The Judge Group jobs

RN Case Manager

The Judge Group is currently seeking a RN Case Manager in the Sacramento, CA area!This job will have the following responsibilities/requirements: Must have interqual and appeals and denialsWill do rounds with Dr. Utilization Review and Discharge Planning Preferred Must have recent in Hospital Case Management experience? If you or someone you might know would be interested, please send your most updated resume to Jacob at [Click Here to Email Your Resum?] ! Associated topics: case manager, c...

CHRONIC CONDITIONS/CASE MANAGEMENT-TRAVEL

Judge Healthcare is actively seeking full time Case Manager RN for California's premier health system!!This position is located in Pasadena, CAThis job will have the following responsibilities: -Staff Nurse in Case Management for chronic condition specialties-5 x 8 hour shifts-Days available Qualifications & Requirements:-1 year experience in Case Management of chronic conditions-Valid CA license and BLSPlease send your MOST UP TO DATE RESUME to Jackie at [Click Here to Email Your Resum ]...

Clinical Review Nurse

CLINICAL REVIEW NURSEThe Health Plan of San Mateo (HPSM), a managed care health plan, seeks a full time Clinical Review Nurse to conduct clinical reviews of grievances and appeals filed by members and providers. Clinically evaluates reports of Potential Quality Incidents (PQI), determining the severity of any issues identified and recommending interventions. Identifies areas for quality improvement, both externally and internally, and works with the Grievance and Appeals (G&A) Unit and Me...

Member Outreach RN

Judge Healthcare is currently seeking a Registered Nurse (RN) to conduct member outreach duties. This job will have the following responsibilities:Main responsibility will be to perform outbound calls to members as a follow up to make sure they are receiving the medical care they need and to help identify any discrepancies or gaps in care.Must have great people skills, phone skills and willing to work as a team player! Qualifications & Requirements:RN or LPN in the state of Tennessee or...

Team Leader – MSW

Judge Healthcare is currently seeking a Team Leader - MSW for our client in Philadelphia, PA. This job will have the following responsibilities: Responsible for overseeing various aspects of the clinical program. This includes selecting, training, supervising, and evaluating staff; coordinating clinical care of patients, program development and quality management initiatives; attending/co-leading clinical staff meetings and assisting in providing direction for resolution of problems identif...

Registered Nurse Case Manager

The Judge Group is looking for a RN Case Manager in Woodland Hills, CA!? Job Description:?The Case Manager is responsible for the coordination of care and services.The Case Manager effectively collaborates directly with the Member, Member's Family, and Interdisciplinary Care Team to achieve consensus and promote positive Member health outcomes through the assessment, planning, implementation and evaluation of the Member?s Care Plan.?The Case Manager identifies gaps in care and coordinates th...

Medical Customer Support (Case Management)

Our client is currently seeking a Medical Customer SupportRequired Education: High School Diploma or G.E.D.Required Experience:?Two or more years experience as a medical assistant, office assistant or other healthcare service administrative support role.Bilingual in Spanish requiredDuties and Responsibilities Provides support to the Case Management staff performing non clinical activities and supporting the management of the department.Responsible for initial review and triage of Case Managem...

CASE MANAGER RN

The Judge Group is looking for a RN Case Manager in Atlanta, GA!? Job Description:?DaysM-F?8-4:30pOnsite? Job Requirements:?2 years of clinical experience within the last 3 years?Active and unrestricted GA RN Licensure?Current BLS from the AHAAssociate Degree Required Please send your most up to date resume to Jaclyn at [Click Here to Email Your Resum?] Associated topics: bsn, cardiothoracic, care, coronary, intensive care unit, nurse, nurse clinical, psychiatric, surgical, unit

Clinical Care Reviewer

Our client is currently seeking a Clinical Care Reviewer to work in Newark, DE. This is an excellent opportunity to work with one of the largest healthcare providers in the nation.?Take action and apply today!This job will have the following responsibilities:?Review provider requests for inpatient and outpatient services,?Work closely with members and providers to collect all information necessary to perform a thorough medical necessity review.Pend requests for additional information or clari...

RN Oncology Case Manager

Day to Day Responsibilities of this Position and Description of Project:?Determines, develops and implements a plan of care based on accurate and comprehensive assessment of the member??s needs. ?Applies detailed knowledge of FEP PPO and Blue Shield of California??s (BSC) established medical/departmental policies, clinical practice guidelines, community resources, contracting and community care standards to each case. ?Works with complex cases, promotes the delivery of quality; cost-effective...

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