialty practice such as minor surgeries, pacemaker device interrogation and reprogramming, stress testing and associated patient monitoring, and nuclear medicine stress testing. Requires the advanced analytical skills necessary to assess the patient''s condition and needs, interpret data, solve patient-related problems, provide patient care throughout the planned treatment and to recognize medication allergic reactions (i.e., anaphylactic shock, adverse reactions, fever, chills, etc.).
Primary Care Medical Director (Nurse Practitioner), Boynton Health University of MinnesotaPrimary Care Medical Director (Nurse Practitioner), Boynton HealthMinneapolis, MNConsistent with the HC Pro 5 classification, this position exercises independent judgment in managing daily clinical operations, supervising providers, resolving operational issues, and implementing organizational priorities established by executive leadership. Working in partnership with the Executive Medical Director and other Medical Directors, this position implements strategic initiatives, supports quality improvement efforts, and provides leadership that promotes safe, efficient, and patient-centered care.
RN Hospice Adm/Benefits Coordinator - Hospice Peace HealthRN Hospice Adm/Benefits Coordinator - HospiceVancouver, WA$54.65–$82.66 / hourCoordinates home services admission activities by: assisting in the gathering of appropriate authorization and medical criteria to meet CMS guidelines for Home Health and Hospice services; demonstrating clinical knowledge of appropriate cause for referral and criteria for admission by evaluating referrals for suitability/eligibility and discussing with physician; identifying patient's physical, psychosocial and cultural needs in conjunction with referring source; providing resources appropriate to patient's age; setting up ancillary services, supplies and equipment needed to maintain patient's safety at home. Receives referrals and coordinates history and physical by completing intake information sheet, securing accurate demographics and directions; reviews information for appropriateness of referral and confirms insurance coverage; coordinates admission times; the core values are integrated comprehensively into the work environment; maintains current competency requirements, both initial and targeted.
Nurse CARE Manager, Wellness Center & Case Management Marriott International IncNurse CARE Manager, Wellness Center & Case ManagementBethesda, MDThe Nurse CARE Manager provides dual support through direct clinical care at the Marriott Headquarters Wellness Center and nurse case management (NCM) services for the Eastern Region Claims Services office. Demonstrated ability to apply strong communication, organizational, and critical thinking skills to assess patient needs, solve complex problems, and manage case workflows with a high level of efficiency and attention to detail.
RN Case Manager, 7W, 40 Hours (Days / 4x10 Hour Shifts / Every 6th Weekend) Boston Medical CenterRN Case Manager, 7W, 40 Hours (Days / 4x10 Hour Shifts / Every 6th Weekend)Boston, MA$38.05–$75.33 / hourPOSITION SUMMARY: Utilizing a collaborative process, the care manager will assess, plan, implement, monitor, and evaluate the options and services required to meet an individual's health needs, using communication and available resources to promote quality, cost-effective outcomes. The care manager helps identify appropriate providers and facilities throughout the continuum of services while ensuring that available resources are being used in a timely and cost-effective manner in order to obtain optimum value for both the patient and the reimbursement source.
Psychiatric Nurse Practitioner - Full Time - Norton FRONTIER HEALTHPsychiatric Nurse Practitioner - Full Time - NortonNorton, VASUMMARY: Psychiatric Nurse Practitioner performs in an expanded role and practices based upon protocols that are established and approved by a physician who serves as a supervisor for the mid-level practitioner. Assist in management of complex/high acuity clients by providing direct service or through mentoring, consultation with, and support of nurse practitioners without psychiatric mental health certification.
Nurse House Supervisor Trinity HealthNurse House SupervisorDES MOINES, IAAs a MercyOne Trinity Health Leader, the incumbent is expected to demonstrate leadership traits which support our Mission Statement and Core Values as identified below: Mission Statement: We, MercyOne Trinity Health, serve together in the spirit of the Gospel as a compassionate and transforming healing presence within our communities. Develops and maintains departmental staffing plan for all departments supervised, detailing appropriate employee classifications and qualifications consistent with the department's operational plan, projected volumes, patient/acuity and other relevant indicators.
