• RN Case Manager

    Tufts Medicine (Lowell, MA)
    **Job Overview** The RN Case Manager manages a designated caseload to coordinate and complete timely assessment, planning, implementation and evaluation of ... issues, including providing clinical updates to insurance companies. + Coordinates insurance appeals related to discharges and adhering to policies and procedures of… more
    Tufts Medicine (08/03/25)
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  • Financial Case Manager Assistant-…

    Bozeman Health (Bozeman, MT)
    …the claims denial process for insurance carriers and develops an appropriate appeals response as necessary. Minimum Qualifications: Required + High School diploma ... Previous ICD-10 and CPT coding + Previous experience in medical pre-authorization, case management and / or financial counseling Essential Job Functions: In addition… more
    Bozeman Health (05/12/25)
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  • RN Case Manager

    Actalent (Seattle, WA)
    Actalent is hiring for RN Case Managers! Job Description This role in care management focuses on transitions of care, including coordination and medication ... Long Term Acute Care, Rehab, or Skilled Nursing settings. + Proficiency in case management and care coordination. + Experience with EPIC software. + Utilization… more
    Actalent (07/30/25)
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  • Case Management Coordinator - Days

    Houston Methodist (The Woodlands, TX)
    …insurance/managed care benefits and assesses need for further education by social worker/ case manager . + Self-motivated to independently manage time effectively ... At Houston Methodist, the Case Management (CM) Coordinator position is a proficient...to improve documentation of insurance correspondence and compliance with payors/ appeals , distribution of regulatory notices, including the CMS Important… more
    Houston Methodist (07/19/25)
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  • Bilingual Case Manager

    Cardinal Health (Phoenix, AZ)
    …insurance plan coverage, including out-of-pocket costs, and provide guidance on the appeals process if needed + Resolve patient's questions and any representative ... for the patient's concerns regarding status of their request for assistance + Demonstrate expertise in payer landscapes and insurance processes. Remain knowledgeable about long and short-range changes in the reimbursement environment including Medicare,… more
    Cardinal Health (07/18/25)
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  • LVN Care Coordinator - SRS Inpatient Case…

    Sharp HealthCare (San Diego, CA)
    …acute patient care, SNF, home health, or hospice settings. + Experience as a case manager or discharge planner interacting with managed care payers. + Experience ... identified per departmental guidelines during hospital stay beginning with the admission review of the case manager and reviews with the Case Manager … more
    Sharp HealthCare (08/02/25)
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  • Per Diem RN - Case Management - Sharp…

    Sharp HealthCare (La Mesa, CA)
    …Status** Per Diem **Shift** Day **FTE** 0 **Shift Start Time** **Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager ... of Registered Nursing -REQUIRED **Preferred Qualifications** + Bachelor's Degree in Nursing + Certified Case Manager (CCM) - Commission for Case Manager … more
    Sharp HealthCare (07/18/25)
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  • Case Management Rep

    Houston Methodist (Houston, TX)
    …and coordination as needed **FINANCE ESSENTIAL FUNCTIONS** + Informs social worker/ case manager of the patients' available benefits through insurance/managed ... At Houston Methodist, the Case Management Representative position is responsible for providing...+ Supports and assists with concurrent insurance denials and appeals process, transmission of utilization reviews to insurance companies,… more
    Houston Methodist (07/18/25)
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  • Delivery Senior Manager

    NTT America, Inc. (Plano, TX)
    …and forward-thinking organization, apply now. We are currently seeking a Delivery Senior Manager to join our team. NTT DATA is seeking to hire a **Medicare ... Appeals Clinical Leader** to lead service delivery engagements and...performance, metrics, and processes. + Track appeal metrics, including case volumes, resolution times, and denial rates. + Analyze… more
    NTT America, Inc. (06/12/25)
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  • High Risk Nurse Care Manager

    Children's Mercy Kansas City (Kansas City, MO)
    …The High-Risk Nurse Lead is an expert at the roles of Clinical Review Nurse Care Manager and Care Coordination Case Manager and provides support to larger ... processes and data related to medical necessity denials, clinical appeals , long length of stay rounds, and clinically/financially risky...required upon hire + One of the following: American Case Management, Certified Case Manager … more
    Children's Mercy Kansas City (06/18/25)
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