- Trinity Health (Fresno, CA)
- …Reporting to the Director CVHP Operations, CVHP Operations, this position coordinates care and service for defined patient populations across the acute care ... continuum for CVHP members. This includes discharge planning, utilization management, care coordination, and support for resource utilization. This position works… more
- 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
- Corewell Health (Ada, MI)
- …Health Ludington Hospital) + 2 years of relevant experience clinical nursing and or case management/ managed care or related field Required + 5 years ... of relevant experience clinical nursing and or case management/ managed care or related... care or related field Preferred + Case Manager , Certified (CCM) - CCMC Commission… more
- Henry Ford Health System (Troy, MI)
- …health, managed care /health insurance preferred. + Certified Case Manager . Certifications/Licensures Required: + Current Michigan Registered Nursing ... to enter and retrieve data from relevant computer systems. + Basic knowledge of managed care and case management principles. + Knowledge of acute care ,… more
- CVS Health (Princeton, 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...of service and with demonstrated performance and attendance. The Case Manager RN (CM RN) is responsible… more
- CVS Health (Charleston, 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...of service and with demonstrated performance and attendance. The Case Manager RN (CM RN) is responsible… more
- 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
- 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
- Charles Schwab (San Francisco, CA)
- …responsible for managing our third-party product marketplaces (Alternative Investments, Managed Accounts, Mutual Funds, ETFs, Structured Products, Fixed Income, ... Insurance, and 529) as well as our proprietary Separately Managed Accounts. Our mission is to provide a positive...more modern and competitive. **What you'll do:** The Senior Manager is an individual contributor role that is vital… more
- University of Michigan (Ann Arbor, MI)
- …which are patient specific most often involving Out of State Payers. The Managed Care Payer Analyst will report to the Manager , Managed Care ... research that together enhance our contribution to society. **Responsibilities + Support Manager , Managed Care Operations and Senior Director, Managed … more
- Highmark Health (Columbus, OH)
- …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
- 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 ... and redirect care within the BILH network. **Job Description:** **The Managed Care Coordinator's Responsibilities are:** 1. Work collaboratively with BILH… 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)
- **Job title: Coordinator, Managed Care II/CM-DM** **Contract on W2** **Work type REMOTE but need to be onsite from (Columbia SC 29203) for 4-6 weeks for ... Certification must be obtained within 4 years of hire as a Case Manager . + Preferred Education: Bachelor's degree- Nursing Preferred Work Experience: 7… 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
- ManpowerGroup (Columbia, SC)
- + **Title:** Managed Care Coordinator UM II + **Location:** Initial on-site work required for the first week, followed by remote work. + **Hours:** ... + Identify and make referrals to appropriate staff (eg, Medical Director, Case Manager , Preventive Services, etc.). + Participate in data collection/input… more
- Molina Healthcare (WA)
- …Experience** 3+ years of healthcare or health plan supervisory experience. Managed Care operations experience. Prior Medical Assistant experience. **Preferred ... review/utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), case management, transition of care , health management… more
- ManpowerGroup (Columbia, SC)
- Job Title: Clinical Case Manager Location: 17 Technology Circle Columbia SC 29203 Job Type: Full-Time **Job Description:** + We are seeking a dedicated Clinical ... Case Manager to join our team and...Case Manager to join our team and play a crucial...for benefits, and ensure quality, cost-effective outcomes through personalized care plans. **Key Responsibilities:** ** Case Management:** +… 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 (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
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