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Nurse Consultant Telephonic Case Management Jobs

Telephonic Case Manager Rn - Richardson, Tx
By Optum At , Richardson, 75081
Provide patient education to assist with self-management
Experience in a leadership, account management or client facing role
Support members with condition education, medication reviews and connections to resources such as Home Health Aides or Meals on Wheels
3+ years of experience in a hospital, acute care or direct care setting
Experience or exposure to discharge planning
Experience in discharge planning or utilization review
Telephonic Nurse Case-Manager – Rn Or Lpn – Workers’ Compensation
By Brown & Brown Insurance At ,
Case-management experience desired – Workers’ Comp preferred.
Developing case management care plan.
Managing the file proactively, utilizing all appropriate case management tools.
Ensuring education is provided to the injured employee.
RN or LPN with a minimum of three years clinical experience (medical-surgical, orthopedic, neurological, ICCU, industrial, ER or occupational).
Maintains knowledge of current trends, standards and law changes.
Case Management - Nurse, Consultant
By Blue Shield of California At , Long Beach $109,120 - $163,680 a year
Certified Case Manager (CCM) Certification or is in process of completing certification when eligible based on CCM application requirements
Assumes supervisor day to day responsibilities in manager’s absence and under the direction of the manager
A minimum of 3+ year experience in inpatient, outpatient or managed care environment required
Health insurance/managed care experience desired.
Requires at least 7 years of prior experience in nursing, healthcare or related field
Transitions of care experience desired
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
Telephonic Case Manager - Remote | Wfh
By Get It Recruit - Healthcare At Chappells, SC, United States

Compassionate Care Coordination: Utilize your exceptional clinical expertise and superb organizational skills to assess patient needs, develop comprehensive care plans, and coordinate all aspects of ...

Telephonic Case Manager - Remote | Wfh
By Get It Recruit - Healthcare At Cayce, SC, United States

As a Remote RN Case Management Specialist, you'll play an integral role in orchestrating and advocating for the comprehensive care needs of patients. By delivering outstanding medical services, ...

Manager, Case Management Nurse Management
By Blue Shield of California At , Long Beach $109,120 - $163,680 a year
Comprehensive knowledge of case management, discharge planning, utilization management and community resources. Strong supervisory, communication and negotiation skills.
Certified Case Manager (CCM) Certification or is in process of completing certification when eligible based on CCM application requirements
Case Management, Quality or other equivalent certification that is related to the specific area to be managed is required.
Establish operational objectives for department or functional area and participate with other managers to establish group objectives
Be responsible for team, department, or functional area results in terms of planning, cost in collaboration with Sr Manager
Participate in the development and implementation of the annual budget under the direction of the Director
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
Consultant - Mhpss Consultant - Protection Case Management
By International Rescue Committee At , New York
Demonstrated experience in pedagogical skills and learning principles
Project Background: Global Protection Case Management Initiative
Participate in working sessions with IRC focal points to brainstorm and finalize key MHPSS content for consultants deliverables – 1 day
Develop content on focused, non-specialized MHPSS interventions for caseworkers for revised PCM Guidance – 6 ½ days
Flexible work attitude, with the ability to follow direction and work independently across a virtual work environment
Fluent in English (verbal and written)
Manager, Case Management Nurse Management
By Blue Shield of California At , Woodland Hills, 91367 $109,120 - $163,680 a year
Comprehensive knowledge of case management, discharge planning, utilization management and community resources. Strong supervisory, communication and negotiation skills.
Certified Case Manager (CCM) Certification or is in process of completing certification when eligible based on CCM application requirements
Case Management, Quality or other equivalent certification that is related to the specific area to be managed is required.
Establish operational objectives for department or functional area and participate with other managers to establish group objectives
Be responsible for team, department, or functional area results in terms of planning, cost in collaboration with Sr Manager
Participate in the development and implementation of the annual budget under the direction of the Director
Telephonic Case Manager Rn - Arizona - Remote
By Optum At , Phoenix, 85040
Provide patient education to assist with self-management
Experience in utilization review, concurrent review and/or risk management
Certified Case Manager (CCM) or the ability to obtain certification within 18 months of employment
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
Identify gaps or barriers in treatment plans
Interact with Medical Directors on challenging cases
Telephonic Nurse Case Manager
By ICW Group At ,
Certification in case management, rehabilitation nursing or a related specialty is strongly preferred.
Creates a case management plan based on the assessment with measurable goals and objectives utilizing evidence-based criteria.
Implements plan through case management interventions and communication with all parties to reach desired goals and objectives.
Maintains accurate record of management including costs, savings and demographic data.
Equivalent combination of education and experience may be considered.
Minimum 2 years of professional experience providing direct clinical care required.
Telephonic Case Manager (Rn) - Tx Only
By Molina Healthcare At , Dallas, Tx $26.41 - $51.49 an hour

Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

To all current Molina employees:

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.
Telephonic Case Manager Jobs
By Sedgwick At , Salt Lake City, Ut
We offer a diverse and comprehensive benefits including medical, dental vision, 401K, PTO and more beginning your first day.
Celebrate your career achievements and each other through professional development opportunities, continuing education credits, team building initiatives and more.
Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.
Enable our Caring counts® mission supporting injured employees from some of the world’s best brands and organizations.
Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
Effectively communicates and builds relationships with the claims’ examiner, client, injured worker, attorney and supervisor.
Telephonic Registered Nurse (Rn) Case Manager - Remote
By Commonwealth Care Alliance At , Providence, 02903, Ri
Provide regularly scheduled telephonic calls to support the management of chronic disease or end of life.
Provide services via telehealth technologies (video, chat, etc.) for clinically appropriate clinical care and care management services.
Assist the member with understanding their CCA Health Benefit package.
Coordinate a host of benefits such as transportation, community resources, interpreter services, hospice services, and more.
Manage panel-wide and member-specific utilization trends.
Participate in activities and education to maintain and advance competency.
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.
Nurse Consultant Telephonic Case Management
By Gallagher At , Rolling Meadows, 60008, Il

Click Here to review our U.S. Eligibility Requirements

Nurse Consultant Telephonic Case Management
By Gallagher At , Dallas, 75251, Tx

Click Here to review our U.S. Eligibility Requirements