- Geisinger (Kingston, PA)
- …structured clinical assessments for identified patients. + This requires knowledge of medical terminology, diagnostic criteria, and chart review . + Designs an ... + Works closely with assigned primary care provider site and functions as a case manager for patients with behavioral health co-morbidities across the care team to… more
- Washington County Mental Health Services (Montpelier, VT)
- …financial, and other resources. + Collaborate with other professional service providers for case review and consultation. + Create treatment plans tailored to ... Services, Inc. NOTICE OF OPEN POSITION School Based Services Case Manager September 2025 For more than 50 years,...each individual's complex needs, as identified by the treatment team. +… more
- Prime Healthcare (Victorville, CA)
- …the continuum of the health care management. Supports ECM patients with complex medical conditions and completes medication reconciliation in collaboration with ... and cost-effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,… more
- Intermountain Health (Sandy, UT)
- …institution. + Case Management Certification + Demonstrated experience in case management, utilization review , value-based care, and/or discharge planning. + ... + Care Planning: Develops, adjusts, and coordinates care plans to address medical and social needs. + Patient Support: Guides self-management using motivational… more
- Veterans Affairs, Veterans Health Administration (Tucson, AZ)
- …complete review of the EDRP application. Responsibilities Senior Social Worker/ Case Manager (BHIP) has direct oversight and responsibility for the functioning of ... consistent with functioning as a licensed independent practitioner (LIP) within this medical center. The incumbent is competent to function in any of the… more
- WellSpan Health (Chambersburg, PA)
- …of services, from wellness and employer services solutions to advanced care for complex medical and behavioral conditions. Our clinically integrated network of ... and comprehensive completion of admission, continued stay, and discharge reviews, using medical care review criteria. Provides third party payors with status… more
- Ochsner Health (Slidell, LA)
- …today!** This job coordinates, negotiates, procures and manages the care of complex patients to facilitate achievement of quality and cost outcomes for admission ... years of hospital-based experience. **Preferred** - Experience in utilization review . **Certifications** **Required** - Current licensed practical nurse (LPN)… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Accountabilities: Level I + Functions as a clinical reviewer of medical records, researching and investigating complex medical cases. Interprets ... management, medical directors and legal, where appropriate, to ensure complex issues are addressed appropriately. + Prepares comprehensive summary reports and… more
- Zurich NA (Schaumburg, IL)
- …Qualifications: + 2 or more years' experience in Utilization Review , Case Management, Workers Compensation, or medical bill reviews + Strong communication ... our Schaumburg, IL office. With limited direction, reviews highly complex medical billing, including more difficult ...standard work practices to ensure compliance. + Monitor and review complex billing information, updating where necessary… more
- Bassett Healthcare (Cooperstown, NY)
- …+ Uses data collection tools to reflect activities, as noted by review of documentation + Provides community resource information as requested and facilitates ... date + Assists C3s with referrals; faxes and photocopies medical record information as needed for post-acute patient placement...to facilitate timely discharges + Support Unit C3s and Complex C3s with setting up transport, DME, and Follow-up… more