13 nurse manager jobs found

Job Title: Registered Nurse (RN) – Case Management Location: Hyannis, MA Duration: 13 Weeks Schedule: 4x10 Hour Shifts (40 hours/week) Shift Options: 7:30 AM – 6:00 PM or 8:00 AM – 6:30 PM Position Overview "Navitas Healthcare, LLC" is seeking an experienced Registered Nurse (RN) – Case Manager to coordinate and facilitate patient care across the continuum. This role focuses on discharge planning, utilization review, and collaboration with interdisciplinary teams to ensure high-quality, cost-effective patient outcomes. Key Responsibilities Conduct daily screening of new admissions for discharge planning needs Develop and implement individualized care and discharge plans Perform initial assessments within one business day and reassess patients as needed Review appropriateness of admissions and level of care using InterQual® criteria Coordinate with physicians, care teams, and third-party payers Facilitate timely utilization review and...

Job Title: Registered Nurse (RN) – Case Management Location: Hyannis, MA Duration: 13 Weeks Schedule: 4x10 Hour Shifts (40 hours/week) Shift Options: 7:30 AM – 6:00 PM or 8:00 AM – 6:30 PM Position Overview "Navitas Healthcare, LLC" is seeking an experienced Registered Nurse (RN) – Case Manager to coordinate and facilitate patient care across the continuum. This role focuses on discharge planning, utilization review, and collaboration with interdisciplinary teams to ensure high-quality, cost-effective patient outcomes. Key Responsibilities Conduct daily screening of new admissions for discharge planning needs Develop and implement individualized care and discharge plans Perform initial assessments within one business day and reassess patients as needed Review appropriateness of admissions and level of care using InterQual® criteria Coordinate with physicians, care teams, and third-party payers Facilitate timely utilization review and...

Job Title: Registered Nurse (RN) – Case Management Location: Hyannis, MA Duration: 13 Weeks Schedule: 4x10 Hour Shifts (40 hours/week) Shift Options: 7:30 AM – 6:00 PM or 8:00 AM – 6:30 PM Position Overview "Navitas Healthcare, LLC" is seeking an experienced Registered Nurse (RN) – Case Manager to coordinate and facilitate patient care across the continuum. This role focuses on discharge planning, utilization review, and collaboration with interdisciplinary teams to ensure high-quality, cost-effective patient outcomes. Key Responsibilities Conduct daily screening of new admissions for discharge planning needs Develop and implement individualized care and discharge plans Perform initial assessments within one business day and reassess patients as needed Review appropriateness of admissions and level of care using InterQual® criteria Coordinate with physicians, care teams, and third-party payers Facilitate timely utilization review and...

Job Description As a Senior Clinical Consultant, you will collaborate with customer stakeholders and leaders to build relationships and positively impact clinical performance, satisfaction, and outcomes during projects involving the Oracle Health Workforce and Workload Solution Suite, formerly known as Clairvia, in Acute and Outpatient care. Drawing on your clinical expertise, you will guide customers and internal teams, help design effective clinical workflows, and analyze current and future states to identify gaps and recommend strategies for change adoption to achieve workforce and workload goals. You will own the customer's value measurement plan, support the engagement management team in meeting deliverables and timelines, lead customer meetings to align clinical goals with technology, and foster relationships to drive business outcomes. This role focuses on Oracle Health Workforce and Workload solutions like scheduling, caregiver assignments, acuity-based outcomes, and...

Job Description As a Senior Clinical Consultant, you will collaborate with customer stakeholders and leaders to build relationships and positively impact clinical performance, satisfaction, and outcomes during projects involving the Oracle Health Workforce and Workload Solution Suite, formerly known as Clairvia, in Acute and Outpatient care. Drawing on your clinical expertise, you will guide customers and internal teams, help design effective clinical workflows, and analyze current and future states to identify gaps and recommend strategies for change adoption to achieve workforce and workload goals. You will own the customer's value measurement plan, support the engagement management team in meeting deliverables and timelines, lead customer meetings to align clinical goals with technology, and foster relationships to drive business outcomes. This role focuses on Oracle Health Workforce and Workload solutions like scheduling, caregiver assignments, acuity-based outcomes, and...

