Director, Healthcare Services - REMOTE Molina Healthcare IncDirector, Healthcare Services - REMOTEBoise, IDRemoteRegistered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). At least 8 years of health care experience, and at least 5 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience.
NewQuality Clinical Reviewer (Idaho license) - Remote Magellan Health IncQuality Clinical Reviewer (Idaho license) - RemoteBoise, IDRemoteLCSW - Licensed Clinical Social Worker - Care MgmtCare MgmtCare Mgmt, LMHC - Licensed Mental Health Counselor - Care MgmtCare MgmtCare Mgmt, LPC - Licensed Professional Counselor - Care MgmtCare MgmtCare Mgmt, MFT - Marriage and Family Therapist - Care MgmtCare MgmtCare Mgmt, PSY - Psychologist - Care MgmtCare MgmtCare Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care MgmtCare MgmtCare Mgmt. Assists in the planning and implementation of activities to improve delivery of services and quality of care including the development and coordination of in-service education programs for providers and care managers.
NewCare Manager (UM/UR) - Remote, Idaho Licensed Magellan Health IncCare Manager (UM/UR) - Remote, Idaho LicensedBoise, IDRemoteCEAP - Certified Employee Assistance Professional - Care MgmtCare MgmtCare Mgmt, LCSW - Licensed Clinical Social Worker - Care MgmtCare MgmtCare Mgmt, LMFT - Licensed Marital and Family Therapist - Care MgmtCare MgmtCare Mgmt, LMSW - Licensed Master Social Worker - Care MgmtCare MgmtCare Mgmt, LPC - Licensed Professional Counselor - Care MgmtCare MgmtCare Mgmt, LSW - Licensed Social Worker - Care MgmtCare MgmtCare Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care MgmtCare MgmtCare Mgmt. Under general supervision, and in collaboration with other members of the clinical team, authorizes and reviews utilization of mental health and substance abuse services provided in inpatient and/or outpatient care settings.
Quality Clinical Reviewer (Idaho license) - Remote Magellan Health Services, Inc.Quality Clinical Reviewer (Idaho license) - RemoteBoise, IDRemoteFull timeLCSW - Licensed Clinical Social Worker - Care MgmtCare MgmtCare Mgmt, LMHC - Licensed Mental Health Counselor - Care MgmtCare MgmtCare Mgmt, LPC - Licensed Professional Counselor - Care MgmtCare MgmtCare Mgmt, MFT - Marriage and Family Therapist - Care MgmtCare MgmtCare Mgmt, PSY - Psychologist - Care MgmtCare MgmtCare Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care MgmtCare MgmtCare Mgmt. Assists in the planning and implementation of activities to improve delivery of services and quality of care including the development and coordination of in-service education programs for providers and care managers.
Utilization Management Registered Nurse Humana IncUtilization Management Registered NurseIDRemote$71,100–$97,800 / yearWork-at-Home Information: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it.
Advice RN, MIST - Work From Home Sutter HealthAdvice RN, MIST - Work From HomeBoise, IDRemote$38.87–$54.42 / hourIn addition to telephone triage, MIST RNs manage electronic in-basket messages, coordinate care across ambulatory and acute care settings, facilitate prescription renewal workflows in collaboration with licensed providers, identify appropriate hospital and community resources, coordinate referrals and consultations, and perform nursing follow-up to support continuity of care and positive patient outcomes. As integral members of the primary care team, MIST RNs partner closely with physicians, advanced practice providers, clinic staff, and interdisciplinary teams to manage patient communications within the electronic medical record, optimize workflow efficiency, and ensure high-quality, patient-centered care.
Urgent Care Nurse Practitioner Included Health IncUrgent Care Nurse PractitionerIdaho, IDRemoteWe're seeking board certified Nurse Practitioners licensed in Idaho (multi licensed strongly preferred) with broad clinical expertise and a passion for improving healthcare access and quality. In this role, you'll deliver virtual comprehensive care to patients of all ages across a wide range of conditions, while working closely with our provider and support teams.
Supervisor, Utilization Management TriWest Healthcare AllianceSupervisor, Utilization ManagementBoise, IDRemoteFull timeTechnical Skills: Thorough knowledge of policies and procedures, knowledge of managed care principles and methods; medical terminology; proficiency in the application of clinical criteria: InterQual, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders, current Procedural Terminology, and Healthcare Common Procedural Coding System, and American Dental codes; working knowledge with medical management systems; proficient with Microsoft Office; knowledge of UM Process; reporting techniques. • Prepares work schedules and monitors staff caseloads to ensure adequate staffing levels at all times and accurate data entry and application of the medical management system.