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Keywords: Utilization Management Nurse (Work from Home), Location: California

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FEP Case Management - Nurse, Senior

+ years managed care experience preferred. Comprehensive knowledge of case management, discharge planning, utilization...Your Role Work schedule is Mon-Fri 10am- 7pm The Federal Employee Program (FEP) team performs integrated case...

Posted Date: 03 Mar 2025

Clinical Manager Home Health FT

’s license, auto insurance and reliable transportation. Two years as a Registered Nurse with at least one-year of management... disciplines required, to determine home health or hospice needs. Accountable to ensure patients meet admission criteria and make...

Posted Date: 12 Feb 2025
Salary: $114300 - 157200 per year

Utilization Management Nurse (Work from Home)

to all populations across the ACA Marketplace, Medicare, and Medicaid. SCOPE OF ROLE The role of the UM Nurse is to promote quality... and resources required to meet desired health and social outcomes. The UM Nurse is responsible for providing patient centered care...

Company: Bright Health
Location: California
Posted Date: 13 Mar 2025
Salary: $27.1 - 40.65 per hour

Utilization Management Nurse, Senior

and correctly applies the guidelines for nationally recognized levels of care. The Utilization Management Nurse, Senior will report... to the Utilization Management Nurse Manager. In this role you will be assigned a list of inpatient facilities and then review...

Posted Date: 01 Mar 2025

Utilization Management Nurse, Senior CalPERS

of designated healthcare services, concurrent review activity, and retrospective review activity. Utilization Management Nurse.... Responsibilities: Your Work In this role, you will: Performs prospective, concurrent, and retrospective utilization reviews...

Posted Date: 01 Mar 2025

Utilization Management Nurse, Senior

and correctly applies the guidelines for nationally recognized levels of care. The Utilization Management Nurse will report to the... Utilization Management Nurse Manager. In this role you will be assigned a list of inpatient facilities and then review clinical...

Posted Date: 26 Feb 2025

Utilization Management Nurse, Senior

Utilization Management Nurse, Senior will report to the Senior Manager, Facility Compliance Review. In this role... and aberrant billing. Responsibilities: Your Work In this role, you will: Perform retrospective utilization reviews...

Posted Date: 23 Feb 2025

Inpatient Utilization Management RN / Job Req 788795521

Job Description: PRINCIPAL RESPONSIBILITIES: The Inpatient Utilization Management (UM) RN is responsible... with UM coordinators to make sure the appropriate disenrollment process is implemented. Work closely with the Alliance Management...

Posted Date: 02 Mar 2025
Salary: $110094.4 - 165131.2 per year

Registered Nurse-Utilization and Care Transitions PACE (Riverside)

senior participants. ROLE OVERVIEW and PURPOSE The Utilization Management (UM) and Transitional Care Nurse Navigator..., with at least 1 year in transitional care, case management, or utilization review. Experience in PACE, SNFs, or hospital settings...

Posted Date: 08 Mar 2025
Salary: $51.5 - 62.75 per hour

FSH RN Discharge/Utilization Review Nurse

of patients for discharge planning and utilization review. This includes those who may have Medicare, Medicaid, HMO or private... and significant others who have an ongoing caring relationship with the patient. Utilization review procedures include those stated...

Posted Date: 23 Jan 2025

FSH RN Discharge/Utilization Review Nurse

of patients for discharge planning and utilization review. This includes those who may have Medicare, Medicaid, HMO or private... and significant others who have an ongoing caring relationship with the patient. Utilization review procedures include those stated...

Posted Date: 22 Jan 2025

Case Management - Nurse, Senior

of case management, discharge planning, utilization management, disease management and community resources. Able to operate...Your Role The Federal Employee Program (FEP) team performs integrated case management (CM) and disease management (DM...

Posted Date: 03 Mar 2025

FEP Case Management - Nurse, Senior

Registered Nurse Case Manager will report to the FEP Care Management Department Manager. In this role you will determine, develop..., discharge planning, utilization management, disease management and community resources preferred Behavioral health, oncology...

Posted Date: 06 Feb 2025
Salary: $89100 - 133650 per year

Delegation Management Nurse

Paid Time Off and Sick Leave. Responsibilities: ***This position is work from home within California. Position Summary...: The Delegation Management Nurse is responsible for overseeing and managing the delegation of healthcare services to third...

Posted Date: 06 Feb 2025

Case Management - Nurse, Senior

planning, utilization management, disease management and community resources Able to operate PC-based software programs... Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work...

Posted Date: 24 Jan 2025
Salary: $87230 - 130900 per year

Manager, Case Management Nurse Management

, utilization management and community resources. Strong supervisory, communication and negotiation skills. Able to operate PC... Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work...

Posted Date: 13 Mar 2025

Case Management - Nurse, Senior

Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work...Job Description: Your Role The Care Management team will serve to support the mission of the department...

Posted Date: 23 Feb 2025

Manager, Case Management Nurse Management

, utilization management and community resources. Strong supervisory, communication and negotiation skills. Able to operate PC... involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork...

Posted Date: 24 Jan 2025
Salary: $109340 - 164120 per year

Full Time Home Hospice Clinical Supervisor - Registered Nurse (RN)

Nurse must have at least 2 years of current or very recent experience in home hospice or health health. Hospice management...We are looking for a Full-Time Registered Nurse (RN) for a Hospice Manager position in the Hospice Home Care setting...

Posted Date: 07 Mar 2025

Full Time Home Hospice Clinical Supervisor - Registered Nurse (RN)

Overview: We are looking for a Full-Time Registered Nurse (RN) for a Hospice Manager position in the Hospice Home... Registered Nurse must have at least 2 years of current or very recent experience in home hospice or health health. Hospice...

Posted Date: 07 Mar 2025