• Complex Case Manager

    Highmark Health (Santa Fe, NM)
    …the appropriate clinical interventions and referrals, the incumbent will manage an active case load of members in his/her panel that are enrolled in case ... management. The incumbent conducts outreach to members enrolled in case management including but is not limited to: developing...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 (Santa Fe, NM)
    …of their members to ensure successful completion of member goals, while providing Complex Case Management and/or care management support through the duration of ... within a matrix organizational design. **Qualifications:** + Current multi-state compact Registered Nurse licensure in state of residence is required,… more
    Sharecare (03/19/25)
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  • Case Manager , RN

    CAI (Santa Fe, NM)
    …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! ... 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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  • RN Field Case Manager

    Sedgwick (Albuquerque, NM)
    …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 (03/13/25)
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  • Medical Claim Review Nurse ( RN )

    Molina Healthcare (Santa Fe, NM)
    …ASSOCIATION:** Certified Clinical Coder, Certified Medical Audit Specialists, Certified Case Manager , Certified Professional Healthcare Management, Certified ... state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
    Molina Healthcare (01/25/25)
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  • Manager , Utilization Management Behavioral…

    Humana (Santa Fe, NM)
    …**Required Qualifications:** **Must meet** **one** **of the following:** + Active unrestricted registered nurse license in the state of Virginia or reside ... coaching, performance review, up to termination. + Certified or certified-eligible case manager required. **Additional Information:** **Workstyle:** Remote work… more
    Humana (03/12/25)
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  • Trainer - Clinical Services - Utilization Review…

    Molina Healthcare (Santa Fe, NM)
    …knowledge on the job. Job Qualifications **REQUIRED EDUCATION** : Completion of an accredited Registered Nurse ( RN ) Program and an Associate's or Bachelor's ... or State Clinical Social Worker/Counseling (or related field) License Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified… more
    Molina Healthcare (03/13/25)
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  • Excess Risk Managed Care Clinician

    Highmark Health (Santa Fe, NM)
    …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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  • Care Coordinator- CISC

    Magellan Health Services (Santa Fe, NM)
    Manager - Care Mgmt, LCSW - Licensed Clinical Social Worker - Care Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care Mgmt Salary ... clinical path variance data that indicates potential areas for improvement of case and services provided. + Works with members and the interdisciplinary care… more
    Magellan Health Services (01/26/25)
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