…medic experience may be considered in lieu of an RN license3+ years of experience in managed care and / or disease management3+ years of experience in a clinical

…Pediatrics, Field Based, Home Care , Home Health, Complex Case Management, Managed Care , Bilingual, Mental Health, Behavioral Health, Case Management, Case

…Keywords: RN, Registered Nurse , BSN, MSN, Utilization Management, Utilization Review, Managed Care , Care Manager, Queue Management, Case Management,

…Pennsylvania RN licensure and three (3) years clinical practice experience in the Managed Care space, highly sought. Must live in the Pennsylvania, Delaware

…patient acuity and staff skill level into consideration to ensure each patient receives proper care . Typical nurse to patient ratios range from 1:1 or 1:2 for

…including demonstrated solutioning and audit goal development Spanish Background in managed care Case Management experience Certified Case Manager (CCM)

…managing the Case and Utilization Management (UM) department, in addition to contributing to managed care operations. A key element of this very important role

…Proficient in PC software computer skills Must have sound knowledge of managed care , medical terminology, referral process, and ICD-9/ICD-10 coding Independent

…they serve. Fallon Health Weinberg in Amherst, NY is currently seeking an experienced RN Nurse Care Manager for our quickly expanding MLTC program. This is a

…process regarding new referrals, including scanning, uploading, indexing documents into the managed care database and assigning utilization review and/or case