Mphc Case Jobs in Usa
5,009 positions found — Page 9
Nurse Case Manager PRN - Flexible Scheduling Opportunities (SEGUIN)
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES
The nurse case manager coordinates, in collaboration with the patient and interdisciplinary team, the treatment/plan of care for a patient within the acute episode of care. He/she proactively facilitates interventions to assure timely delivery of services, evaluates the effectiveness of interventions, tracks variances and/or barriers in the plan of care, and functions as the patient advocate to identify and communicate health care needs.
EDUCATION/EXPERIENCE
Bachelor’s degree in Nursing is highly preferred. Three to five years nursing experience required (as a Staff nurse II or above). Work experience in case management, utilization review or hospital quality is preferred.
LICENSURE/ CERTIFICATIONS
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. An approved case management certification (ACM, CCM or ANCC) is preferred and must be achieved within two years of placement. Current American Heart Association, Basic Cardiac Life Support and/or Health Care Provider card preferred.
Remote working/work at home options are available for this role.
The nurse case manager coordinates, in collaboration with the patient and interdisciplinary team, the treatment/plan of care for a patient within the acute episode of care. He/she proactively facilitates interventions to assure timely delivery of services, evaluates the effectiveness of interventions, tracks variances and/or barriers in the plan of care, and functions as the patient advocate to identify and communicate health care needs.
EDUCATION/EXPERIENCE
Bachelor’s degree in Nursing is highly preferred. Three to five years nursing experience required (as a Staff nurse II or above). Work experience in case management, utilization review or hospital quality is preferred.
LICENSURE/ CERTIFICATIONS
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. An approved case management certification (ACM, CCM or ANCC) is preferred and must be achieved within two years of placement. Current American Heart Association, Basic Cardiac Life Support and/or Health Care Provider card preferred.
Remote working/work at home options are available for this role.
temporary
Healthcare Case Management Specialist (BOERNE)
🏢 University Health
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES
Identifies Community First Health Plan members with specific health care needs and provides case management interventions. Analyzes, approves health care services and monitors outpatient care planning for Community First Health Plans members based on established criteria, plan policies and procedures. Formulates and communicates case management plans that efficiently utilize health care services to move the member along the continuum of care towards optimum outcomes in the safest, most cost effective manner.
EDUCATION/EXPERIENCE
Graduation from an accredited school of professional nursing is required, BSN preferred. Master’s degree is preferred. Minimum three years’ acute care experience or managed care experience is required. Minimum one-year of concurrent review experience is required. Candidate must have utilization management and/or quality assurance experience. Basic knowledge of Medicaid, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD-9 and CPT coding is preferred.
LICENSURE/CERTIFICATION
Current Registered Nurse license to practice professional nursing issued by the Board of Nurse Examiners for the State of Texas is required. Active Certification in Case Management (CCM) designation is preferred.
Identifies Community First Health Plan members with specific health care needs and provides case management interventions. Analyzes, approves health care services and monitors outpatient care planning for Community First Health Plans members based on established criteria, plan policies and procedures. Formulates and communicates case management plans that efficiently utilize health care services to move the member along the continuum of care towards optimum outcomes in the safest, most cost effective manner.
EDUCATION/EXPERIENCE
Graduation from an accredited school of professional nursing is required, BSN preferred. Master’s degree is preferred. Minimum three years’ acute care experience or managed care experience is required. Minimum one-year of concurrent review experience is required. Candidate must have utilization management and/or quality assurance experience. Basic knowledge of Medicaid, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD-9 and CPT coding is preferred.
LICENSURE/CERTIFICATION
Current Registered Nurse license to practice professional nursing issued by the Board of Nurse Examiners for the State of Texas is required. Active Certification in Case Management (CCM) designation is preferred.
temporary
Nurse Case Manager PRN - Flexible Scheduling (PLEASANTON)
🏢 University Health
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES
The nurse case manager coordinates, in collaboration with the patient and interdisciplinary team, the treatment/plan of care for a patient within the acute episode of care. He/she proactively facilitates interventions to assure timely delivery of services, evaluates the effectiveness of interventions, tracks variances and/or barriers in the plan of care, and functions as the patient advocate to identify and communicate health care needs.
EDUCATION/EXPERIENCE
Bachelor’s degree in Nursing is highly preferred. Three to five years nursing experience required (as a Staff nurse II or above). Work experience in case management, utilization review or hospital quality is preferred.
