- KPH Healthcare Services, Inc. (Hoffman Estates, IL)
- …activities, educational programs, and departmental/branch meetings. + Drives the Primary Case Management Model (PCMM) in daily interactions through the ... to patients, nurses and physicians as required regarding the contents, utilization , therapeutic actions, possible adverse reactions, or interactions of drugs. +… more
- Deloitte (Washington, DC)
- …multiple engagements and priorities simultaneously, ensuring efficient and effective project management and resource utilization . + The Team Deloitte Tax's ... role and compensation decisions are dependent on the facts and circumstances of each case . A reasonable estimate of the current range is $146,510 to $272,090. You… more
- Molina Healthcare (Augusta, GA)
- …(CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) ... of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies… more
- Sharp HealthCare (San Diego, CA)
- …leadership experience, preferably in a managed care setting. **Other Qualification Requirements** + Utilization , Case Management , or Quality Management ... Will Do** Supervise the effective implementation of the Ambulatory Case Management (ACM) programs that includes the...and implement new programs under the direction of the Manager of Integrated Care Management and Director… more
- Elevance Health (Indianapolis, IN)
- …Capabilities, and Experiences:** + Prior claims experience is strongly preferred. + Utilization Management experience is strongly preferred. + Health insurance ... in process improvement initiatives to improve the efficiency and effectiveness of the utilization reviews within the medical management processes. + Assesses and… more
- CVS Health (Springfield, IL)
- …meet the requirements of the position **Preferred Qualifications** + Certified Case Manager + 3+ years Care Management , Discharge Planning and/or Home Health ... TOC team will review prior claims to address potential impact on current case management and eligibility status. Assessments and/or questionnaires are designed… 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
- Huntington Ingalls Industries (Coronado, CA)
- … management of the site's accountable assets, including acquisition, utilization , tracking, and disposition. + Administer inventory control and ensure proper ... the Department of Energy's national security mission through the management and operation of its sites, as well as...materials and services. + Work closely with the Logistics Manager and Property Manager to streamline operations.… more
- Federal Communications Commission (Washington, DC)
- …agency objectives, justifies and defends resources requirements to senior level management , ensuring efficient utilization of allocated resources. Ensures ... and purchase card activities and projects; and reviews and prepares related management reports and other performance measures. Analyzes and evaluates controls to… 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