- Healthfirst (NY)
- …operational discipline and capacity for executive-level decision-making** + **Experience working as a case manager for a long-term care programs such as ... **Demonstrated understanding of UM regulatory requirements, clinical review process, and managed care operations** + **Work experience interpreting and… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …+ Minimum of 2-3 years' experience functioning as a clinical pharmacist in a managed care or hospital setting + Experience in direct supervision of technical ... about their medications, conditions, and pharmacy benefits to achieve optimal participant care outcomes. + Collaborate with Pharmacy Benefit Manager (PBM)… more
- Northwell Health (Staten Island, NY)
- …plan and makes all necessary referrals. Completes Discharge Summary at time of release.*3. Case Management*Functions as a case manager with overall ... program limits, as required.*Serves as primary contact to insurance carriers and managed care companies. Ensures patients are appropriately certified and assists… more
- The Cigna Group (Orlando, FL)
- …technology systems + Bilingual in Spanish or Haitian Creole preferred + Knowledge of managed care preferred If you will be working at home occasionally or ... support. + Facilitate critical incident response by consulting with requesting manager and direct service providers to arrange appropriate clinical services,… more
- Genesis Healthcare (Beckley, WV)
- …to ensure seamless patient transitions into the skilled nursing setting. + Navigate managed care authorization processes and hospital discharge workflows. + Use ... the lives we touch through the delivery of high-quality care and exceptional service. As a leading provider in...experience as a **Clinical Liaison, Admissions Director, Hospital Liaison, Case Manager , or similar role** . +… more
- Molina Healthcare (Green Bay, WI)
- …(CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America ... new programs. Preferred Qualifications * Experience with utilization/quality program management. * Managed care experience. * Peer review experience. * Certified… more
- Northern Light Health (Bangor, ME)
- …and referring to community-based providers. They are adept at articulating case reviews and creating documentation that reflects both active treatment provisions ... and client response to care . This person performs duties and/or responsibilities as assigned by the Manager or Supervisor. Responsibilities: + Completes… more
- HCA Healthcare (Fort Walton Beach, FL)
- …patients with discharge planning or psychosocial needs. + Obtains input from the RN case manager to ensure the discharge plan is appropriate and aligns with ... regulations and processes, and possesses a thorough understanding of managed - care concepts and length-of-stay management relating to...do in this role: + Works collaboratively with RN case managers, acute care nurses, physicians, insurance… more
- Mount Sinai Health System (New York, NY)
- …day-to-day operations, in collaboration with the School Based Health Center Administrative Practice Manager , in the care and treatment of patients as delineated ... Center ("MSAHC" or the "Center") works to provide health care and wellness for young people by providing vital...charged with ensuring that the above functions are developed, managed and delivered within a culture that is youth-centric,… more
- Northern Light Health (Bangor, ME)
- …direct client care or clinical formulations, are adept at articulating case reviews and creating documentation that reflects both active treatment provisions and ... an LMSW-CC, LCPC-C, LCSW, LCPC or LMFT with experience in providing trauma-informed care in the treatment of substance use and co-occurring disorders who provides… more