2 rn medical office jobs found

ChristianaCare is currently seeking a Statewide Registered Nurse to support the CMS GUIDE program.  The Statewide GUIDE Nursing Care Delivery Specialist is a registered nurse who provides clinical care coordination, education, and triage support across all three GUIDE program sites in Delaware. This role supports consistent delivery of CMS clinical care requirements while supporting care navigators and maintaining collaborative relationships with beneficiaries' existing medical providers. This position requires regular travel to and service delivery at all three locations including Smyrna, Rehoboth, and Wilmington. Clinical Care Coordination (70%). The Swank Center for Memory Care and Geriatric Consultation at ChristianaCare is Delaware's first and most comprehensive outpatient office for patients with memory disorders and their families. The Swank Center for Memory Care and Geriatric Consultation offers these patient and their families essential support, education, and guidance...

Registered Nurse (RN) - Utilization Management FT Day Shift (Hrs.: 8a-4:30p) Newark, DE ChristianaCare Hospital in Newark, DE, is seeking a Utilization Management Nurse (RN) with experience with insurance providers such as Aetna and Cigna, along with a background in an acute care hospital. PRIMARY FUNCTION: Responsible for ensuring the delivery of efficient and effective health care while evaluating the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities under the provision of the applicable health benefits plan. UTILIZATION MANAGEMENT Performs admission and concurrent review to identify medical necessity, level of care, and appropriateness of setting using established criteria and clinical guidelines within 24 hours of admission. Reviews the admission assessment and collaborates with primary nurse and other health care providers to ensure a multidisciplinary plan-of-care is in place to meet...