• Per Diem (On Call) Inpatient Clinician…

    Sacramento Behavioral Healthcare Hospital (Sacramento, CA)
    …of information with the treatment team, external providers, collateral contacts, and/or managed care organizations; and implementation of the discharge planning ... including completion of a thorough risk assessment and arranging for follow-up care and resources. Supports with department training of on-boarding new clinicians to… more
    Sacramento Behavioral Healthcare Hospital (10/24/25)
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  • Director of Strategic Growth - FQHC & Physician…

    Genesis Orthopedics & Sports Medicine (Chicago, IL)
    …+ Familiarity with the Illinois healthcare market + Understanding of Medicaid and managed care frameworks Benefits Genesis is an equal opportunity employer and ... orthopedic practice headquartered in Chicago, dedicated to delivering exceptional care with an emphasis on innovation, accessibility, and mission-driven service.… more
    Genesis Orthopedics & Sports Medicine (10/19/25)
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  • Quality RN

    CenterWell (North Charleston, SC)
    …Office applications **Preferred Qualification** + Bachelor's Degree in Nursing + 3+ years of managed care experience + 3+ years of case management experience + ... insurance and many other opportunities. **About Us** About CenterWell Senior Primary Care : CenterWell Senior Primary Care provides proactive, preventive care more
    CenterWell (10/16/25)
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  • Quality Improvement RN - Chesapeake

    CenterWell (Hampton, VA)
    …applications **Preferred Qualification** + Bachelor's Degree in Nursing + 3+ years of managed care experience + 3+ years of case management experienceBilingual; ... insurance and many other opportunities. **About Us** About CenterWell Senior Primary Care : CenterWell Senior Primary Care provides proactive, preventive care more
    CenterWell (10/16/25)
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  • Physician Advisor Lead

    Nuvance Health (Danbury, CT)
    …reviews to assist with appeals of denied or downgraded coverage determinations by managed care , commercial payers, and recovery audit contractors. * Maintain and ... physician leadership and expertise related to appropriate utilization/level of care (LOC) and appropriate clinical documentation. Provides oversight for other… more
    Nuvance Health (10/12/25)
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  • RN Case Manager - Commercial TOC

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …to work in the US Preferred Skills and Experience * 1+ years of managed care experience; eg case management/health coach, utilization management and/or auditing ... The Case Manager is a critical component of BCBSMN Care Management team as the primary clinician providing condition...exists to support member needs across the continuum of care by leveraging member partnership, case and disease management… more
    Blue Cross and Blue Shield of Minnesota (10/08/25)
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  • UM Prior Authorization Review Nurse - RN

    UCLA Health (Los Angeles, CA)
    …+ Proficient computer skills including Internet search capabilities, Microsoft Word, Excel, and Managed Care software (ie EZ Cap, Diamond, IDX) required + ... plays a vital role in ensuring the delivery of high-quality, evidence-based care . This position is responsible for reviewing and evaluating clinical documentation… more
    UCLA Health (10/03/25)
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  • Advanced Practice Provider - HealthWorks in York

    Penn Medicine (Lititz, PA)
    …Medicare, Medicaid, and Tricare programs and such other third-party-payment programs, including managed care programs in which LGMG participates. Benefits at a ... is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field… more
    Penn Medicine (10/02/25)
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  • Supervisor - Cost Report, Contract Analysis

    Hawaii Pacific Health (Honolulu, HI)
    …Contract Analysis department provides financial analysis and planning in the review of managed care contracts. This dedicated team of professionals audits and ... Hawai'i Pacific Health is a not-for-profit health care network with over 70 locations statewide including...Hawai'i and the Pacific Region with high quality, compassionate care . Its four medical centers - Kapi'olani, Pali Momi,… more
    Hawaii Pacific Health (09/30/25)
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  • Financial Analyst - Cost Report, Contract Analysis

    Hawaii Pacific Health (Honolulu, HI)
    …Contract Analysis department provides financial analysis and planning in the review of managed care contracts. This dedicated team of professionals audits and ... Hawai'i Pacific Health is a not-for-profit health care network with over 70 locations statewide including...Hawai'i and the Pacific Region with high quality, compassionate care . Its four medical centers - Kapi'olani, Pali Momi,… more
    Hawaii Pacific Health (09/30/25)
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