- Novo Nordisk Inc. (Plainsboro, NJ)
- …Earned. This role may regularly interface with their direct report (Channel Analyst ) and the Omnichannel Orchestration teams. Additionally, this role will interface ... or workshops to educate marketers on best practices for search. Sharing tips, case studies, and success stories to inspire and guide marketers in their efforts… more
- The Cigna Group (Nashville, TN)
- …individuals regarding Medicare appeals and related issues, implications and decisions. The Case Management Analyst reports to the Supervisor/Manager of ... regarding denials of medical services as well as Part B drugs. The Case Management Analyst will be responsible for analyzing and responding appropriately to… more
- ASM Research, An Accenture Federal Services Company (Columbus, OH)
- The Bilingual Case Management Analyst III is responsible for efficient and timely hands-on troubleshooting, remediation, coordination, escalation, tracking ... and management . Also responsible for conducting research, workflow investigations, business...the project goals, will complement the role as a case analyst . + Employee is expected to… more
- Amentum (Springfield, VA)
- …and national security solutions to customers around the world. If you are an experienced Case Management Analyst seeking a way to positively impact US ... ** Case Management Support Analyst I** Amentum is a leading provider of enduring support for the essential missions of the US government, its allied partners… more
- CVS Health (Springfield, IL)
- …make health care more personal, convenient and affordable. **Position Summary** The Case Management Coordinator utilizes critical thinking and judgment to ... collaborate and inform the case management process. The Case Management Coordinator facilitates appropriate healthcare outcomes for members by providing… more
- Beth Israel Lahey Health (Burlington, MA)
- …Description:** The Utilization Analyst works with physicians, the payers and inpatient case management team to validate the medical necessity of the hospital ... review, clinical documentation improvement and revenue integrity, these specialized case managers analyze medical documentation to ensure that proper reimbursement… more
- CVS Health (Tallahassee, FL)
- …**Position Summary** We are seeking self-motivated, energetic, detail oriented, highly organized, tech-savvy Case Management Coordinator to join our Case ... and flexibility as you coordinate the care of your members. Case Management Coordinator is responsible for telephonically and/or face to face assessing,… more
- CVS Health (Springfield, IL)
- …Summary:** Utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes ... member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate. - Coordinates and… more
- CVS Health (Springfield, VA)
- …Summary** Utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes ... member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate. - Coordinates and… more
- CVS Health (Richmond, VA)
- …overcoming barriers in meeting goals and objectives, presents cases at interdisciplinary case conferences * Utilizes care management processes in compliance with ... regulatory and company policies and procedures. Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation. **Required Qualifications** + 1+ years care… more
- CVS Health (Tallahassee, FL)
- …is a member of the Care Team. The Care Manager is responsible for the care management of members that are enrolled in the Dual Special Needs Plan and have limited ... health conditions. These members are usually stratified as low risk. The Care Manager will work in conjunction with the Nurse Care Manager, Care Coordinator, Transition of Care (TOC) Coach, and other members of the Care Team to improve the member's health… more
- The Cigna Group (Bloomfield, CT)
- Nurse Case Management Lead Analyst -Nurse Clinician - Accredo Job Description Summary The Nurse Clinician - RN is responsible for reviewing escalated clinical ... or + 2+ years of relevant RN experience with a BSN degree + Case management experience preferred + 5+ years of experience is preferred in prior authorization or… more
- The Cigna Group (Mobile, AL)
- **Evernorth Nurse Case Management Senior Analyst (Home-Based TOC)** Objective: Prevention of readmission for high-risk members by leveraging telephonic and ... and health plans upon conclusion of the program to support transition, including Case Management referrals for ongoing services License Requirements: + Current… more
- Amazon (Seattle, WA)
- Description CMS Data Platform team's mission is to empower Case Management tenants to make data driven decisions and derive insights. As a Business Analyst , ... of available metrics, dashboards and data catalog around routing, case /issue handling and workforce management themes. Launch...of 80% and ability to customize around routing and case handling sections. The Business Analyst will… more
- Northwell Health (New Hyde Park, NY)
- …communication, and collaboration skills, preferred. Preferred: + Epic Clinical Case Management certification preferred + Actively demonstrated excellent ... following the software and solution delivery lifecycle and hybrid project management methods. + Maintains direct responsibility for successful outcome of assigned… more
- CVS Health (Frankfort, KY)
- …Aetna. Health Services strategies, policies, and programs are comprised of utilization management , quality management , network management and clinical ... quality outcomes. * Creates direction and communicates a business case for change by focusing on and addressing key...the unit. * May be accountable for the day-to-day management of teams for appropriate implementation and adherence with… more
- Henry Ford Health System (Detroit, MI)
- GENERAL SUMMARY/PRIMARY FUNCTION: The Senior (Sr.) Application Analyst is responsible for participating in the overall design, implementation, training, ... design, implementation, and optimization of their specific application. The Sr. Application Analyst takes general direction from their supervisor or manager. The Sr.… more
- The Cigna Group (Bloomfield, CT)
- …transition of care, product rate negotiations, and accurately calculates medical cost savings. Case Managers performs case management evaluation to identify ... Required Results** + Obtains informed verbal consent from customers for case management services + Establishes a collaborative relationship with the client (plan… more
- The Cigna Group (Bloomfield, CT)
- …services available allowing them to identify and service each individual's needs. The case manager offers Specialty Care Management services that utilize a ... risk of opioid overdose, substance use issues or chronic pain management issues_** . The case manager will utilize a coaching approach and their experience to… more
- The Cigna Group (Bloomfield, CT)
- …+ Engage with customers and families to understand needs, facilitate access to coaching/ case management programs and community resources. + Work in a team ... a mental health or chemical dependency treatment facility in the area of utilization management , or in direct provision of service as a mental health or chemical… more
