- Elevance Health (Costa Mesa, CA)
- **Telephonic Nurse Case Manager II ** **Sign on Bonus: $5000.** **Location: This role enables associates to work virtually full-time, with the exception of ... therefore, Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II ** is responsible...as applicable. + Assists in problem solving with providers, claims or service issues. + Assists with development of… more
- Elevance Health (Grand Prairie, TX)
- **Nurse Case Manager II ** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... from 11:30 AM to 8:00 PM EST. The **Nurse Case Manager II ** is responsible...as applicable. + Assists in problem solving with providers, claims or service issues. Assists with development of utilization/care… more
- Elevance Health (St. Louis, MO)
- **Telephonic Nurse Case Manager II ** **Sign On Bonus: $3000** **Hours: Monday thru Friday 10:30am - 7pm Central Time** **Location** : This role enables ... therefore Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II ** is responsible...treatment plans. + Assists in problem solving with providers, claims or service issues. **Minimum Requirements:** + Requires a… more
- AO Smith (Lebanon, TN)
- Regional Field Service Manager II Date: Dec 4, 2025 Location(s): Lebanon, TN, US, 37090 Company: A. O. Smith Corporation Hybrid, Onsite or Remote: Remote PRIMARY ... SCOPE OF RESPONSIBILITY: Position reports to the Field Service Engineering Manager SPECIFIC DUTIES/ACCOUNTABILITIES(List in order of importance) + Aligned with… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …policies and procedures and related health plan functions such as member services, claims , and the referral process. As well as functions related to legislative and ... the Health Plan Essential Accountabilities: Level I + Review / prep clinical case for clinical staff. + Navigates and utilizes corporate applications; core claims… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …compliance and regulatory requirements. Primary activities include substantiating referrals, case planning and research, conducting onsite or desk audits, clinical ... in a clear and concise manner. + Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. + Manages cases as assigned,… more
- Sutter Health (Modesto, CA)
- …patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the timely ... management, quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and contracted providers and… more
- LA Care Health Plan (Los Angeles, CA)
- …Social Worker; current and unrestricted California License. Licenses/Certifications Preferred Certified Case Manager (CCM) Accredited Case Manager ... Care Management Specialist II Job Category: Clinical Department: Care Management Location:...skills and judgement. Management of the caseload assigned by Manager includes: coordinating health care benefits, providing education and… more
- ZOLL Medical Corporation (Houston, TX)
- …Hospitalists, CT Surgeons etc.), Nurse Practitioners, Physician Assistants, nurses, case managers and administrators. Other duties include selling the value ... intake and reimbursement to ensure appropriate and timely filing of billing claims + Maintain credentialing/access to all assigned accounts at all times… more
- Elevance Health (Indianapolis, IN)
- **eCOB Specialist II ** **Location:** Virtual, this role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... Friday, 8:00 am - 4:30 pm The **eCOB Specialist II ** responsible for researching and investigating other coverage for...when they are entitled. + Determines primacy on each case using a complex set of Primacy Rules as… more
- LA Care Health Plan (Los Angeles, CA)
- Authorization Technician II (ALD) Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ... net required to achieve that purpose. Job Summary The Authorization Technician II supports the Utilization Management (UM) Specialist by handling all administrative… more
- LA Care Health Plan (Los Angeles, CA)
- …Active, current and unrestricted California License Licenses/Certifications Preferred Certified Case Manager (CCM) Required Training Physical Requirements Light ... to develop and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, post-service… more
- Elevance Health (Indianapolis, IN)
- …Saturday and Sunday) as well as 3 consecutive week days. The **Transplant Nurse II ** will be responsible for providing case and/or medical management for members ... **Transplant Nurse II ** **Location:** Virtual: This role enables associates to...preparation for advancement to the senior level. Within the case management role will within the scope of licensure… more
- US Tech Solutions (Chesapeake, VA)
- …all levels to enable decision making at most appropriate level **Duties:** + Nurse Case Manager is responsible for face to face and telephonically assessing, ... and multiple diagnoses that impact functionality. + Reviews prior claims to address potential impact on current case... claims to address potential impact on current case management and eligibility. Assessments include the member's level… more
- HCA Healthcare (Lone Tree, CO)
- …quality and/or risk issues and reports these to the appropriate individual/department As a Case Manager , your role will be to support patients and families ... care like family! Jump-start your career as a(an) RN Case Mgr PRN today with HCA HealthONE Sky Ridge....the acute care setting. Performs telephonic clinical reviews with claims insurance personnel to facilitate reimbursement for the delivery… more
- PPL Corporation (Allentown, PA)
- …that support education, sustainability, and wellbeing. Overview The **Associate Project Manager ** is the single point of accountability for small to routine ... Project Leader for complicated projects. The **Project and Contract Manager ** position is the single point of accountability for...of both. Assigned work location may change. In the case of remote work, physical presence in the office/on-site… more
- The County of Los Angeles (Los Angeles, CA)
- MANAGER , AUTOPSY OPERATIONS AND SUPPORT SERVICES Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4670156) Apply MANAGER , AUTOPSY ... Forensic Technician (https://www.governmentjobs.com/careers/lacounty/classspecs/1065384?keywords=Supervising%20Forensic%20Technician%20&pagetype=classSpecifications) for Los Angeles County. Option II : Four years of experience assisting pathologists in… more
- PPL Corporation (Allentown, PA)
- …typically be sought by the Project Leader for complicated projects. The **Project Manager ** position is the single point of accountability for large PPL Electric ... status, recognizing trends and project variances, and implementing corrective action. ii . Reporting project status, forecasting cash flows and final project cost… more
- Army National Guard Units (VA)
- …Liaison, and the Director, Human Resources, serves as the local OHN Case Manager Consultant for ensuring development, evaluation, implementation and monitoring ... efficiency and to reduce or eliminate future hazardous conditions. 3. Manages the Case Management Program. In coordination with the US Department of Labor (DOL)… more
- Ventura County (Ventura, CA)
- …Management and/or Quality Assurance in a Managed Health Care Plan. + Experience working as a case manager in a health plan case managing complex cases. + ... Senior Medical Management Nurse is responsible for performing utilization review, case management, and quality improvement functions to ensure that members receive… more
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