309 E Graham, Pryor, Oklahoma, 79935-5204, United States of AmericaDaVita is looking for a Full-Time Nurse Practitioner (NP) to join us in Tulsa, OK area. *Must live locally.As a Nurse Practitioner (NP) you will support some of our most complex patients, assisting them in navigating a challenging healthcare system. You'll focus on delivering holistic, integrated care to improve the quality of life for our kidney patients. You'll work autonomously and in collaboration with all members of the healthcare team to coordinate and facilitate quality, consistent, cost-effective care. Position DetailsWork from home (75%) and see patients in DaVita Clinics (25%) in Tulsa.Great Work-Life Balance- Monday-Friday schedule-*Self-managed*.Full-TimeCompetitive pay Excellent Benefit packageCME reimbursementPaid License renewals & many other benefitsRequirementsCurrent license to practice in the state of practiceCurrent Drug Enforcement Administration (DEA) license required or eligible to obtain...

An exciting career opportunity for Remote Nurse Recruiter is now available in Portland Oregon and surrounding markets. In this challenging and fast paced role, the Remote Nurse Recruiter will direct recruiting strategy, develop employment marketing materials, conduct interviews with Healthcare professionals and interact with Hospital clients in multiple states. The Remote Nurse Recruiter will specialize in filling employment needs in Nursing Management, Advanced Practice Nursing, and specialized nursing roles throughout the West Coast and nationally. In this full cycle recruiting role, the Remote Nursing Recruiter will have the opportunity to participate in many aspects of the job. This includes new business development, management of existing accounts, marketing & advertising, recruiting and hands-on client consulting. As one of the nation's fastest growing Nursing Recruitment Firms, the path for career growth is clear and achievable. Join a successful and positive...

Are you an experienced Registered Nurse (RN) that enjoys working on high performance team looking for your next opportunity? Apply today to become part of the team that is not only changing people s lives for the better but changing the health care system for the next generations to come! GRIZHCThe CSI Companies is currently seeking a REMOTE Registered Nurse (RN) for a contract position with one of our clients, one of the largest physician-led healthcare delivery networks in the state United States, a Fortune 100 healthcare provider! #talenthedis The REMOTE Registered Nurse (RN) will be supporting an annual HEDIS Project. The goal of this project is to achieve extraordinary performance that exceeds the expectations of the constituents, customers, and members we serve. In this position, you will work with the Quality and Value Solutions Delivery staff to assist with the 2021 data collection cycle. The purposes of this role include, but are not limited to: Market specific data...

Are you an experienced Registered Nurse (RN) that enjoys working on high performance team looking for your next opportunity? Apply today to become part of the team that is not only changing people s lives for the better but changing the health care system for the next generations to come! GRIZHCThe CSI Companies is currently seeking a REMOTE Registered Nurse (RN) for a contract position with one of our clients, one of the largest physician-led healthcare delivery networks in the state United States, a Fortune 100 healthcare provider! #talenthedis The REMOTE Registered Nurse (RN) will be supporting an annual HEDIS Project. The goal of this project is to achieve extraordinary performance that exceeds the expectations of the constituents, customers, and members we serve. In this position, you will work with the Quality and Value Solutions Delivery staff to assist with the 2021 data collection cycle. The purposes of this role include, but are not limited to: Market specific data...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm) OptumCare is a network of health care providers in the Southwest, whose mission is to connect and support providers by working together to deliver the most effective and compassionate care to each and every patient they serve. OptumCare's focus is to do the right things for members, physicians, and the community. OptumCare's Core Business is contracting directly with health insurers to deliver a highly personal care management and service model to their members. The current focus of OptumCare is on seniors, and those with complex care needs,...

The Clinical Supervisor is responsible for the clinical oversight from admissions through discharge of homecare clients and patients served. This oversight will include supervision of care management as required by regulation or contract and personnel management associated with the clinical delivery. The Clinical Supervisor is accountable to all federal, state, and local contracts and programs, and Maxim requirements, and where applicable or required by state regulations may be the Administrator. The Clinical Supervisor is also responsible for the orientation and ongoing evaluation of homecare caregivers. Critical to this role is the assurance of clinical skills and competency of caregivers. This position will include ongoing caregiver development through education and training under the direction of the Clinical Manager or other office clinical leader. Essential Duties and Responsibilities: Participates in patient and client engagement through care planning and excellent customer...

The Clinical Supervisor is responsible for the clinical oversight from admissions through discharge of homecare clients and patients served. This oversight will include supervision of care management as required by regulation or contract and personnel management associated with the clinical delivery. The Clinical Supervisor is accountable to all federal, state, and local contracts and programs, and Maxim requirements, and where applicable or required by state regulations may be the Administrator. The Clinical Supervisor is also responsible for the orientation and ongoing evaluation of homecare caregivers. Critical to this role is the assurance of clinical skills and competency of caregivers. This position will include ongoing caregiver development through education and training under the direction of the Clinical Manager or other office clinical leader. Essential Duties and Responsibilities: Participates in patient and client engagement through care planning and excellent customer...

