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Nurse Case Mgr Jobs

Case Management - Nurse, Senior
By Blue Shield of California At , Rancho Cordova, 95670 $85,360 - $128,040 a year
Certified Case Manager (CCM) Certification or is in process of completing certification when eligible based on CCM application requirements
Provide Referrals to Quality Management (QM), Disease Management (DM) and Appeals and Grievance department (AGD)
Requires at least 5 years of prior experience in nursing, healthcare or related field
Extensive knowledge of evidenced based clinical practice guidelines particularly for chronic conditions.
Knowledge of Coordination of Care, Medicare regulations, prior authorization, level of care and length of stay criteria sets desirable.
Design appropriate and fiscally responsible plan of care with targeted interventions that enhance quality, access and cost-effective outcomes
Nurse Case Coordinator Jobs
By NYU Langone At , New York, 10016 $88,979 - $126,399 a year
Care Coordination and Case Management for WTC responders
Assess active members for case-management service needs as clinically indicated
Develops Intensive case management Plan of Care and necessary follow-ups
Coordination with case management for post-discharge outreach
Address the unique health care needs of individual members and improve member satisfaction with the Program
Review of authorizations for medical necessity (prior authorization/prospective reviews and retrospective authorizations) as related to member’s WTC certified condition(s)
Case Management - Nurse, Senior
By Blue Shield of California At , $85,360 - $128,040 a year
Certified Case Manager (CCM) Certification or is in process of completing certification when eligible based on CCM application requirements
Provides Referrals to Quality Management (QM), Disease Management (DM) and Appeals and Grievance department (AGD).
A minimum of 1 year experience in inpatient, outpatient or managed care environment required
Health insurance/managed care experience desired.
Requires at least 5 years of prior experience in nursing, healthcare or related field
Transitions of care experience desired
Nurse Case Mgr Jobs
By Sentara Healthcare At , Norfolk, 23502
Keywords: nursing, discharge planning, managed care, case management, RN, nurse, health plan, health care, Indeed, Monster
Nursing experience 3 years required
Sentara Health Plans is currently seeking a full-time, Nurse Case Manager
Associates or Bachelor’s Degree in Nursing
Registered Nurse License (RN) - Virginia
Registered Nurse License (RN) - Compact/Multi-State License
Sr Nurse Case Analyst (Remote)
By CSX At ,
Knowledge of FRA Conductor and Engineer certification requirements
Review medical qualification of new hires, job transfers and certification examinations
Miscellaneous activities and responsibilities as assigned by manager
Knowledge of FRA drug testing requirements
Knowledge of Commercial Driver's License (CDL) medical requirements
3 or more years of work experience in the medical field
Sr Nurse Case Analyst (Remote)
By CSX At United States
Knowledge of FRA Conductor and Engineer certification requirements
Review medical qualification of new hires, job transfers and certification examinations
Miscellaneous activities and responsibilities as assigned by manager
Knowledge of FRA drug testing requirements
Knowledge of Commercial Driver's License (CDL) medical requirements
3 or more years of work experience in the medical field
Nurse Case Manager/Ukhc
By University of Kentucky At , Lexington, Ky $54,080 - $95,056 a year
Skills / Knowledge / Abilities
Nurse Case Manager - ELIGIBLE FOR RECRUITMENT BONUS
Does this position have supervisory responsibilities?
A minimum of three years of experience providing patient care as a BSN, RN.
Click here for more information about equivalencies:
Monday through Friday, (8:00 am – 4:30 pm); occasional weekends and/or holidays required.
Telephonic Nurse Case Mgr Ii
By Elevance Health At , Costa Mesa, Ca $70,320 - $126,576 a year
Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.
Certification as a Case Manager is preferred.
Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
Minimum 2 years’ experience in acute care setting.
Nurse Case Mgr Ii
By Elevance Health At Phoenix, AZ, United States
Preferred Skills, Capabilities, And Experiences
Monitors and evaluates the effectiveness of the care management plan and modifies, as necessary.
Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.
Assists with the development of utilization/care management policies and procedures.
Certification as a Case Manager is preferred.
Prior managed care experience is strongly preferred.
Nurse Case Manager Jobs
By Actalent At Happy Valley, OR, United States
This position is remote* Must sit within 50 miles of Portland
Maintaining an inclusive environment through persistent self-reflection
Building a culture of care, engagement, and recognition with clear outcomes
Ensuring growth opportunities for our people
DE&I Are Embedded Into Our Culture Through
Nurse Case Manager Jobs
By Actalent At Beaverton, OR, United States
Maintaining an inclusive environment through persistent self-reflection
Building a culture of care, engagement, and recognition with clear outcomes
Ensuring growth opportunities for our people
DE&I Are Embedded Into Our Culture Through
Field Nurse Case Manager
By EagleOne Case Management Solutions At Anaheim, CA, United States
Previous case management experience a plus
Understands and demonstrates the ability to apply Eagle One™ case management protocols
Utilizes appropriate cost management programs per account or company protocol (i.e., Pharmacy, DME, etc.)
Consults with Manager on case strategy as needed
Carbon copies the Manager on any documentation relating to initial assignment, claim barriers/complex cases or any case resolution issues
Alerts Manager of any requests to deviate from Eagle One™ or account specific protocols and obtains approval to proceed as necessary
Case Manager Nurse Jobs
By Clinical Management Consultants At Redondo Beach, CA, United States

