- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist LVN II...implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist LVN II will...oversight, and/or CNA experience. At least 2 years of Utilization Management/ Case Management experience in a hospital… more
- Universal Health Services (Palmdale, CA)
- …plan with company match + SoFi Student Loan Refinancing Program Essential Job Duties: The Case Manager , a Licensed Vocational Nurse, under the Director of C ase ... and his family. This person is the expert on issues related to utilization review and discharge planning. Qualifications Requirements: + Ability to read, analyze,… more
- CVS Health (Albany, NY)
- …team will review prior claims to address potential impact on current case management and eligibility status. Focus assessments and/or questionnaires are designed to ... driven timelines. Utilizes weekly and daily reporting to identify utilization for the purpose of reducing Emergency Department ...years LPN nursing experience + Unrestricted and active Compact LPN/ LVN licensure in New Jersey or New York Preferred… more
- Emanate Health (Glendora, CA)
- …Excellent customer service skills required. **Minimum License Requirement:** Current California LVN License. BLS. Other certification in Case Management ... the care and services of selected patient populations. Promotes effective utilization and monitoring of health care resources. Interacts with the Emergency… more
- Universal Health Services (Riverside, CA)
- …and/or EXPERIENCE: High School Diploma or GED required. Graduate of an accredited LVN Program. AA, Diploma preferred. One to two years related experience and/or ... education and experience. CERTIFICATES, LICENSES, AND REGISTRATIONS: Current California LVN license. ESSENTIAL FUNCTIONS: Essential functions are those tasks, duties… more
- Sharp HealthCare (San Diego, CA)
- …Certified Case Manager (CCM) - Commission for Case Manager Certification; California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing ... with physicians and non-physician health care practitioners involved in case management + California Licensed Vocational Nurse ( LVN...Other Continued college education + Bachelor's Degree + Certified Case Manager (CCM) - Commission for … more
- Genesis Healthcare (Los Angeles, CA)
- POSITION SUMMARY: The Case Manager is responsible to ensure the collaborative process of assessment, planning, facilitation and advocacy for options and services ... performance improvement and communicates to s supervisor and/or Administrator.The Case Manager manages the patient case...patient plan of care subject to contract terms and case negotiations in order to minimize over- utilization … more
- Prime Healthcare (Ontario, CA)
- …of the Case Management Department under the direction of the assigned Case Manager /Social Worker in the development and implementation of the discharge plan. ... EDUCATION, EXPERIENCE, TRAINING Required qualifications: 1. Knowledge in discharge planning/ utilization management/ case management terminology and functions, in… more
- Centene Corporation (Arlington, VA)
- …including a fresh perspective on workplace flexibility. **Centene is hiring a Care Manager LVN /LPN to cover the Silver Spring, Maryland or Woodbridge, Vienna, ... member cases with complex medical needs to Supervisor or Manager . + Act as liaison and member advocate between...nursing** **Candidate Experience:** Required 2+ years of experience in utilization management and/or case management in a… more
- Sharp HealthCare (San Diego, CA)
- …Nursing & Psychiatric Technicians -REQUIRED **Preferred Qualifications** + Experience as a case manager or discharge planner interacting with managed care ... 1 **Shift Start Time** **Shift End Time** California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing & Psychiatric Technicians; Other **Hours**… more
- Sharp HealthCare (Coronado, CA)
- …Registered Nurse (RN) - CA Board of Registered Nursing; Bachelor's Degree in Nursing; Certified Case Manager (CCM) - Commission for Case Manager ... Case Manager (ACM) - American Case Management Association (ACMA) **Hours** **:** **Shift Start Time:**...or case management experience. + 3 Years case management, utilization review, care coordination experience.… more
- Elevance Health (Brazil, IN)
- …spend 4-5 days per week in-person with patients, members or providers. The ** Case Manager - LCSW/LSW/LMSW** (also called the **LTSS Service Coordinator - ... Clinician)** has overall responsibility for the member's case , as required by the IN PathWays for Aging...health care team, to ensure cost effective and efficient utilization of health benefits. + Decision making skills will… more
- Elevance Health (Cumberland, IN)
- …4-5 days per week in-person with patients, members or providers The **RN Case Manager ** **(LTSS Service Coordinator- RN)** is responsible for overall management ... of member's case within the scope of licensure; provides supervision and...co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits. + Obtains a thorough and… more
- The Cigna Group (Nashville, TN)
- …+ Three to Five (3-5) years recent experience in an acute-care environment, case -management or utilization management position (experience can be a combination ... participating provider practices + Identifies high-risk/high-cost patients for possible case management intervention. + Interfaces with providers of medical services… more
- Tenet Healthcare (Detroit, MI)
- … Management and Compliance policies, Transition Management, and other topics specific to case management. 6. Accredited Case Manager (ACM) preferred. Skills ... Clinical Social Worker Case Management FT Days - 1406001636 Description :...patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient's resources and… more
- Molina Healthcare (Glen Allen, VA)
- …experience. **Preferred License, Certification, Association** Any of the following: Certified Case Manager (CCM), Certified Professional in Healthcare Management ... the state of VIRGINIA. Manager will support a team of field Nurse Case Managers supporting our Medicaid program We are looking for someone with strong leadership… more
- Molina Healthcare (Dallas, TX)
- …experience. **Preferred License, Certification, Association** Any of the following: Certified Case Manager (CCM), Certified Professional in Healthcare Management ... Registered Nurse or equivalent combination of Licensed Vocational Nurse ( LVN ) or Licensed Practical Nurse (LPN) with experience in...years in one or more of the following areas: utilization management, case management, care transition and/or… more
- Banner Health (Mesa, AZ)
- …and challenges), an in-office team of QI specialists, telehealth resources, clinical manager and in office triage support. This structure is designed to assist ... "alone" in the field! We recognize that our nurse case managers are the key to a successful journey...Reviews audit results and presents summary information for management utilization and review. 7. May coordinate the admission process… more
- Molina Healthcare (TX)
- …unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management + Certified ... this position we are seeking a REGISTERED NURSE (RN) with prior experience in Utilization Review / Utilization Management and knowledge of Interqual / MCG… more
- Prime Healthcare (Boonton Township, NJ)
- …the Case Management Department under the direction of the assigned Case Manager /Social Worker assist with development and implementations of discharge plans. ... Plan. Qualifications Education and Work Experience + Knowledge of Discharge Planning/ Utilization Management / Case Management terminology and functions, in both… more