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care Develop, assess and adjust, as necessary, the care plan and promote desired outcome Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients Develop plan of...

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care Develop, assess and adjust, as necessary, the care plan and promote desired outcome Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients Develop plan...

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care Develop, assess and adjust, as necessary, the care plan and promote desired outcome Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients Develop plan...

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care Develop, assess and adjust, as necessary, the care plan and promote desired outcome Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients Develop plan...

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care Develop, assess and adjust, as necessary, the care plan and promote desired outcome Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients Develop plan of...

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care Develop, assess and adjust, as necessary, the care plan and promote desired outcome Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients Develop plan of...

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care Develop, assess and adjust, as necessary, the care plan and promote desired outcome Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients Develop plan...

Reviews requests for authorization for specific medications by reviewing medical records and documents related to the Medi-Cal program. Considers each prior authorization request and collects evidence and patient information to support the decision. Communicates with the prescriber and pharmacy to obtain additional information if needed. Ensures the authorization meets contractual obligations. May also require coordinating with administrators and healthcare providers to gain necessary information and ensures that patients receive authorized prescriptions. As a key clinical member of the service center team, interacts with prescribers and pharmacy staff to review prior authorization requests and make appropriate determinations. Consults with physicians/providers as necessary, interprets clinical guideline criteria, and renders/reviews coverage determination for prior authorization cases. Consults with pharmacy staff regarding use of medications and recommend appropriate formulary...

Seeking Registered Nurse 100% Remote! Description: •Telephonically assess Medicare, Medicaid, Commercial, and/or and Group Account members in seven domains of functioning •Evaluate member needs and requirements to achieve and/or maintain optimal wellness state •Guide members and their families toward and facilitate interaction with resources appropriate for the care and wellbeing of members Requirements Active Registered Nurse (R.N.) license with no disciplinary action. Hold an active Compact nursing license- must have prior to applying for the role 3 years of Experience Able to work 40 hours per week between the hours of 8am-8pm EST with occasional Saturdays. Work schedule to be determined after offer is made and is in EST time. About Actalent: Actalent connects passion with purpose. Our scalable talent solutions and services capabilities drive value and results and provide the expertise to help our customers achieve more. Every day, our experts around the...

Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care. 3 Month Contract Education/Experience: Graduate from an Accredited School of Nursing. Bachelors degree in Nursing preferred. 2+ years of clinical nursing experience in a clinical, acute care, or community setting. 1+ years of case management experience in a managed care setting. Knowledge of utilization management principles and healthcare managed care. Experience with medical decision support tools (i.e. InterQual, NCCN) and government sponsored managed care programs. Licenses/Certifications: Current states RN license. Job Description: * Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options * Utilize assessment skills and...

CareHarmony's Licensed Practical Nurses are experts in helping patients and caregivers navigate the healthcare system and better manage the patient's chronic illnesses. LPN Care Coordinators work cooperatively with the patient's providers to help achieve health goals.Position Details This is a telephonic coordinator position with no face-to-face patient contact. CareHarmony is seeking a Licensed Practical Nurse, with at least one year of prior clinical work experience, to support providers in delivering comprehensive chronic care management services for their patients.All work will be Remote. You must have internet, preferably Fiber or Cable, in order to be considered for an interview. Applicants will not proceed to the interview stage without proof of a reliable home network.Each LPN Care Coordinator is assigned a set census of patients. You will be responsible for providing all telephonic support required to coordinate care for their patients. You have experience identifying and...

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) As a Case Manager working with Medicaid members you'll wear many hats, and work in a variety of environments. Sometimes, you'll interact with members leaving the hospital - possibly with new medications or diagnoses. Or perhaps you'll perform home visits, assisting members with safe, effective transitions from care environments to where they live. You may also act as an intermediary between providers and members - serving in numerous roles, such as educator, evaluator, service coordinator, community resource researcher and more. The result? Fewer hospitalizations, ER visits and costly service gaps; and a less stressed, more effective health...

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) As a Case Manage r working with Medicaid member s you'll wear many hats, and work in a variety of environments. Sometimes, you'll interact with members leaving the hospital - possibly with new medications or diagnoses. Or perhaps you'll perform home visits, assisting members with safe, effective transitions from care environments to where they live. You may also act as an intermediary between providers and members - serving in numerous roles, such as educator, evaluator, service coordinator, community resource researcher and more. The result? Fewer hospitalizations, ER visits and costly service gaps; and a less stressed, more effective health...