• Case Manager

    Sevita (Ypsilanti, MI)
    …live a full, more independent life. We provide people with quality services and individualized supports that lead to growth and independence, regardless of ... of programs, including vocational and therapy programs, day treatments, and specialized services for infants, children, adolescents, Military Service Members and… more
    Sevita (10/29/25)
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  • Utilization Management Reviewer, RN (Multiple…

    Excellus BlueCross BlueShield (Rochester, NY)
    …and post- service clinical reviews to determine the appropriateness of services requested for the diagnosis and treatment of members' medical health conditions, ... + Acts as a resource and liaison to the provider community in conjunction with Provider Relations,...assignments; cross-trained to review various levels of care and/or services . + Participate in committees and lead more
    Excellus BlueCross BlueShield (10/07/25)
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  • OCM Consultant

    Public Consulting Group (Trenton, NJ)
    …streamline operations and achieve strategic goals to serve the public better. We provide the full spectrum of technology consulting services to help state ... and operations improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986, PCG employs approximately 2,000… more
    Public Consulting Group (10/04/25)
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  • Nurse Practitioner - Internal Medicine Parkview

    UCHealth (Pueblo, CO)
    …, reimbursable services , and maintain provider status with Medicare and Medicaid . + Eligible to provide services with no sanctions or exclusion ... on physicians in every career stage and specialty to lead and provide direction for the future...+ Full or provisional prescriptive authority eligibility is required. Provider must apply for prescriptive authority as a condition… more
    UCHealth (10/31/25)
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  • IDD Specialty Care Manager

    Elevance Health (Jacksonville, NC)
    services , including LTSS, Behavioral Health, therapeutic, and physical health services . + Service delivery coordination, discharge planning or behavioral ... _We are partnering with North Carolina DHHS to operationalize a statewide Medicaid Plan designed to support Medicaid -enrolled infants, children, youth, young… more
    Elevance Health (11/20/25)
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  • Medical Director, Behavioral Health

    Molina Healthcare (UT)
    provider contracting experience. * Experience with NCQA, HEDIS, Medicaid , Medicare and Pharmacy benefit management, Group/IPA practice, capitation, HMO ... and case management programs for mental health and chemical dependency services and assists with implementing integrated Behavioral Health care management programs.… more
    Molina Healthcare (10/18/25)
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  • Chief Medical Officer - CHIP Health Plan…

    CVS Health (Harrisburg, PA)
    …to children and adolescents enrolled in the CHIP program. The CMO will lead efforts to improve health outcomes, ensure regulatory compliance, and foster innovation ... Develop and implement evidence-based clinical guidelines for pediatric care. + Provide oversight for care management, utilization review, and case management… more
    CVS Health (10/29/25)
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  • Board Certified Behavior Analyst (BCBA) - Center…

    Advancing Beyond the Spectrum (Eldersburg, MD)
    …academic success, functional behaviors, and effective communication. Our mission is to provide exceptional service to our clients and their families. For ... services they are receiving. The BCBA will also lead and manage a team of Behavior Therapists through...+ Free CEUs for topics of interest + New provider & maintenance credentialing provided, CAQH support, Medicaid more
    Advancing Beyond the Spectrum (11/12/25)
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  • Field Reimbursement Manager Immunology GI-…

    J&J Family of Companies (Portland, ME)
    …Manager (FRM) is responsible for serving as the primary field-based lead for education, assistance, and issue resolution with healthcare providers (HCPs), ... personal experiences and beliefs, the presence or absence of support networks, provider and payer dynamics, and socioeconomic factors. For many patients, the… more
    J&J Family of Companies (11/21/25)
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  • Field Reimbursement Manager (Immunology…

    J&J Family of Companies (Milwaukee, WI)
    …Manager (FRM) is responsible for serving as the primary field-based lead for education, assistance, and issue resolution with healthcare providers (HCPs), ... personal experiences and beliefs, the presence or absence of support networks, provider and payer dynamics, and socioeconomic factors. For many patients, the… more
    J&J Family of Companies (11/08/25)
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