RN - Utilization Review Nurse - Managed Care
Nurse Resolutions - Seattle, WA
Performs technical and administrative work required to evaluate the necessity, appropriateness and efficiency of the use of medical services procedures and facilities. Licensed RN responsible for clinical review of all acute and subacute services for appropriateness based on medi...
RN-Case Manager II-Insurance/Managed Care
Nurse Resolutions - Westmont, IL
Case Manager II Position Purpose: Perform collaborative duties to assess, plan and coordinate continuum of care for select members at high risk in order to promote quality, cost effective programs. Knowledge/Experience: Bachelors degree preferred. At least two years clinical nurs...
RN-Utilization Review/Utilization Management
Nurse Resolutions - Tarrytown, NY
POSITION SUMMARY: The Utilization Management Nurse is responsible for ensuring the effective utilization of medical services through the application of nationally recognized medical necessity criteria. This position is responsible for all aspects of the utilization review functio...
Health Care Contract Negotiator
Nurse Resolutions - Lexington, KY
Position Purpose: To coordinate and negotiate hospital, physician (IPAs, PPMs, individual providers, multispecialty groups) and ancillary service agreements that are in accordance with Corporate, health plan and State guidelines.Knowledge/Experience:Bachelors degree in healthcare...
RN-Registered Nurse-Home Health
Nurse Resolutions - Tempe, AZ
RN Case Manager Home Health CompanyTempe, AZ$70,000$75,000 SalaryA national home health company is seeking an RN Case Manager to provide home health management for the Tempe, AZ area. Will work at the clients home, health center or other place of residence providing services in a...
RN Field Case Manager - NICU - Work from home
Nurse Resolutions - Lexington, KY
This is a work from home opportunity! The nurse will be traveling to Louisville, KY and Lexington, KY. There will also be some travel into Southern Ohio (Cincinnati area). NICU experience required. Signon bonus and 3 weeks paid vacation. Position Purpose: Review inpatient admissi...
RN - Quality Management Nurse - Managed Care
Nurse Resolutions - Seattle, WA
RN Quality Management Coordinator Managed Care JOB SUMMARY: The Coordinator Quality Management RN Plan is responsible in conjunction with management for developing, coordinating, implementing, and evaluating the continuous quality improvement activities throughout the company acc...
Nurse Resolutions - Colorado Springs, CO
RNNurse Case Manager Colorado Springs, CO Home Care * Makes the initial nursing evaluation visit. * Manages a Caseload of Home Care patients. * Continually evaluates the patient's nursing needs. * Initiates and coordinates the plan of treatment and necessary revisions. * Renders ...
LSW-LPN-LPC-RN-Service Coordinator/Case Manager-Managed Care
Nurse Resolutions - Gallup, NM
The Service Coordinator is responsible for identification of Members needs, including physical health, mental health, social services and long term support services and the development of the members Individualized Service Plan or Treatment Plan to address those needs.The Service...
Contract Negotiator - Provider Relations
Nurse Resolutions - Baton Rouge, LA
Job Description: Contract Negotiator Managed Care Organization Baton Rouge, LAPosition Purpose: Coordinate and negotiate hospital, physician (IPAs, PPMs, individual providers, multispecialty groups) and ancillary service agreements that are in accordance with corporate, health pl...
LSW-LPN-LPC-RN-Service Coordinator/Case Manager-Managed Care
Nurse Resolutions - Gallup, NM
The Service Coordinator is responsible for identification of Members needs, including physical health, mental health, social services and long term support services and the development of the members Individualized Service Plan or Treatment Plan to address those needs.The Service...
RN Field Case Manager - Work From Home
Nurse Resolutions - Philadelphia, PA
Work From Home Field Case Manager JOB SUMMARY: A nurse liaison who communicates pertinent medical information among the Injured Worker, the Insured and the Carrier and who facilitates appropriate medical treatment for a successful rehabilitation outcome and work reentry. Provides...
RN Case Manager - Managed Care Organization
Nurse Resolutions - San Antonio, TX
Job Description: RN Case ManagerPosition Purpose: Perform collaborative duties to assess, plan and coordinate continuum of care for select members at high risk in order to promote quality, cost effective programs.Knowledge/Experience:Bachelors degree preferred. At least two years...
Worker's Compensation Marketing Representative
Nurse Resolutions - Nashville, TN
A third party Medical Management firm specializing in Worker's Compensation claims is seeking a Marketing Rep to cover their Tennessee territory. Scope of duties: Maintain working relationships with new and existing customers. Responsible for selling Company's Case Management ser...
RN Field Case Manager - Workers Compensation -Work from home
Nurse Resolutions - Richmond, VA
RN Case Manager Work from Home Workers Compensation Medical Management A Third Party Medical Management Firm is seeking RN Case Managers experienced in Workers Compensation claims for positions in Richmond, VA. The Medical Case Manager conducts onsite, facetoface meetings with th...
Director of Quality Management - Managed Care
Nurse Resolutions - Westmont, IL
Position Purpose: Lead and direct process improvement activities that provide more efficient and streamlined workflow. Position Responsibilities: * Research and incorporate best practices into operations. * Formulate and establish policies, operating procedures, and goals in comp...
LSW-LPN-LPC-RN-Service Coordinator/Case Manager-Managed Care
Nurse Resolutions - Gallup, NM
The Service Coordinator is responsible for identification of Members needs, including physical health, mental health, social services and long term support services and the development of the members Individualized Service Plan or Treatment Plan to address those needs.The Service...
RN-Work From Home Field Case Manager-Worker's Comp
Nurse Resolutions - Nashville, TN
JOB SUMMARY:A nurse liaison who communicates pertinent medical information among the Injured Worker, the Insured and the Carrier and who facilitates appropriate medical treatment for a successful rehabilitation outcome and work reentry.Provides efficient, cost effective communica...
RN-Bilingual-Work From Home Field Case Manager-Worker's Comp
Nurse Resolutions - Arlington, VA
This Nurse needs to be bilingual Spanish JOB SUMMARY:A nurse liaison who communicates pertinent medical information among the Injured Worker, the Insured and the Carrier and who facilitates appropriate medical treatment for a successful rehabilitation outcome and work reentry.Pro...
Provider Relations Specialist - Managed Care - Lafayette, LA
Nurse Resolutions - Shreveport, LA
Position Purpose: Perform duties to act as a liaison between providers, the health plan and Corporate including investigating and resolving provider claims issues. Perform training, orientation and coaching for performance improvement within physician practices. Position Responsi...