• Associate Medical Director, Pharmacovigilance…

    Sumitomo Pharma (Augusta, ME)
    …marketed products. + Conduct safety surveillance over product life cycle, reviewing clinical trial and post-marketing Individual Case Safety Reports (ICSRs), ... on behalf of PVRM for: Study Protocols, Informed Consent Forms (ICF), Safety Management Plans (SMP), Clinical Study Reports (CSR), Investigator's Brochures (IB),… more
    Sumitomo Pharma (08/15/25)
    - Related Jobs
  • Care Management Processor Remote In

    Molina Healthcare (Idaho Falls, ID)
    …team members as needed. + Screens members using Molina policies and processes, assisting clinical Case Management staff as they identify appropriate medical ... have the following:** + Healthcare knowledge or background either clinical (Medical Assistant) or in an administrative capacity +...Provides telephone, clerical, and data entry support for the Case Management team. + Responsible for initial… more
    Molina Healthcare (09/05/25)
    - Related Jobs
  • Care Management Coordinator (Florida)

    CVS Health (Tallahassee, FL)
    …needs that may impact member outcomes and care planning with appropriate referral to clinical case management or crisis intervention as appropriate. + ... care issues through established channels. + Monitors, evaluates and documents care utilizing case management and quality management processes in compliance… more
    CVS Health (09/12/25)
    - Related Jobs
  • Manager, Care Management

    Humana (Springfield, IL)
    …managers to ensure alignment and operational efficiency. + Identify members for specific case management and / or disease management activities. + ... health first** Humana Gold Plus Integrated is looking for Managers of Care Management who will lead teams of nurses, care coordinators and behavioral health… more
    Humana (08/29/25)
    - Related Jobs
  • Senior Denials Mgmt Specialist

    Houston Methodist (Sugar Land, TX)
    …plan, regulatory guidelines, medical necessity, and accrediting standards for all requests. Provides clinical support to Case Management staff, others as ... nonclinical and clinical service areas, physicians, and Case Management staff. **QUALITY/SAFETY ESSENTIAL FUNCTIONS** +...degree or higher from an accredited school of nursing ** WORK EXPERIENCE** + Seven years clinical nursing/patient… more
    Houston Methodist (07/31/25)
    - Related Jobs
  • Counselor Military Support - Remote Opportunity

    Zeiders Enterprises, Inc (San Diego, CA)
    …Sailor to strengthen their coping skills and build resilience. SAIL provides rapid-assistance clinical case management services addressing risk management ... recovery in accordance with the DoDI 6490.08. + Provide clinical case management to Sailors...clinical practice in the fields of professional counseling, clinical social work , marriage and family therapy… more
    Zeiders Enterprises, Inc (09/24/25)
    - Related Jobs
  • RN Manager - Care Management

    Providence (Apple Valley, CA)
    …include a manager on-call responsibility every other week for emergent issues. Case Management is a collaborative practice including patients, caregivers, ... physicians, payers, support staff, other practitioners and the community. The Case Management process facilitates communication and care coordination along… more
    Providence (08/27/25)
    - Related Jobs
  • Denials Management Specialist, Registered…

    St. Luke's University Health Network (Allentown, PA)
    …AND RESPONSIBILITIES: + Reviews all Inpatient Retroactive Denials in the Denials Management Work Queues for Medical Necessity and Late-Pick-Up/Notification that ... are entered by Case Management and Business Office. + Monitors...preferred. TRAINING AND EXPERIENCE: Minimum of 2-5 years of clinical nursing experience in an acute care hospital setting… more
    St. Luke's University Health Network (08/19/25)
    - Related Jobs
  • Quality Management Consultant Risk…

    Veterans Affairs, Veterans Health Administration (Kansas City, MO)
    …to facilitate a corrective action plan. Responsible for loss prevention and reduction ( clinical and non- clinical ), claims management , through patient and ... Summary The Quality Management (QM) Consultant Risk Management Registered...and Patient Safety Service Line and functions as a clinical expert and executes position responsibilities that demonstrate leadership,… more
    Veterans Affairs, Veterans Health Administration (09/21/25)
    - Related Jobs
  • Director, Care Transitions

    The County of Los Angeles (Los Angeles, CA)
    case management services is defined as:development, implementation, and/or evaluation of clinical or case management services or direct supervision of ... clinical or case management staff in a comprehensive health...Correctional Health. AVAILABLE SHIFT: Appointees may be required to work any shift including evenings, nights, weekends and holidays.… more
    The County of Los Angeles (08/28/25)
    - Related Jobs