Post Acute Clinical Program Manager (RN or LCSW) SNF Network FT Advocate Health and Hospitals CorporationPost Acute Clinical Program Manager (RN or LCSW) SNF Network FTCharlotte, North CarolinaFacilitates communication with post-acute providers at the skilled sites such as Nursing Home Administrators, Directors, Admissions staff, social services staff, nurses as well as Physicians SNF and Advance Practice Nurses. Manages and facilitate communication between the inpatient care managers, external care providers and outpatient care managers for patients transitioning in and out of the acute care setting and post-acute programs.
NewMDS Coordinator - Registered Nurse / Sequim, WA Avamere Skilled Advisors, LLCMDS Coordinator - Registered Nurse / Sequim, WASequim, WA$53–$63 / hourThe MDS Coordinator (Minimum Data Set Coordinator) is the primary point of contact for the review and coordination of patient care plans to promote quality care and services to residents. Voluntary Benefits: Life insurance, disability coverage, supplemental hospital, accident and critical illness coverage, Legal Services, Pet Insurance, discount programs and more.
Inpatient Care Navigator/Complex Care Navigator RN Or SW, Day Shift, Care Navigation Adventist HealthCareInpatient Care Navigator/Complex Care Navigator RN Or SW, Day Shift, Care NavigationSilver Spring, MD$71,932.12–$115,980.80 / yearNicotine products" include, but are not limited to: cigarettes, cigars, pipes, chewing tobacco, e-cigarettes, vaping products, hookah, and nicotine replacement products (e.g., nicotine gum, nicotine patches, nicotine lozenges, etc.). Those testing positive are given the opportunity to re-apply in 90 days, if they can truthfully attest that they have not used any nicotine products in the past ninety (90) days and successfully pass follow-up testing.
Temp RN Case Manager Santaclara Family Health PlanTemp RN Case ManagerSan Jose, CAThrough the development and implementation of member individualized care plans, the RN Case Manager provides medical and psychosocial case management support to help coordinate resources and services for individuals across the healthcare and social services continuum, and facilitate the use of available healthcare benefits in compliance with all applicable state and federal regulatory requirements, SCFHP policies and procedures, and business requirements. Maintenance of a valid California driver's license and acceptable driving record, in order to drive to and from offsite meetings or events; or ability to use other means of transportation to attend offsite meetings or events.
Case Manager Care Continuity Services RN - Care Continuity - UH Truman Medical Center (4 Days Per Week; 6A-4:30P) Truman Medical CentersCase Manager Care Continuity Services RN - Care Continuity - UH Truman Medical Center (4 Days Per Week; 6A-4:30P)Kansas City, MOYou'll assess individual needs, develop and implement personalized care plans, monitor progress, and advocate for the services and support that enable patients to achieve the best possible outcomes-clinically, functionally, and financially. In this role, you will identify patients who would benefit from case management services and coordinate care across the continuum by collaborating with patients, their support systems, and the multidisciplinary healthcare team.
Professional Development Specialist RN - Main IV Therapy - Full Time - Varies The Christ Hospital Health NetworkProfessional Development Specialist RN - Main IV Therapy - Full Time - VariesCincinnati, OHDemonstrates leadership skills such as the ability to motivate, educate, delegate, and mentor peers and other members of the healthcare team while effectively managing the care of patients and family members. Evidence also exists that shows the staff demonstrates those competencies that address the unique characteristics related to developmental, physical, psychosocial, mental, emotional, and social needs of patients across the life span.
Mount Sinai Hospital - RN Case Manager Interview Day - August 12 - Invite Only Mount Sinai Health SystemMount Sinai Hospital - RN Case Manager Interview Day - August 12 - Invite OnlyNew York, NYMount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time - discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics, top 5 in Cardiology/Heart Surgery, and top 20 in Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology.
RN Case Manager - PRN Summit Healthcare ExternalRN Case Manager - PRNShow Low, ArizonaThis employee must be service oriented and have excellent customer service skills, computer skills, critical thinking skills, problem-solving skills, organizational skills, multitasking skills, professional interpersonal skills, time management skills, the ability to prioritize work, the ability to work in a team, and telephone etiquette. This position requires operational knowledge of all equipment in the Care Resource Management department, including: fax, printers, copy machine, phone systems, and commonly used association-wide computer programs (including Hospital Information Systems, MS Office, e-mail, and internet).
