- Excellus BlueCross BlueShield (Rochester, NY)
- …cases to the Medical Director for review. Refer to and work closely with Case Management to address member needs. Participates in rotating on-call schedule, as ... processes for accessing Health Plan to perform medical review, obtains case or disease management support, or otherwise interacts with Health Plan programs and… more
- Robert Half Legal (Marietta, GA)
- …a Paralegal, with a focus on litigation and discovery. * Strong proficiency in case management software and Excel. * Strong knowledge of civil litigation ... in supporting legal processes, coordinating with external counsel, and ensuring efficient case tracking and discovery oversight. * Manage and update the litigation… more
- LA Care Health Plan (Los Angeles, CA)
- …RN clinical experience in an acute hospital setting. At least 2 years of Utilization Management / Case Management experience in a hospital or HMO setting . ... Utilization Management Nurse Specialist RN II Job Category: Clinical...Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, post-service and retrospective claims… more
- Humana (Raleigh, NC)
- …prior experience participating in teams focusing on quality management , utilization management , case management , discharge planning and/or home health or ... working with Case managers or Care managers on complex case management , including familiarity with social determinants of health. + The curiosity to… more
- Rush University Medical Center (Chicago, IL)
- …and/or level of care management processes. In accordance with the case management external faxing policy and HIPPA guidelines, communicates clinical ... for the position. Offers may vary depending on the circumstances of each case . **Summary:** The Care Management Navigator I is part of a care management team… more
- OhioHealth (Columbus, OH)
- …corporate interests and service recovery ; consults with the Risk Manager for case management , and settlement authority in negotiating and settling patient ... liability claims, it is essential that the Sr Consultant Risk Management effectively engage in Risk Assessment, Analysis, Prevention, and Education activities… more
- LA Care Health Plan (Los Angeles, CA)
- …members manage health conditions (including chronic disease). (10%) Care Coordination, Case Management , and System Navigation: Participating in care coordination ... Care Management Community Health Worker II (12 Month Contract)...and case management . Making referrals and providing follow-up....and case management . Making referrals and providing follow-up. Coordinating transportation to… more
- CareFirst (Baltimore, MD)
- …staffing and coverage. + Oversees and participates in care coordination activities including case management and disease management to ensure effective ... **Resp & Qualifications** **PURPOSE:** The Inpatient Management Onsite Care Management Supervisor will...(HEDIS) and knowledge of the standards of practice for case managers. + Ability to mentor and coach associates… more
- Motion Recruitment Partners (Atlanta, GA)
- …skills + Excellent oral and written communication skills + Exposure to HR and/or case management technologies (eg, portal technology, case management , ... to Company policies and legal requirements. + Log all interactions in the case management system and/or leave management system. + Abide by documented… more
- McLaren Health Care (Port Huron, MI)
- …experience with an acute care hospital **Preferred:** ⦁ Experience in utilization management / case management , critical care, clinical documentation, or ... patient outcomes/quality management . ⦁ Certification in Case Management Certification (ACM or CCM) ⦁ Basic Life Support (BLS) certification as a Healthcare… more