- Actalent (Sacramento, CA)
- Remote Licensed Vocational Nurse (LVN) Fully remote but MUST reside within 50 miles of the Sacramento area Job Duties + Perform timely utilization reviews for ... + Conduct in-person hospital rounds 2-3 days per week, telephonic review and participate in interdisciplinary case reviews +...health, or DME + Communicate avoidable days, delays in care , and readmission risks to UM leadership + Participate… more
- Humana (Salem, VA)
- …first** Humana Healthy Horizons in Virginia is looking for RN, Field Care Managers (Field Care Manager Nurse 2) who performs primarily face to face and ... telephonic assessments to adult and pediatric members. The RN, Field Care Manager (Field Care Manager Nurse 2) will evaluate member's needs to… more
- Point32Health (MA)
- …and wellness interventions, and disease/chronic condition management per department guidelines. The nurse care manager possesses strong clinical knowledge, ... Learn more about who we are at Point32Health (https://www.point32health.org/) . **Job Summary** The Care Manager - Nursing Field (RN CM) will ensure that all… more
- Centene Corporation (Oklahoma City, OK)
- …with appropriate providers or specialists to ensure member has timely access to needed care or services + May perform telephonic , digital, home and/or other site ... background in OB/Maternity, including Labor & Delivery and Postpartum care ** + **Experience with newborn care and/or...8:00 am - 5:00 pm Central Time** + **Provide telephonic case management and education to pregnant members** +… more
- US Tech Solutions (Columbia, SC)
- …Identifies and makes referrals to appropriate staff (Medical Director, Case Manager , Preventive Services, Subrogation, Quality of Care Referrals, etc.). ... plan, implement, health coach, coordinate, monitor, and evaluate medical necessity and/or care plan compliance, options, and services required to support members in… more
- Molina Healthcare (Fort Worth, TX)
- …welfare. * May provide consultation, resources and recommendations to peers as needed. * Care manager RNs may be assigned complex member cases and medication ... unrestricted RN license in the state of TX. Case Manager RN will work Hybrid ( Telephonic and...regimens. * Care manager RNs may conduct medication reconciliation… more
- Molina Healthcare (Charleston, SC)
- …who lives in South Carolina and must be licensed for the state of Carolina. Care Manager RN will work with Medicaid SC population completing assessments, care ... network to address member needs and goals. * Conducts telephonic , face-to-face or home visits as required. * Performs...consultation, resources and recommendations to peers as needed. * Care manager RNs may be assigned complex… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** MD-DC-Northern VA **PURPOSE:** Under minimal supervision, the Care Manager researches and analyzes a member's medical and behavioral ... health needs and healthcare cost drivers. The Care Manager works closely with members and...School Diploma or GED **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or Compact State Licensure RN-… more
- Molina Healthcare (Louisville, KY)
- …team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care , ... ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on...to address the member needs and goals. + Conducts telephonic , face-to-face or home visits as required. + Performs… more
- AmeriHealth Caritas (Norristown, PA)
- **Role Overview** The Community Care Manager assists members appropriate for care management and care coordination services in achieving their optimal ... level of health through self-management. The Community Care Manager is responsible for engaging the...clinic + 3+ years of Case Management experience, preferably telephonic within a managed care organization, desired… more