• IDD Specialty Care Manager Lead

    Elevance Health (Goldsboro, NC)
    …+ Service delivery coordination, discharge planning or behavioral health experience in a managed care setting preferred. + Travels to worksite and other ... \#HealthyBlueCareTogetherCFSP **IDD Specialty Care Manager Lead ** **$3,500 SIGN ON BONUS** _We are partnering with North Carolina DHHS to operationalize a… more
    Elevance Health (09/17/25)
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  • Utilization Management Systems Trainer

    Dignity Health (Bakersfield, CA)
    …training programs focused on the technical workflows and compliance requirements of the managed care platforms. This position will work directly with the UM ... customized training programs on the technical workflows of the managed care platform, with an emphasis on...of scale across provider types and geographies and will lead the effort in developing Dignity Health's Medicaid population… more
    Dignity Health (09/11/25)
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  • Medical Director, Behavioral Health Children's…

    MVP Health Care (Rochester, NY)
    …adolescent psychiatry. + Minimum of five years of experience working with children in BH managed care settings or BH clinical settings (at least two years must ... setting). Previous experience as a medical director in a managed care /health plan is desirable. + Individuals...medical necessity criteria as necessary. + Conducts pediatric reviews. Lead 's MVP's efforts to collaborate in person and virtually… more
    MVP Health Care (09/24/25)
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  • Director, Utilization Management BH

    Commonwealth Care Alliance (Boston, MA)
    …active RN license required Required Experience: * 7-10 years * 8-10 years of managed care operations experience, including a minimum five (5) years of leadership ... care delivery Required Knowledge, Skills & Abilities: * Medicare and Medicaid managed care experience * Demonstrated knowledge of federal and state… more
    Commonwealth Care Alliance (10/02/25)
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  • Provider Contracts Manager (Skilled Nursing…

    Molina Healthcare (Ann Arbor, MI)
    …in health care field including, but not limited to, provider's office, managed care , or other health care field. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS ... provider and routine ancillary contracts. * Identified as contract system lead by developing and maintaining provider contracts in contract management software.… more
    Molina Healthcare (09/11/25)
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  • Leader , Outreach Staff

    MVP Health Care (North Coventry, PA)
    …for our customers in every interaction. Preferred skills: + Experience in a Managed care retail setting + NYSOH Marketplace facilitated enroller certification ... At MVP Health Care , we're on a mission to create a...continuous improvement. To achieve this, we're looking for a ** Leader , Outreach Staff** to join #TeamMVP. This is the… more
    MVP Health Care (09/23/25)
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  • Case Manager, Registered Nurse - Indiana - McLaren…

    McLaren Health Care (Indianapolis, IN)
    …setting. Performs as the member advocate with emphasis on education regarding managed care , disease management and PCP treatment plans. Monitors member's ... Two (2) years' experience and knowledge of HMO, PPO, TPA, PHO and Managed Care functions including understanding of claims administration, including CPT-4 codes,… more
    McLaren Health Care (10/07/25)
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  • Intensive Community Care Manager…

    ChenMed (Largo, FL)
    …the Commission for Case Manager Certification (CCMC) or the American Association of Managed Care Nurses (CMCN) desired + This position requires possession and ... Intensive Community Managers (ICCMs) will serve as a clinical lead for the Complex Care Team. They...necessary to meet their needs and engage them in care . As a clinical leader for the… more
    ChenMed (10/02/25)
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  • Senior Patient Care Manager, RN - Hospice…

    Gentiva (Auburndale, MA)
    …industry regulations (Medicare, Medicaid, JCAHO, ACHC), and best practices * Familiarity with managed care principles and human resource guidelines * Ability to ... **$10,000 SIGN ON BONUS AVAILABLE** **Are you ready to lead and elevate the standard of hospice care...**We Offer** **Why Join Us?** We are a national leader in home-based care with more than… more
    Gentiva (08/27/25)
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  • Regional Strategy Director Primary Care

    Trinity Health (Boise, ID)
    …experience in developing, overseeing or interacting with physician groups, product lines, managed care and/or business development activities, in a large, ... Alphonsus Health System is seeking a strategic and collaborative leader to serve as the **Director of Strategy &...Lead strategic planning and business development for primary care and behavioral health services across multiple sites. +… more
    Trinity Health (09/06/25)
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