Case Manager Registered Nurse UnitedHealth Group Inc.Case Manager Registered NurseBangor, ME$60,200–$107,400 / yearThe Care Manager, RN provides leadership in the coordination of patient-centered care across the continuum, develops a safe discharge plan through collaboration with the patients/caregivers and multidisciplinary healthcare team to arrange appropriate post discharge services and optimal transitions in care. Continuum of Care planning will emphasize education and collaboration with physicians, family members, clinical social workers, nursing staff, therapists, and case managers from contracted payors when appropriate to determine discharge plan that will be of maximum benefit to the patient.
Clinical Nurse Manager Gifford Health CareClinical Nurse ManagerRandolph, VTRequirements: Associates in Nursing Degree required, BSN preferred 2 years of Med/Surg nursing required Emergency Department and/or Critical Care experience preferred Current RN license in the state of VT BLS certification MOAB, ACLS, PALS and NRP obtained within 12 months of employment Gifford Health Care offers competitive compensation and a comprehensive benefits package. In addition to managing and coordinating direct care staff, the Clinical Nurse Manager acts as a key resource, leader, and liaison across all GHC staff, departments, providers, and partner organizations, ensuring the delivery of safe, efficient, and effective patient care while optimizing resource utilization.
RN Case Manager Shea HonorHealthRN Case Manager SheaScottsdale, ArizonaESSENTIAL FUNCTIONS Collaborates with patient/significant others as well as other members of the health care team in determining the appropriate level of care, utilization of resources and length of stay (utilizing electronic admission and discharge criteria program and physician input). Guides care coordination for high risk acute care patients, and facilitate the discharge plan for patients with medically complex post-acute care needs.
Oncology Research Nursing Professional (Rn), South Bay Cancer Center Stanford Health CareOncology Research Nursing Professional (Rn), South Bay Cancer CenterSan Jose, CA$83.98–$111.27 / hourThe Oncology Research Nursing Professional (ORNP) -is a Registered Nurse (RN) who works collaboratively with Clinical Research Staff including, but not limited to Physicians, Clinical Research Associates (CRA), APPs, Clinical Nurses, Pharmacists, and clinic staff to coordinate care for an assigned population of patients who are enrolled into cancer center clinical research trials. The ORNP works with the PIs on the assessment, management, and coordination of research patient care across the continuum of care (outpatient, inpatient and home) including triage of phone calls and proactive patient communication.
RN Care Coordinator (Case Manager) BWH Brigham and Women's HospitalRN Care Coordinator (Case Manager) BWHBoston, MA$41.71–$105.65 / hourSkills and Abilities Previous experience in a hospital or health care setting; bilingual (English/Spanish) preferred; strong clinical assessment skills; excellent interpersonal skills including ability to work collaboratively and cooperatively within a team and with internal and external customers; strong organizational skill and ability to set priorities; ability to compile data from concurrent and retrospective medical record review to determine clinical appropriateness, able to demonstrate the ability to meet a patient's needs based on their clinical diagnosis, level of care and discharge plan; ability to negotiate several aspects of care coordination simultaneously; excellent written and verbal communication skills. Utilizing industry accepted utilization and/or medical management criteria (InterQual) identifies, monitors and reports variances from established treatment plan, including appropriateness of admission, continued stay, delays in treatment, and discharge plan.
NewTravel Nurse RN - Administration / Management in Chico, CA Health Advocates NetworkTravel Nurse RN - Administration / Management in Chico, CAChico, CAThe Care Coordinator promotes and evaluates the effective utilization of resources using current clinical knowledge, awareness of community services, and assuming a leadership role with the patient care team to achieve optimal clinical and resource outcomes. In collaboration with the patient/family, multidisciplinary team including physicians and payors ensure the patient�s progress along with emergency episode of care in an efficient and cost effective manner for assigned case load.
RN Case Manager Serene HealthRN Case ManagerSan Diego, CA$90,000–$110,000 / yearAt Optima MMG and all of its divisions: Serene Health, Community Support, and American TrueCare, our mission is to provide comprehensive support and care that not only addresses immediate concerns but also fosters long-term well-being. The RN Clinical Case Manager provides clinical assessment, care plan development, and ongoing clinical oversight within the Enhanced Care Management (ECM) program.
