- Elevance Health (Waukesha, WI)
- **Agile Product Manager - Claim Anomaly Detection/Data Mining** _This position will work a hybrid model (remote and office), 1-2 times per week. The Ideal ... Experiences:** + Leading SAFe (SA), and/or SPO/PM (SAFE Product Owner/Product Manager ) strongly preferred . + Data mining experience preferred . + Jira… more
- Sutter Health (San Francisco, CA)
- …& LICENSURE** + RN-Registered Nurse of California (required) + CCM-Certified Case Manager ( preferred ) ** PREFERRED EXPERIENCE AS TYPICALLY ACQUIRED IN:** ... CPMC-California Pacific Med Center Van Ness **Position Overview:** The RN Case Manager is responsible for Care Coordination, Care Transitions, Discharge Planning and… more
- Elevance Health (Louisville, KY)
- …states._ ** Preferred Skills, Capabilities, and Experiences:** + Certification as a Case Manager is preferred . + Compact license preferred . + Kentucky RN ... **Nurse Case Manager II** **National Management and Support** **Location** :...as applicable. + Assists in problem solving with providers, claims or service issues. + Assists with development of… more
- Elevance Health (Houston, TX)
- …multiple states. ** Preferred Capabilities, Skills and Experiences:** + Certification as a Case Manager is preferred . + Ability to talk and type at the same ... **Telephonic Nurse Case Manager II** **Location: This is a virtual position....as applicable. + Assists in problem solving with providers, claims or service issues. **Minimum Requirements:** + Requires a… more
- CVS Health (Columbus, OH)
- …able to obtain multi state RN licenses if needed, company will provide. * Bilingual preferred - Spanish * Certified Case Manager is preferred . * Additional ... to the defined metrics, as required by the business. Nurse Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing… more
- CVS Health (Trenton, NJ)
- …within 50 miles of Mercer County, New Jersey (50-mile radius from applicant's home) ** Preferred Qualifications** + Certified Case Manager is preferred + ... home). Standard working hours Monday - Friday 8-5 pm EST. **ICM Case Manager RN** **WFH Flexible** **Position Summary:** Help us elevate our patient care to… more
- Elevance Health (Columbus, OH)
- …Capabilities and Experiences:** + 3 years case management experience. + Certification as a Case Manager is preferred . + Certification as a Case Manager and a ... of a relevant Elevance Health location. The **Nurse Case Manager Sr.** is responsible for care management within the...as applicable. + Assists in problem solving with providers, claims or service issues. + Assists with development of… more
- Elevance Health (Atlanta, GA)
- … Capabilities, Skills and Experiences:** + Ability to talk and type at the same time preferred . + Certification as a Case Manager is preferred . + Demonstrate ... **Telephonic Nurse Case Manager I - $3000 Sign-On Bonus Offered** **Location:...treatment plans. + Assists in problem solving with providers, claims or service issues. + Assists with development of… more
- Elevance Health (Tampa, FL)
- …states. ** Preferred Capabilities, Skills, and Experiences:** + Certification as a Case Manager is preferred . + BS in a health or human services-related field ... **Telephonic Nurse Case Manager I** **Sign-on Bonus: $3000** Elevance Health supports...reimbursement, as applicable. + Assists in problem-solving with providers, claims , or service issues. **Minimum** **Requirements:** + Requires BA/BS… more
- Elevance Health (MO)
- …states. ** Preferred skills, qualifications and experiences:** + Certification as a Case Manager is preferred . + BS in a health or human services related ... **Title** : Nurse Case Manager II **Location:** Candidates must reside within 50...as applicable. + Assists in problem solving with providers, claims or service issues. + Assists with development of… more
- Elevance Health (NV)
- …states. ** Preferred skills, qualifications and experiences:** + Certification as a Case Manager is preferred . + BS in a health or human services related ... **Title** : Nurse Case Manager II **Location:** Candidates must reside within 50...as applicable. + Assists in problem solving with providers, claims or service issues. + Assists with development of… more
- UCLA Health (Los Angeles, CA)
- …+ Ability to travel/attend off-site meetings and conferences + ACM - Accredited Case Manager preferred + CCM - Certified Case Manager preferred ... all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management, you'll provide direct...+ Concurrent Review + Continuity of Care + Retro Claims + Retrospective Review + Referral Automation Business Rules/Configuration… more
- Parsons Corporation (Boise, ID)
- …of action items following discussions/meetings with the client and Project Manager . ** PREFERRED EDUCATION/EXPERIENCE:** + Bachelor's degree related field is ... other technical support groups within the company. + Assists the Project Manager in planning, directing, supervising, and controlling the execution of technical,… more
- CVS Health (Albany, NY)
- … that RN license is part of the compact. + Certified Case Manager is preferred . + Demonstrates proficiency with standard corporate software applications, ... + Conducts assessments that consider information from various sources, such as claims , to address all conditions including co-morbid and multiple diagnoses that… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Senior CBO Revenue Cycle Manager reporting to the Senior Director of CBO Operations, is responsible for directing and coordinating the ... meetings with department staff and providers to provide information/feedback on claims /denials to ensure optimal AR management. Analyzes Department metrics to assess… more
- Thrive Communities (Cooper, TX)
- …6 months' supervisory experience, with demonstrated strong leadership skills + Certified Apartment Manager (CAM) preferred + High School Diploma or equivalent ... plan! + 30% Housing Discount with Ownership and Regional Manager Approval + 12% Bonus Potential + $150 Leasing...Home Office departments immediately. Ensures that all workers' compensation claims are reported and proper paperwork is completed. +… more
- Sutter Health (San Francisco, CA)
- …**CERTIFICATION & LICENSURE** RN-Registered Nurse of California CCM-Certified Case Manager (optional) ** PREFERRED EXPERIENCE AS TYPICALLY ACQUIRED** Minimum ... Pacific Med Center - Mission Bernal **Position Overview:** The RN Case Manager is responsible for Care Coordination, Care Transitions, Discharge Planning and… more
- Commonwealth Care Alliance (Boston, MA)
- …cross functional business and technology implementations with some reliance on direct manager **Experience Preferred :** + Experience working in a managed care ... **Why This Role is Important to Us:** The Enterprise Senior Project Manager is a key project delivery leadership role in the Enterprise Project Delivery Team… more
- AdventHealth (Daytona Beach, FL)
- …** Preferred qualifications:** + Degree in health or business administration is preferred . + Certified Office Manager or Practice Manager designation ... **Practice Manager - AdventHealth Medical Group** **All the benefits...correct use of modifiers and physician coding for "Clean Claim " processing. + Represents HCP to outside agencies, including… more