- CareFirst (Baltimore, MD)
- …staffing and coverage. + Oversees and participates in care coordination activities including case management and disease management to ensure effective ... in addition to the required work experience. **Experience:** 3 years Care Management , Discharge Coordination, Home Health, Utilization Review, Disease … more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …clinical nursing experience, including behavioral/mental health + Experience in a managed care, case management , or utilization review setting + Strong ... on clinical guidelines and insurance coverage. + Provide telephonic and/or in-person case management and member education regarding conditions, medications, and… more
- Carle Health (Peoria, IL)
- …to improve access to care and achieve optimal clinical outcomes. Qualifications Certifications: Certified Case Manager within 2 years - Commission for Case ... bonus - External candidates with at least 1 year of experience The OP Care Management RN provides care management and population health services to patients. The… more
- UNC Health Care (Kinston, NC)
- … Manager provides efficient and effective delivery of patient care through case management process. Works toward desirable patient outcomes with MD, staff, ... family and patient involvement to enhance awareness of length of stay, resource utilization and principles of patient care. Functions on a highly interactive level,… more
- Elevance Health (Miami, FL)
- …in process improvement initiatives to improve the efficiency and effectiveness of the utilization reviews within the medical management processes. + Assesses and ... Med Management Clinician Senior- Licensed Nurse **Location:** Miami, FL...May collaborate with healthcare providers. Focuses on relatively complex case types that do not require the training or… more
- Elevance Health (WA)
- …is providing services in multiple states. **Preferred Skills, Capabilities and Experiences:** + Utilization Management and/ore Case Management experience ... **Medical Management Clinician Associate** Carelon Post Acute Solutions A...a minimum of 2 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted… more
- State of Connecticut, Department of Administrative Services (Norwich, CT)
- Developmental Services Resource Management Specialist Hybrid Recruitment # 251222-1609EG-001 Location Norwich, CT Date Opened 12/24/2025 12:00:00 AM Salary $70,012* ... full time job opportunity for a Developmental Services Resource Management Specialist (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=1609EG&R1=&R3=) , supporting the Private Administration Division… more
- Molina Healthcare (Chandler, AZ)
- … (CPHM), Certified Professional in Healthcare Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) ... the health plan in the development and execution of care management and utilization management programs. Develops clinical practice guidelines and oversees… more
- UPMC (Pittsburgh, PA)
- …clinical and social history, current medications, geriatric syndromes, healthcare resource utilization , and case management interventions. Updates the ... staff assigned to the geographic region of the care manager . Attends and participates in face-to-face case ...1 year of experience in clinical, utilization management , home care, discharge planning, and/or case … more
- Baylor Scott & White Health (Temple, TX)
- …responsible for assessing and coordinating patient care across the continuum to include case management , social work, utilization review and care ... **JOB SUMMARY** Manager Comphrensive Care Management RN manages...ongoing problem solving related to care coordination, discharge planning, case management and utilization review.… more