LICENSURE/ CERTIFICATIONS
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. An approved case management certification (ACM, CCM or ANCC) is preferred and must be achieved within two years of placement. Current American Heart Association, Basic Cardiac Life Support and/or Health Care Provider card preferred.
Remote working/work at home options are available for this role.
The nurse case manager coordinates, in collaboration with the patient and interdisciplinary team, the treatment/plan of care for a patient within the acute episode of care. He/she proactively facilitates interventions to assure timely delivery of services, evaluates the effectiveness of interventions, tracks variances and/or barriers in the plan of care, and functions as the patient advocate to identify and communicate health care needs.
EDUCATION/EXPERIENCE
Bachelor’s degree in Nursing is highly preferred. Three to five years nursing experience required (as a Staff nurse II or above). Work experience in case management, utilization review or hospital quality is preferred.
LICENSURE/ CERTIFICATIONS
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. An approved case management certification (ACM, CCM or ANCC) is preferred and must be achieved within two years of placement. Current American Heart Association, Basic Cardiac Life Support and/or Health Care Provider card preferred.
Remote working/work at home options are available for this role.
temporary
Part-Time Clinical Case Worker (PLEASANTON)
🏢 University Health
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES
The nurse case manager coordinates, in collaboration with the patient and interdisciplinary team, the treatment/ plan f care for a patient within the acute episode of care. He/she proactively facilitates interventions to assure timely delivery of services, evaluates the effectiveness of interventions, tracks variances and/or barriers in the plan of care, and functions as the patient advocate to identify and communicate health care needs.
EDUCATION/EXPERIENCE
Bachelor’s degree in Nursing is highly preferred. Three to five years nursing experience required (as a Staff nurse II or above). Work experience in case management, utilization review or hospital quality is preferred.
LICENSURE/ CERTIFICATIONS
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. An approved case management certification (ACM, CCM or ANCC) is preferred and must be achieved within two years of placement. Current American Heart Association, Basic Cardiac Life Support and/or Health Care Provider card preferred.
The nurse case manager coordinates, in collaboration with the patient and interdisciplinary team, the treatment/ plan f care for a patient within the acute episode of care. He/she proactively facilitates interventions to assure timely delivery of services, evaluates the effectiveness of interventions, tracks variances and/or barriers in the plan of care, and functions as the patient advocate to identify and communicate health care needs.
EDUCATION/EXPERIENCE
Bachelor’s degree in Nursing is highly preferred. Three to five years nursing experience required (as a Staff nurse II or above). Work experience in case management, utilization review or hospital quality is preferred.
LICENSURE/ CERTIFICATIONS
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. An approved case management certification (ACM, CCM or ANCC) is preferred and must be achieved within two years of placement. Current American Heart Association, Basic Cardiac Life Support and/or Health Care Provider card preferred.
temporary
Nurse Case Manager - CFHP PRN - Flexible Scheduling Options for Work-Life Balance (HONDO)
🏢 University Health
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES
Identifies Community First Health Plan members with specific health care needs and provides case management interventions. Analyzes, approves health care services and monitors outpatient care planning for Community First Health Plans members based on established criteria, plan policies and procedures. Formulates and communicates case management plans that efficiently utilize health care services to move the member along the continuum of care towards optimum outcomes in the safest, most cost effective manner.
EDUCATION/EXPERIENCE
Graduation from an accredited school of professional nursing is required, BSN preferred. Master’s degree is preferred. Minimum three years’ acute care experience or managed care experience is required. Minimum one-year of concurrent review experience is required. Candidate must have utilization management and/or quality assurance experience. Basic knowledge of Medicaid, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD-9 and CPT coding is preferred.
LICENSURE/CERTIFICATION
Current Registered Nurse license to practice professional nursing issued by the Board of Nurse Examiners for the State of Texas is required. Active Certification in Case Management (CCM) designation is preferred.
Remote working/work at home options are available for this role.
Identifies Community First Health Plan members with specific health care needs and provides case management interventions. Analyzes, approves health care services and monitors outpatient care planning for Community First Health Plans members based on established criteria, plan policies and procedures. Formulates and communicates case management plans that efficiently utilize health care services to move the member along the continuum of care towards optimum outcomes in the safest, most cost effective manner.