RN Case Coordinator- Oncology BWH Brigham and Women's HospitalRN Case Coordinator- Oncology BWHBoston, MA$41.71–$105.65 / hourThis position requires a broad knowledge of clinical care and systems management, case management expertise, prudent nursing judgment, health care reimbursement, sound problem-solving skills, independent thinking, excellent organizational and interpersonal skills, creativity, flexibility, and the ability to multitask. Influences utilization of health care resources by providing direct care coordination to patients, encouraging enrollment in disease and case management programs, providing care coordination intervention and follow-up prior to and after interaction with health care system, e.g., inpatient, ED visit, outpatient services, etc.
Registered Nurse Care Coordinator- Inpatient Specialty Program - 8 Hour Days $5K Sign on Bonus Cedars-Sinai Medical CenterRegistered Nurse Care Coordinator- Inpatient Specialty Program - 8 Hour Days $5K Sign on BonusCalifornia, CACountry Code+1+1242+1246+1264+1268+1284+1340+1441+1473+1649+1664+1670+1671+1684+1758+1767+1784+1849+1868+1869+1876+1939+20+211+212+213+216+218+220+221+222+223+224+225+226+227+228+229+230+231+232+233+234+235+236+237+238+239+240+241+242+243+244+245+248+249+250+251+252+253+254+255+256+257+258+261+262+264+265+266+267+268+269+27+290+291+297+298+299+30+31+32+33+34+345+350+351+352+353+354+355+356+357+358+359+36+370+371+372+373+374+375+376+377+378+379+380+381+382+385+386+387+389+39+40+41+420+421+423+43+44+45+46+47+48+49+500+501+502+503+504+505+506+507+508+509+51+52+53+54+55+56+57+58+590+591+593+594+595+596+597+598+599+60+61+62+63+64+65+66+670+672+673+674+675+676+677+678+679+680+681+682+683+685+686+687+688+689+690+692+7+77+81+82+84+850+852+853+855+856+86+872+880+886+90+91+92+93+94+95+960+961+962+963+964+965+966+967+968+970+971+972+973+974+975+976+977+98+992+993+994+995+996+998Phone Number. Req ID 16285 Working Title Registered Nurse Care Coordinator- Inpatient Specialty Program - 8 Hour Days $5K Sign on Bonus Department Case Management Business Entity Cedars-Sinai Medical Center Job Category Patient Services Job Specialty Case Management Additional Locations Los Angeles,CA,United States Overtime Status NONEXEMPT Primary Shift Day Shift Duration 8 hour Base Pay $55.11 - $88.18.
Intensive Community Manager, Complex Care (RN) ChenMed LLCIntensive Community Manager, Complex Care (RN)Jacksonville, FL$36.90–$52.70 / hourResponsibilities include all the above "Core" duties/responsibilities plus the following: Provides telephonic or outpatient visits to patients at high-risk for readmissions (as identified by CM Plan) to the ER or hospital, to patients with active care planning requirements, to disease management patients per the Disease Management Plan and to others as referred via transitional care team, acute case managers and Transitional Care team. The Nurse Case Manager 1 (RN) role also involves establishing relationships with patients' families and care givers, primary care physicians, specialists, other care providers, social workers, other case managers and nurses, acute and post-acute facilities, home health care companies, and health plans.
Clinical Appeals Nurse (Remote) Blue Cross and Blue Shield AssociationClinical Appeals Nurse (Remote)DCRemote$67,320–$133,705 / yearESSENTIAL FUNCTIONS: Investigates, interprets, and analyzes written appeals and reconsideration requests from multiple sources including applicants, subscribers, attorneys, group administrators, internal stake holders and any other initiators. Investigates, interprets, analyzes and prioritizes appeal requests using nursing expert knowledge and all available clinical information for both medical and behavioral health conditions, as well as medical policies, to determine if the adverse coverage and adverse decisions are appropriate.
