• Case Manager RN - Western Region

    CVS Health (Charleston, WV)
    …planning experience + Medicaid experience + Crisis intervention skills + Managed care experience + Certified Case Manager (CCM) certification + ... purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our...of service and with demonstrated performance and attendance. The Case Manager RN (CM RN) is responsible… more
    CVS Health (01/19/25)
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  • RN Case Manager , Managed

    Sutter Health (Goleta, CA)
    …AND KNOWLEDGE:** A broad knowledge base of health care delivery and case management within a managed care environment. Comprehensive knowledge of ... Nurse of California + BLS-Basic Life Support Healthcare Provider + CCM - Certified Case Manager (certification may be required by entity and time to acquire… more
    Sutter Health (01/22/25)
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  • Case Manager RN - Southern Region

    CVS Health (Lewisburg, WV)
    …intervention skills + Managed care /utilization review experience + Certified Case Manager (CCM) certification + Case management experience in an ... purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our... more personal, convenient and affordable. **Position Summary** The Case Manager RN (CM RN) is responsible… more
    CVS Health (01/01/25)
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  • Medical Case Manager CARE

    Sedgwick Government Solutions (Dublin, OH)
    …answers within that large "pile" of documents intrigue you? As a Medical Case Manager with Managed Care Advisors, working in your home office on Federal ... Job Details Medical Case Manager CARE (Remote)...simply doing the exceptional! **Sedwick Government Solutions (SGS) / Managed Care Advisors (MCA),** a rapidly expanding… more
    Sedgwick Government Solutions (01/15/25)
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  • Case Manager RN

    CVS Health (Columbus, OH)
    …Qualifications:** - Compact RN License or Multi state licensure - Certified Case Manager (CCM) - Managed Care experience - Hospital experience in ICU, ... solutions to make health care more personal, convenient and affordable. This Case Manager RN position is 100% remote and the employee can live in any state.… more
    CVS Health (01/22/25)
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  • Nurse Case Manager

    Elevance Health (Latham, NY)
    …states **Preferred Capabilities, Skills and Experiences:** + Certification as a Case Manager is preferred. + Managed Care experience preferred. + Ability ... **Nurse Case Manager I - NICU** **Location:**... Management. Assess, develop, implement, coordinate, monitor, and evaluate care plans designed to optimize member health care more
    Elevance Health (01/22/25)
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  • Program Manager - Managed

    Cedars-Sinai (CA)
    …people throughout Los Angeles and beyond. **Req ID** : 5668 **Working Title** : Program Manager - Managed Care (Hybrid) **Department** : MNS Managed ... **Job Description** The Program Manager is responsible for supporting all facets of...membership. + Monitors and Tracks all other aspects of Managed Care , quality & efficiency measures, Star… more
    Cedars-Sinai (11/07/24)
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  • Executive Director, Office of Mail Renewal (OMR),…

    City of New York (New York, NY)
    …(MCP), interfaces with managed care delivery systems comprised of Managed Care Organizations (MCOs) and case management providers through which ... Assistance Program (MAP), is recruiting for one (1) Administrative Manager NM-III, to function as the Executive Director, of...the Executive Director, of the Office of Mail Renewal, Managed Care Program (MCP), and Third-Party Health… more
    City of New York (01/24/25)
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  • Excess Risk Managed Care Clinician

    Highmark Health (St. Paul, MN)
    …job is responsible for analyzing clinical data to assess potential stop loss and managed care claim liability, utilizing Case Management oversight techniques ... to assess potential stop loss and managed care claim liability and utilize Case Management...or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Case Manager (CCM) **Language (Other than English):**… more
    Highmark Health (11/25/24)
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  • Managed Care Coordinator

    Beth Israel Lahey Health (Westwood, MA)
    …taking a job, you're making a difference in people's lives.** The Manager Care Coordinator initiates and process managed care insurance referral requests ... the BILH network. **Job Description:** + **Hybrid / Remote Schedule** **The Managed Care Coordinator's Responsibilities are:** 1. Work collaboratively with BILH… more
    Beth Israel Lahey Health (12/19/24)
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  • Managed Care Claims Validator…