EDUCATION/EXPERIENCE
Graduation from an accredited school of professional nursing is required, BSN preferred. Master’s degree is preferred. Minimum three years’ acute care experience or managed care experience is required. Minimum one-year of concurrent review experience is required. Candidate must have utilization management and/or quality assurance experience. Basic knowledge of Medicaid, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD-9 and CPT coding is preferred.
LICENSURE/CERTIFICATION
Current Registered Nurse license to practice professional nursing issued by the Board of Nurse Examiners for the State of Texas is required. Active Certification in Case Management (CCM) designation is preferred.
Remote working/work at home options are available for this role.
temporary
Nurse Case Manager - CFHP PRN - Flexible Scheduling for Work-Life Balance (SEGUIN)
🏢 University Health
Salary not disclosed
Identifies Community First Health Plan members with specific health care needs and provides case management interventions.
Analyzes, approves health care services and monitors outpatient care planning for Community First Health Plans members based on established criteria, plan policies and procedures.
Formulates and communicates case management plans that efficiently utilize health care services to move the member along the continuum of care towards optimum outcomes in the safest, most cost effective manner.
Graduation from an accredited school of professional nursing is required, BSN preferred.
Master's degree is preferred.
Minimum three years' acute care experience or managed care experience is required.
Minimum one-year of concurrent review experience is required.
Candidate must have utilization management and/or quality assurance experience.
Basic knowledge of Medicaid, community resources and alternate funding programs is desired.
Knowledge of InterQual screening criteria as well as DRG, ICD-9 and CPT coding is preferred.
Current Registered Nurse license to practice professional nursing issued by the Board of Nurse Examiners for the State of Texas is required.
Active Certification in Case Management (CCM) designation is preferred.
Remote working/work at home options are available for this role.
Not Specified
Nurse Case Manager PRN - Flexible Scheduling Option (HONDO)
🏢 University Health
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES
The nurse case manager coordinates, in collaboration with the patient and interdisciplinary team, the treatment/ plan f care for a patient within the acute episode of care. He/she proactively facilitates interventions to assure timely delivery of services, evaluates the effectiveness of interventions, tracks variances and/or barriers in the plan of care, and functions as the patient advocate to identify and communicate health care needs.
EDUCATION/EXPERIENCE
Bachelor’s degree in Nursing is highly preferred. Three to five years nursing experience required (as a Staff nurse II or above). Work experience in case management, utilization review or hospital quality is preferred.
LICENSURE/ CERTIFICATIONS
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. An approved case management certification (ACM, CCM or ANCC) is preferred and must be achieved within two years of placement. Current American Heart Association, Basic Cardiac Life Support and/or Health Care Provider card preferred.
Remote working/work at home options are available for this role.
The nurse case manager coordinates, in collaboration with the patient and interdisciplinary team, the treatment/ plan f care for a patient within the acute episode of care. He/she proactively facilitates interventions to assure timely delivery of services, evaluates the effectiveness of interventions, tracks variances and/or barriers in the plan of care, and functions as the patient advocate to identify and communicate health care needs.
EDUCATION/EXPERIENCE
Bachelor’s degree in Nursing is highly preferred. Three to five years nursing experience required (as a Staff nurse II or above). Work experience in case management, utilization review or hospital quality is preferred.
LICENSURE/ CERTIFICATIONS
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. An approved case management certification (ACM, CCM or ANCC) is preferred and must be achieved within two years of placement. Current American Heart Association, Basic Cardiac Life Support and/or Health Care Provider card preferred.
Remote working/work at home options are available for this role.
temporary
Nurse Case Manager PRN - Flexible scheduling options (SEGUIN)
🏢 University Health
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES
The nurse case manager coordinates, in collaboration with the patient and interdisciplinary team, the treatment/ plan f care for a patient within the acute episode of care. He/she proactively facilitates interventions to assure timely delivery of services, evaluates the effectiveness of interventions, tracks variances and/or barriers in the plan of care, and functions as the patient advocate to identify and communicate health care needs.
EDUCATION/EXPERIENCE
Bachelor’s degree in Nursing is highly preferred. Three to five years nursing experience required (as a Staff nurse II or above). Work experience in case management, utilization review or hospital quality is preferred.
LICENSURE/ CERTIFICATIONS
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. An approved case management certification (ACM, CCM or ANCC) is preferred and must be achieved within two years of placement. Current American Heart Association, Basic Cardiac Life Support and/or Health Care Provider card preferred.
Remote working/work at home options are available for this role.
