• Complex Case Manager RN

    Highmark Health (Boise, ID)
    **Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** **Fully Remote ** This job has primary ownership and oversight over a specified panel of members ... interventions and referrals, the incumbent will manage an active case load of members in his/her panel that are...in addressing targeted populations **LICENSES AND CERTIFICATIONS** **Required** + RN license in PA or WV or DE or… more
    Highmark Health (03/13/25)
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  • Care Manager , Registered

    Sharecare (Boise, ID)
    …within a matrix organizational design. **Qualifications:** + Current multi-state compact Registered Nurse licensure in state of residence is required, ... telephonic Case or Care Management with members. The Care Manager partners with members, caregivers, providers, and the interdisciplinary care team to… more
    Sharecare (03/19/25)
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  • Case Manager , RN

    CAI (Boise, ID)
    …Type** Full time **Worksite Flexibility** Remote **Job Summary** We are looking for a motivated Case Manager , RN ready to take us to the next level! If ... apply now. **Job Description** We are looking for a Case Manager , RN to provide...duties as assigned/requested **What You'll Need** Required: + Current Registered Nurse , licensed in the state of… more
    CAI (02/01/25)
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  • Program Manager , HCS RN , LMSW,…

    Molina Healthcare (Caldwell, ID)
    …materials and other related documentations. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational ... Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of ...**Preferred License, Certification, Association** Any of the following: Certified Case Manager (CCM), Certified Professional in Healthcare… more
    Molina Healthcare (03/21/25)
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  • RN Field Case Manager

    Sedgwick (Boise, ID)
    …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer RN Field Case Manager **Looking for** **experienced** **Workers Comp ... RN Field Case Manager Nurses across multiple cities in...the next round, a recruiter will be in touch. \# nurse #fieldcasemanager # RN #workerscompensation \#LI-DV1 **​** _As… more
    Sedgwick (03/12/25)
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  • Manager , Utilization Management Behavioral…

    Humana (Boise, ID)
    …or certified-eligible case manager required. **Additional Information:** **Workstyle:** Remote work at Home **Location for Registered Nurse :** must ... **Required Qualifications:** **Must meet** **one** **of the following:** + Active unrestricted registered nurse license in the state of Virginia or reside… more
    Humana (03/12/25)
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  • Clinical Appeals Nurse ( RN ): Texas…

    Molina Healthcare (Caldwell, ID)
    …unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management + Certified ... outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of previously denied… more
    Molina Healthcare (02/09/25)
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  • Manager , Healthcare Services…

    Molina Healthcare (Boise, ID)
    …identifying opportunities for improvement. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational ... Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of ...**Preferred License, Certification, Association** Any of the following: Certified Case Manager (CCM), Certified Professional in Healthcare… more
    Molina Healthcare (03/07/25)
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  • Manager , HCS Clinical Policy - Medicare…

    Molina Healthcare (ID)
    …identifying opportunities for improvement. **Job Qualifications** **REQUIRED EDUCATION** : Registered Nurse or equivalent combination of Licensed Vocational ... enhance the continuity of care + Functions as hands-on manager responsible for supervision and coordination of enterprise clinical... Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of … more
    Molina Healthcare (02/14/25)
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  • Manager , Clinical Policy HCS…

    Molina Healthcare (ID)
    …identifying opportunities for improvement. **Job Qualifications** **REQUIRED EDUCATION** : Registered Nurse or equivalent combination of Licensed Vocational ... Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of ...one or more of the following areas: utilization management, case management, quality, compliance. + Minimum 2 years of… more
    Molina Healthcare (03/04/25)
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  • Excess Risk Managed Care Clinician

    Highmark Health (Boise, ID)
    …Bachelor's degree in Nursing **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Case Manager (CCM) **Language ... data to assess potential stop loss and managed care claim liability, utilizing Case Management oversight techniques to ensure front line case management and… more
    Highmark Health (02/24/25)
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