A nearly 450 bed medical center in southern LA County is seeking a Nurse Case Manager. The RN Case Manager will enjoy the supportive environment at this hospital that is part of a regional healthcare ...

Case Mgr - Rn - Outpatient Wound Healing
By St. Bernards Healthcare At Jonesboro, AR, United States

Current licensure or permit as a registered nurse in the state of Arkansas.

This is a safety sensitive position. Please see the St. Bernards Substance Abuse Policy for further information.

Case Management Nurse Jobs
By Solis Health Plans At Doral, FL, United States
Provides patient education on self-management of chronic conditions, medication management, preventive care, and healthcare navigation.
Works closely with the health plan's utilization management team to ensure that services are authorized and reimbursed appropriately.
3 years of clinical experience as an RN in acute care, community, or home health settings, and
Knowledge of evidence-based clinical guidelines, care coordination and integration models, healthcare systems and policies, and quality improvement methods.
Conducts comprehensive assessments of patients with complex medical needs to identify their physical, psychological, social, and environmental needs.
Maintains accurate and timely documentation of patient assessments, care plans, interventions, and outcomes, using electronic health record systems.
Compone Case Mgr Admin Asst Ft - 1St Shift (Located At Cochran Center Off Wall Triana Blvd)
By Huntsville Hospital At Huntsville-Decatur-Albertville Area, United States
Education & Professional Development : https://www.huntsvillehospital.org/education
Life In Huntsville : https://www.huntsvillehospital.org/about-huntsville-al
Best Regional Hospital and #2 in Alabama by U.S. News & World Report
Learn More About Huntsville Hospital Health System
Nurse Case Manager I
By Elevance Health At , Miami, Fl
Preferred Qualifications, Skills & Experiences:
Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.
Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
Job Family: Medical and Clinical
Case Manager 2 - (Us) - Case Mgr Vbqp
By FRESENIUS At , San Juan, 00917, Pr
Utilizes effective telephonic case management skills to maximize patient engagement and compliance.
Promotes, advances, and assists with implementation of FMS clinical, educational and quality initiatives as they relate to the case management department.
1 year of case management experience required.
Certification in case management required.
Demonstrated skills in diversity management and performance management.
A fundamental knowledge of managed care a plus.
Return To Work Case Mgr Trainee
By The Travelers Companies, Inc. At , Charlotte, Nc $46,200 - $76,200 a year
Bachelor’s Degree preferred or a minimum of 2 years of work OR customer service related experience preferred.
Verbal and written communication skills –Intermediate
High School Diploma or GED and one year of customer service experience OR Bachelor’s Degree required.
The on the job training includes practice and execution and coaching on the following core assignments:
Pursue all offset opportunities, including apportionment, contribution and subrogation. Evaluate claims for potential fraud.
Participate in Telephonic and/or onsite File Reviews.
Nurse Case Manager Jobs
By Halifax Health At Daytona Beach, FL, United States
Ability to prioritize assignments and effective time-management skills
Three years acute care experience in a hospital setting; one year as a utilization review nurse preferred
Demonstrates effective interpersonal and communication skills
Basic knowledge of clinical and psychosocial aspects of patient care
Demonstrates skills in planning, organizing, and managing multiple functions and complex processes
Excellent verbal and written communication skills required