The nurse case manager coordinates, in collaboration with the patient and interdisciplinary team, the treatment/ plan f care for a patient within the acute episode of care. He/she proactively facilitates interventions to assure timely delivery of services, evaluates the effectiveness of interventions, tracks variances and/or barriers in the plan of care, and functions as the patient advocate to identify and communicate health care needs.
EDUCATION/EXPERIENCE
Bachelor’s degree in Nursing is highly preferred. Three to five years nursing experience required (as a Staff nurse II or above). Work experience in case management, utilization review or hospital quality is preferred.
LICENSURE/ CERTIFICATIONS
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. An approved case management certification (ACM, CCM or ANCC) is preferred and must be achieved within two years of placement. Current American Heart Association, Basic Cardiac Life Support and/or Health Care Provider card preferred.
Remote working/work at home options are available for this role.
temporary
Healthcare Case Coordinator PRN (BOERNE)
🏢 University Health
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES
The nurse case manager coordinates, in collaboration with the patient and interdisciplinary team, the treatment/plan of care for a patient within the acute episode of care. He/she proactively facilitates interventions to assure timely delivery of services, evaluates the effectiveness of interventions, tracks variances and/or barriers in the plan of care, and functions as the patient advocate to identify and communicate health care needs.
EDUCATION/EXPERIENCE
Bachelor’s degree in Nursing is highly preferred. Three to five years nursing experience required (as a Staff nurse II or above). Work experience in case management, utilization review or hospital quality is preferred.
LICENSURE/ CERTIFICATIONS
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. An approved case management certification (ACM, CCM or ANCC) is preferred and must be achieved within two years of placement. Current American Heart Association, Basic Cardiac Life Support and/or Health Care Provider card preferred.
The nurse case manager coordinates, in collaboration with the patient and interdisciplinary team, the treatment/plan of care for a patient within the acute episode of care. He/she proactively facilitates interventions to assure timely delivery of services, evaluates the effectiveness of interventions, tracks variances and/or barriers in the plan of care, and functions as the patient advocate to identify and communicate health care needs.
EDUCATION/EXPERIENCE
Bachelor’s degree in Nursing is highly preferred. Three to five years nursing experience required (as a Staff nurse II or above). Work experience in case management, utilization review or hospital quality is preferred.
LICENSURE/ CERTIFICATIONS
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. An approved case management certification (ACM, CCM or ANCC) is preferred and must be achieved within two years of placement. Current American Heart Association, Basic Cardiac Life Support and/or Health Care Provider card preferred.
temporary
Community Health Case Coordinator (PLEASANTON)
🏢 University Health
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES
Identifies Community First Health Plan members with specific health care needs and provides case management interventions. Analyzes, approves health care services and monitors outpatient care planning for Community First Health Plans members based on established criteria, plan policies and procedures. Formulates and communicates case management plans that efficiently utilize health care services to move the member along the continuum of care towards optimum outcomes in the safest, most cost effective manner.
EDUCATION/EXPERIENCE
Graduation from an accredited school of professional nursing is required, BSN preferred. Master’s degree is preferred. Minimum three years’ acute care experience or managed care experience is required. Minimum one-year of concurrent review experience is required. Candidate must have utilization management and/or quality assurance experience. Basic knowledge of Medicaid, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD-9 and CPT coding is preferred.
LICENSURE/CERTIFICATION
Current Registered Nurse license to practice professional nursing issued by the Board of Nurse Examiners for the State of Texas is required. Active Certification in Case Management (CCM) designation is preferred.
Identifies Community First Health Plan members with specific health care needs and provides case management interventions. Analyzes, approves health care services and monitors outpatient care planning for Community First Health Plans members based on established criteria, plan policies and procedures. Formulates and communicates case management plans that efficiently utilize health care services to move the member along the continuum of care towards optimum outcomes in the safest, most cost effective manner.
EDUCATION/EXPERIENCE
Graduation from an accredited school of professional nursing is required, BSN preferred. Master’s degree is preferred. Minimum three years’ acute care experience or managed care experience is required. Minimum one-year of concurrent review experience is required. Candidate must have utilization management and/or quality assurance experience. Basic knowledge of Medicaid, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD-9 and CPT coding is preferred.
LICENSURE/CERTIFICATION
Current Registered Nurse license to practice professional nursing issued by the Board of Nurse Examiners for the State of Texas is required. Active Certification in Case Management (CCM) designation is preferred.
temporary
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