- 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
- Elevance Health (Grand Prairie, TX)
- …the ability to interpret and apply member contracts, member benefits, and managed care products preferred. + Certification as a Case Manager is ... the applicable medical policy and industry standards, accurately interpreting benefits and managed care products, and steering members to appropriate providers,… more
- AdventHealth (Maitland, FL)
- …Provides guidance and direction to PFS, Central Denials, Patient Access and Managed Care staff regarding contract terms and policies including governmental ... the Florida division. This position assists the Sr. Contract Manager with ensuring that preferred contract language provides for...key contract data elements which are populated into the Managed Care database including addition of new… more
- 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
- Houston Methodist (Houston, TX)
- …planning, utilization management, case management, performance improvement and managed care reimbursement. + Understanding of pre-acute and post-acute ... At Houston Methodist, the Case Manager (CM) Certified position is...communicating medical information required by all external review entities, managed care contracts, insurers, fiscal intermediaries, state,… more
- Molina Healthcare (Bronx, NY)
- … Management program . We are seeking a Registered Nurse with previous Case / Care Management and managed care experience. Candidates with experience in ... of Nursing. Bachelor's Degree in Nursing preferred. **Required Experience** 1-3 years in case management, disease management, managed care or medical or… more
- CommuniCare Health Services Corporate (Akron, OH)
- …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
- ManpowerGroup (Columbia, SC)
- …Identifies and makes referrals to appropriate staff (Medical Director, Case Manager , Preventive Services, Subrogation, Quality of care Referrals, etc.). + ... **Title:** ** Managed Care Coordinator UM II** **Location:...Experience: 7 years-healthcare program management. Preferred Licenses and Certificates: Case Manager Certification, clinical certification in specialty… more
- 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
- National Health Care Associates (Wethersfield, CT)
- …Serves as an advocate for patients by producing case documentation, plan of care and discharge planning to the patient's managed care plan. Your ... our team! **-** **What You'll Do:** As a Regional Case Manager , you are responsible for conducting...concurrent chart review of medications and treatments for the managed care patient population and assessing the… more
- ManpowerGroup (Columbia, SC)
- …Identifies and makes referrals to appropriate staff (Medical Director, Case Manager , Preventive Services, Subrogation, Quality of Care Referrals, etc.). + ... **Title: Coordinator, Managed Care I** **Location: Columbia SC**...Behavioral Health Experience + Previous Utilization Management (UM) or Case Management (CM) experience + Training will be onsite… more
- ChenMed (St. Petersburg, FL)
- … Case Manager Certification (CCMC) or the American Association of Managed Care Nurses (CMCN) desired. We're ChenMed and we're transforming healthcare for ... A minimum of 3 years experience in home health case management and community care highly preferred...maintenance of a current, valid driver's license. + Certified Case Manager certification is preferred. Certification through… more
- 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
- Banner Health (Gilbert, AZ)
- …your future. Apply today. Our Care Coordination staff is seeking an RN Case Manager to work closely with patients and their families, physicians, and other ... members of the health care team on case management and managed care ...require a minimum of one year Case Manager experience in an acute care hospital.… more
- Banner Health (Sun City, 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 (Mesa, 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
- Mount Sinai Health System (New York, NY)
- …+ Develops and maintains effective working relationships with interdisciplinary team and Case Managers within the managed care organizations. 7. ... **Job Description** **RN/ Case Manager MSH Case ...**Job Description** **RN/ Case Manager MSH Case Management FT Days**...population; + Provides the clinical information requested by the managed care companies as part of the… more
- Banner Health (Phoenix, AZ)
- …your future. Apply today. Our Care Coordination staff is seeking an RN Case Manager to work closely with patients and their families, physicians, and other ... members of the health care team on case management and managed care ...require a minimum of one year Case Manager experience in an acute care hospital.… more
- Molina Healthcare (Dearborn, MI)
- …a fast-paced position and productivity is important. Preferred candidates will have previous case management, managed care , hospital, and/or home health ... unrestricted Transitions of Care Sub-Specialty Certification and/or Certified Case Manager (CCM) To all current Molina employees: If you are interested… more
- BronxCare Health System (Bronx, NY)
- Overview The Case Manager will coordinate care using a collaborative approach with the multidisciplinary team in identifying the required services needed to ... cases with extended LOS providing updated information to Utilization Case Manager and /or Director for further... Case Management. Experience with InterQual and Milliman Care Guidelines. Knowledge of DRG and GMLOS, Managed… more
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