• Medical Social Worker - LCSW Preferred! Tampa…

    ChenMed (St. Petersburg, FL)
    …Work (MSW) preferred + A minimum of 2 years' work experience in social work, case management , and/or discharge planning experience required + A minimum of 2 ... The incumbent in this role is responsible for providing psychosocial assessment, social case work and linkage to community resources for patients who have chronic,… more
    ChenMed (12/03/25)
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  • HCMS Director

    Elevance Health (Washington, DC)
    …quality outcomes. + Oversees the development and execution of medical and case management policies, procedures, and guidelines; assists in developing clinical ... The **HCMS Director** will be responsible for managing the utilization or care management process for one...or MBA with Health Care concentration preferred. + Certified Case Manager preferred. For candidates working in… more
    Elevance Health (01/09/26)
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  • Human Services Coordinator I

    State of Massachusetts (Northampton, MA)
    …in services and other system problems via participation in the Quality Improvement and Utilization processes for case management in order to maintain ... client's needs and wishes are recognized and respected. The Case Manager carries a caseload of assigned...criteria specified in DMH regulations and guidelines. . Attends case management staff meetings, ongoing and regular… more
    State of Massachusetts (01/07/26)
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  • Mgr Surg Admin & BS Ops

    Covenant Health Inc. (Knoxville, TN)
    …Departments (business office, materials management , utilization management , IT, credentialing, medical records, facilities manager , and accounting ... operations, management of properties, budgeting and financial management . Works alongside the Nurse Manager of...capacity + Oversight of student affiliations + Operating room utilization + Oversight and management of block… more
    Covenant Health Inc. (12/02/25)
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  • Master Social Worker Care Coordination

    Banner Health (Tucson, AZ)
    …regulatory requirements. 6. Educates internal members of the health care team on case management and managed care concepts. Facilitates integration of concepts ... responsibility. Internal customers: Patients, families, all levels of nursing management and staff, medical staff, and all other members...and Travel positions require a minimum of one year Case Manager experience in an acute care… more
    Banner Health (11/26/25)
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  • Referral Clerk

    Katmai (Fort Carson, CO)
    …and providers, network/outside providers and ancillary healthcare workers. + Apply principles of utilization review (UR) and utilization management (UM) in ... benefit from alternative levels of care and involve the case manager as needed to provide direction...manager as needed to provide direction in care management . + Plan and prioritize UR activities to ensure… more
    Katmai (11/26/25)
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  • Registered Nurse - Home Health

    St. Peters Health (Helena, MT)
    …interdisciplinary team. Maintains open communication with the Director and/or clinical manager /coordinator in relation to case management responsibilities ... to move the patient through the care continuum. Understands the principles of case management to ensure effective coordination of care and utilization more
    St. Peters Health (01/03/26)
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  • Clinical Care Coordinator

    Kaleida Health (Williamsville, NY)
    …required. Current experience (minimum of 2 years) discharge planning, case management and home care required. Knowledge of Utilization Management . ... Bachelors degree in Nursing. Current NYS Registration as a Professional Nurse. Certified Case Manager (CCM) preferred. **Experience** **At least 3 years of acute… more
    Kaleida Health (12/31/25)
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  • Medical Review Nurse (RN)- Remote

    Molina Healthcare (Rio Rancho, NM)
    …(CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified Professional ... ensure appropriate reimbursement to providers. + Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS)… more
    Molina Healthcare (01/09/26)
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  • Care Coord

    UnityPoint Health (Des Moines, IA)
    …and evaluation of patient-focused care for prioritized patients . + Documents the case management plan to include: clinical needs, barriers to quality care, ... plan and execute a safe discharge + Collaborate with Utilization Management team on continued stay review....verbal communication with the ambulatory / cross continuum care manager regarding patients who have moderate or red vulnerability… more
    UnityPoint Health (10/17/25)
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