• RN Utilization Review - Case Management

    Tenet Healthcare (Detroit, MI)
    …denial information for UR Committee, Denial and Revenue Cycle Collaborate with Patient Access, Case Management, Managed Care and Business Office to improve ... patient is in the appropriate status and level of care based on Medical Necessity and submits case...experience preferred. Active and valid RN license required. Accredited Case Manager (ACM) preferred. Skills Required Analytical… more
    Tenet Healthcare (12/03/25)
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  • RN Supervisor Case Management - Full Time…

    Mohawk Valley Health System (Utica, NY)
    care to our diverse member population. Provides direct oversight of the case manager 's daily operations of utilization review practice, processes and ... Case Management - Full Time - Days Department: CARE MANAGEMENT SERVICES Job Summary The Supervisor Case...care needs are met and documented per the managed long term care program (MLTC) insurance… more
    Mohawk Valley Health System (10/07/25)
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  • Case Management Supervisor - Full Time…

    Mohawk Valley Health System (Utica, NY)
    care to our diverse member population. Provides direct oversight of the case manager 's daily operations of utilization review practice, process and procedures ... Case Management Supervisor - Full Time - Days...care needs are met and documented per the managed long term care program (MLTC) insurance… more
    Mohawk Valley Health System (11/21/25)
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  • Discharge Planner -per diem, 10:00 pm - 6:30 am…

    Cedars-Sinai (CA)
    …resources and social supports required. One (1) year of utilization management or managed care experience preferred. **Req ID** : 13036 **Working Title** : ... The Discharge Planner provides a broad range of support services to the Care Coordinators and to the licensed Clinical Social Workers with their transition planning… more
    Cedars-Sinai (10/31/25)
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  • Health Home Care Manager II

    HCR Home Care (Canton, NY)
    … needs in the Health Home Program. This position is designated as a higher-skilled Care Manager , capable of exceeding the basic tenants of care management. ... effectively reduce duplicative services. + Consult with the physicians, Managed Care Organizations and other members of...and prioritize multiple assignments. Work Environment The Health Home Care Manager 2 is primarily in an… more
    HCR Home Care (10/18/25)
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  • Care Manager (LSW/LISW)

    Molina Healthcare (OH)
    …gerontology, public health or social work or related **REQUIRED EXPERIENCE:** 1-3 years in case management, disease management, managed care or medical or ... with reliable transportation. **STATE SPECIFIC REQUIREMENTS:** **PREFERRED EXPERIENCE:** 3-5 years in case management, disease management, managed care or… more
    Molina Healthcare (12/13/25)
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  • Care Manager (RN)

    Molina Healthcare (Louisville, KY)
    …of Nursing. Bachelor's Degree in Nursing preferred. **Required Experience** 1-3 years in case management, disease management, managed care or medical or ... and must be licensed for the state of Kentucky Case Manager RN will work with KY...Bachelor's Degree in Nursing **Preferred Experience** 3-5 years in case management, disease management, managed care more
    Molina Healthcare (11/02/25)
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  • Nurse Care Manager

    Beth Israel Lahey Health (Wakefield, MA)
    …the social and emotional impact of illness and disability. The Care Manager upholds the current standards of professional case management practice, and ... are provided to the BILHPN provider's risk populations. The Care Manager provides care management...Medicare Guidelines preferred 3. Experience with Medicare population in managed care preferred Must be proficient in… more
    Beth Israel Lahey Health (12/03/25)
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  • Mobile Professional Care Manager

    UPMC (Pittsburgh, PA)
    UPMC Community Care Behavioral Health is seeking a full-time Mobile Professional Care Manager to support the Community Services Department in Blair County! ... The Mobile Professional Care Manager will work flexible hours, Monday...software applications required. + Three years experience in a managed care environment preferred + Experience with… more
    UPMC (12/08/25)
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  • Mobile Professional Care Manager

    UPMC (Pittsburgh, PA)
    …better. UPMC Health Plan is hiring a full-time Mobile Professional Care Manager position to support the Population Health Case Management department. This is ... Occasional travel may be required throughout surrounding counties. The Care Manager will support UPMC Health Plan...software applications required. + Three years experience in a managed care environment preferred Experience with geriatric… more
    UPMC (12/08/25)
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