Utilization Management Nurse Consultant

• Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.

  Utilization Management Nurse Consultant in Work At Home, Illinois | Clinical at CVS Health ←——— APPLY HERE

RN Phone Advice/Triage - Part Time (Oregon - Remote)

At COPA, the Pediatric Phone Advice/ Triage RN plays an integral role serving patients at our friendly and welcoming medical clinic for children of all ages. The Pediatric Phone Advice/ Triage RN is a collaborative member of the Patient Centered Primary Care Home and performs the primary functions of a Registered Nurse in assessing patient’s medical conditions over the phone and dispensing the appropriate medical advice. The age ranges that will be evaluated are the infant, toddler, preschool, school age or adolescent patient. The RN is responsible for meeting the standards of advice/triage care established by the organization.Career Center | Recruitment APPLY HERE!

RN Pre-Service Authorizations

Conducts Managed Care Programs in conjunction with third party administrators’ health care agreements. Works collaboratively with and provides clinical expertise and leadership to Access Coordinators to perform all aspects of managed care, including the referral, prior authorization/precertification processes, using and revising Essentia Health’s established policies and procedures for managed care activities. Performs complex care coordination and referral management. Works collaboratively with the Essentia Health customer service personnel to provide efficient service for insurance issue resolution and smooth operations. Works collaboratively with clinical areas and business services both internally and externally. Supports efforts and participates with the Supervisor of Contracting & Payor Relations and the Health Plans Medical Directors regarding health care initiatives and compliance issues for health plans. RN Pre-Service Authorizations ←——— CLICK HERE

Chronic Care Manager (Remote - Compact States)Harris CCM is seeking Nurses to work part-time from their home office while complying with HIPAA privacy laws. You will set your own hours and will not be held to a daily work hour schedule. You will be contracted to work a minimum of 20hrs/wk. Harris CCM wants its team members to have the flexibility to balance their work-life with their home life. Part-time team members will typically need to dedicate an average of 20-30 hours per week to care for their assigned patients. This unique business model allows you to choose what days and what hours of the day you dedicate to care for your patients

Chronic Care Manager (Remote - Compact States) Job in Washington, DC ←—— APPLY HERE

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