Case Manager (RN) - Inpatient - 0.8 FTE, 08-hr, Day Shift Stanford Health CareCase Manager (RN) - Inpatient - 0.8 FTE, 08-hr, Day ShiftPalo Alto, CA$96.35–$111.14 / hourOther - Participates in department program planning, goal setting, systems development and process improvement; participates in department and hospital committees and task forces; develops and maintains documentation of findings, discharge arrangements, and actions taken according to departmental guidelines; prepares and maintains records as required; collects, analyzes and reports on data for utilization, quality improvement, compliance, and other areas as assigned. Monitors patients' length of stay and collaborates with physicians to ensure resource utilization remains within covered benefits and are appropriate in relationship to the patient's clinical and psychosocial needs; plans and implements (through multi-disciplinary meetings or rounds) strategies to reduce length of stay, reduce resource consumption, and achieve positive patient outcomes, analyzes and addresses aggregate variances as well as variances for individual patients and shares this information with staff, physicians, and administration.
NewDirector of Clinical Quality & Safety Improvement (CA RN License is MUST) Macpower Digital Assets Edge Private LimitedDirector of Clinical Quality & Safety Improvement (CA RN License is MUST)Los Angeles, CA$178,500–$215,000 / yearBachelor degree in Business Administration, Health Care Administration, Nursing, Public Health, or related field AND Minimum eight (8) years of experience in health care quality assurance/improvement or directly related field OR Minimum eleven years of experience in health care quality assurance/improvement or a directly related field. Oversees the operation of multiple units within a department by identifying member and operational needs; ensures the management of work assignment completion; translates business strategy into actionable business requirements; ensures products and/or services meet member requirements and expectations while aligning with organizational strategies.
NewMDS Nurse - Sign On Bonus Regency at FremontMDS Nurse - Sign On BonusFremont, MIIs prepared to conduct PPS meetings maintaining MDS assessments per Medicare schedule and maintains PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management Coordinator. See Ciena Healthcare Management Privacy Policy at https://apploi.com/privacy_policy/ and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions.
Utilization Review Nurse Advocate Aurora Health IncUtilization Review NurseAurora, CO$35.50–$53.25 / hourProviding care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise.
Utilization Review RN- Care Coordination- Full Time SolutionHealthUtilization Review RN- Care Coordination- Full TimeManchester, NHBy developing individualized care plans, facilitating smooth transitions between care settings, and offering proactive support, we help patients navigate complex healthcare needs while improving overall access to high-quality, coordinated care. Our team is dedicated to care management, discharge planning, and patient advocacy, working closely with providers, social workers, and community resources to enhance patient outcomes.
Case Manager (RN) - PRN Houston MethodistCase Manager (RN) - PRNPEOPLE ESSENTIAL FUNCTIONS Collaborates with the physician and all members of the interprofessional health care team to facilitate care for designated case load; monitors the patient’s progress, intervening as needed to ensure that the plan of care and services provided are patient-focused, high quality, efficient, and cost-effective; facilitates timely: • completion and reporting of diagnostic testing; • completion of treatment plan and discharge plan; • modification of plan of care, as necessary, to meet the ongoing needs of the patient; • assignment of appropriate levels of care; • completion of all required documentation in EPIC and MIDAS. Also, on the beautiful hospital campus, located at the intersection of Interstate 45 and Texas State Highway 242, are two medical office buildings, which include a Breast Care Center; Cancer Center; infusion center; heart and vascular services; neurology; orthopedics and sports medicine; rehabilitation services; wellness services; an outpatient laboratory; and several other multispecialty physician practices.
Nurse Reviewer 1 Elevance HealthNurse Reviewer 1Atlanta, GAMinimum Requirements: Requires AS in nursing and minimum of 3 years of clinical nursing experience in an ambulatory or hospital setting or minimum of 1 year of prior utilization management, medical management and/or quality management, and/or call center experience; or any combination of education and experience, which would provide an equivalent background. Through work experience and mentoring learns to conduct medical necessity clinical screenings of preauthorization requests to assess the medical necessity of diagnostic imaging procedures, out of network services, and appropriateness of treatment.
Appeals & Grievance RN Wollborg Michelson RecruitingAppeals & Grievance RNOakland, CAUtilize National Coverage Determination (NCD), Local Coverage Determination (LCD), Milliman Care Guidelines, and other nationally recognized clinical guidelines such as NCCN and ACOG. This role is responsible for concurrent review of medical records and documentation, determining appropriate outcomes, and ensuring members have quality access to provider care.