Utilization Management Representative I Location : This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Utilization Management Representative I is responsible for coordinating cases for precertification and prior authorization review. How you will make an impact: Managing incoming calls or incoming post services claims work. Determines contract and benefit eligibility; provides...

Telephonic Nurse Disease Management I Sign-on Bonus: $2000 Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Work schedule: Monday-Friday, 11-7:30 pm or 12:30 - 9 pm EST. Federal Employee Program - FEP , a proud member of the Elevance Health, Inc. family of companies, it is a powerful combination, and the foundation upon which we are creating greater access to care for...

Telephonic Nurse Disease Management I Sign-on Bonus: $2000 Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Work schedule: Monday-Friday, 11-7:30 pm or 12:30 - 9 pm EST. Federal Employee Program - FEP , a proud member of the Elevance Health, Inc. family of companies, it is a powerful combination, and the foundation upon which we are creating greater access to care for...

Thank you for considering Progyny! Progyny is looking for a Utilization Management Coordinator to support all utilization review cases with an expanded focus on compliance and accreditation standards. This coordinator will be directly responsible for reviewing and analyzing member cases to determine the appropriateness and medical necessity to issue authorizations for treatment. This person will review clinical dashboards to understand case load, review pending cases, provide necessary documentation, and serve as the liaison between different internal and external partners including providers, payers, and compliance teams; monitor and interpret accreditation standards (e.g., URAC, NCQA) and integrate them into UM workflows, conduct internal audits and readiness assessments for accreditation reviews, collaborate with Legal and Compliance teams to update clinical guidelines and reviewer protocols, maintain awareness of licensure requirements and state-specific UM regulations....

Summary This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific eligibility requirements per VHA policy and submit your EDRP application within four months of appointment. Program Approval, award amount (up to $200,000) & eligibility period (one to five years) are determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. Responsibilities Recruitment Incentive (Sign-on Bonus): Authorized Permanent Change of Station (Relocation Assistance): Authorized Education Debt Reduction Program (Student Loan Repayment): Authorized Learn more. EDRP Authorized: Former EDRP participants ineligible to apply for incentive. Contact VHAVISN04HREDRP@va.gov, the EDRP Coordinator for questions/assistance Pay: Competitive salary, annual performance bonus, regular salary increases Paid Time Off: 50-55 days of paid time...

Director, Payor Management & Medical Staff Credentialing - Tarrytown, NY (Onsite) - Full-Time - (Mon-Fri On-site) - $165,910-$195,365 Per Year Title: Director, Payor Management & Medical Staff Credentialing Location: Tarrytown, NY (Onsite) Employment Type: Full-Time - (Mon-Fri On-site) Compensation: Pay Range: $165,910-$195,365 Per Year Great Benefits: Medical, Dental, Vision 27 days PTO frontloaded (prorated based on start date) 10%-year end discretionary bonus $900/annum cell phone allowance About the Role: A leading multi-specialty healthcare organization is seeking a strategic and hands-on Director of Payor Management and Medical Staff Credentialing to lead the lifecycle of provider verification, health plan enrollment, facility enrollment, and post-claim reconciliation. This role is central to ensuring accurate billing and collections while serving as the key liaison between the organization, providers, and insurance payors....

University of Iowa Health Care department of Patient Financial Services is seeking a Revenue Cycle Coordinator for the Medical Center on the University Campus (MCU) Emergency Department (ED) as a supervisory position that may have 8-15 direct reports, could be a mix of P&S and/or student positions and will serve as a resource for complex billing issues and high-level patient events. You must have outstanding customer service skills, leadership abilities and excellent interpersonal and communication skills that will enable respectful interactions with our various range of internal and external customers, including but not limited to; our patients and their families, insurance companies, physicians, nurses, and other medical personnel. To be successful you will need strong analytical skills to perform quality assurance checks, productivity audits and a broad range of accounting & financial analysis to ensure effective and...

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