    CommuniCare Health Services Corporate (Charleston, WV)
    …to support our Central Billing Office team. PURPOSE/BELIEF STATEMENT The position of Managed Care Claims Validator / Biller is responsible for accurate and ... timely filing of all managed care claims on their assigned caseload...cash collections team, CBO cash posting team, Business Office Manager , Regional Director of Finance, MDS, Case more
    CommuniCare Health Services Corporate (01/22/25)
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  • Managed Care Contract Reimbursement…

    Henry Ford Health System (Troy, MI)
    …EDUCATION/EXPERIENCE REQUIRED: + Bachelor's degree in Finance, Accounting, Business Administration, Managed Care Contracting, Reimbursement, or related field. + ... GENERAL SUMMARY: Under minimal supervision of the Manager , independently leads financial and data analysis to...to seven (5-7) years of experience in healthcare finance, managed care contracting, or reimbursement in a… more
    Henry Ford Health System (01/10/25)
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  • Care Manager II, Complex, RN/LCSW

    AmeriHealth Caritas (Jacksonville, NC)
    …homecare or community health setting.; + Case management experience, preferably within a managed care organization desired. + Certification as a case ... to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and...Discover more about us at; www.amerihealthcaritas.com .; **Responsibilities** The Care Manager II is responsible for managing… more
    AmeriHealth Caritas (01/10/25)
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  • RN Acute Case Manager - System…

    Guthrie (Binghamton, NY)
    Manager monitors clinical approaches and make recommendations for alternate levels of care . The Acute Case Manager collaborates cooperatively with the ... patient and members of the interdisciplinary health care team. The Acute Case ...positive and professional relationship with payers that supports continued managed care contracts. c) Articulates the primary… more
    Guthrie (11/13/24)
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  • Complex Case Manager Ambulatory…

    Henry Ford Health System (Troy, MI)
    …to promote patient safety, quality of care and cost-effective outcomes. The Case Manager addresses the needs of patients who have experienced a critical ... hiring a passionate and dedicated RN or Social Worker Case Manager to join a new Henry...health care , rehabilitative medicine, community health or managed care preferred. + Knowledge of preventive… more
    Henry Ford Health System (01/18/25)
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  • Case Manager - Long Term Care

    Molina Healthcare (Bal Harbour, FL)
    …with disabilities/chronic conditions and Long Term Services & Supports. + 1-3 years in case management, disease management, managed care or medical or ... **JOB DESCRIPTION** Case Manager will work in remote...behavioral health settings. **PREFERRED EXPERIENCE:** + 3-5 years in case management, disease management, managed care more
    Molina Healthcare (01/24/25)
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  • Coordinator, Managed Care I

    ManpowerGroup (Columbia, SC)
    **Title: Coordinator, Managed Care I** **Address: Columbia, SC 29229** **Duration: 3 months** **Rate range: $25 to $30** **Position Overview** The Utilization ... Refer cases to appropriate staff, such as Medical Directors, Case Managers, or Quality of Care teams....will participate in Microsoft Teams interviews with the hiring manager . **What We're Not Looking For** + No hospital… more
    ManpowerGroup (01/15/25)
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  • RN Case Manager Care

    Dignity Health (Northridge, CA)
    …Visit dignityhealth.org/northridgehospital (https://www.dignityhealth.org/socal/locations/northridgehospital) for more information. RN Case Manager ( Care ... a clinical or insurance setting is required. + Certified Case Manager (CCM), Accredited Case ... (ACM-RN), or UM Certification preferred. + Knowledge of managed care and payer environment preferred. +… more
    Dignity Health (01/07/25)
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  • Managed Care Coordinator

    Elevance Health (Richmond, VA)
    ** Managed Care Coordinator** Location: Candidate must reside within 50 miles of Richmond, VA. While primarily remote, occasional travel to meet with members face ... to face is required. The ** Managed Care Coordinator** is responsible for overall...experiences:** + BA/BS degree field of study in health care related field preferred. + Prior case more
    Elevance Health (01/24/25)
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  • Registered Nurse RN Case Manager

    Banner Health (Tucson, AZ)
    …requirements. 6. Educates internal members of the health care team on case management and managed care concepts. Facilitates integration of concepts ... positions require a minimum of one year Case Manager experience in an acute care hospital. PREFERRED QUALIFICATIONS Certification for CCM (Certified Case more
    Banner Health (01/17/25)
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