- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt Position Summary: Commonwealth Care Alliance's (CCA) Utilization Management (Authorization) Unit is primarily responsible for ... facilities under the provisions of CCA's benefits plan. The Manager , Utilization Management is responsible for overseeing...Act as liaison with medical director, provider relations, case management and quality teams to support care … more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer is ... Experience (must have):** + 2 to 3 years Utilization Management experience in a managed care setting...Care experience + 2 or more years of LTSS experience + 2 or more years working in… more
- Commonwealth Care Alliance (Boston, MA)
- … Alliance's (CCA) Community Intensive Care (CIC) program is responsible for providing care delivery and care management to a specific panel of high ... significant medical, behavioral, and social complexities that require intensive care management and care delivery....with external providers, including but not limited to Primary Care staff, specialty services, LTSS coordinators, Aging… more
- Molina Healthcare (Albany, NY)
- …**Job Summary** The Care Manager RN provides support for care management / care coordination activities and collaborates with multidisciplinary team ... . This position will be supporting our Complex Pediatric Care Management program. The ideal candidate will...consultation, resources and recommendations to peers as needed. * Care manager RNs may be assigned complex… more
- Molina Healthcare (TX)
- …which are either older adults or disabled adults. Applicants who have experience supporting the LTSS population as a Care Manager with another MCO are highly ... a Texas licensed RN to join Molina as a Care Manager working with DSNIP members. The...in Nursing preferred. **Required Experience** 1-3 years in case management , disease management , managed care … more
- Elevance Health (Goldsboro, NC)
- \#HealthyBlueCareTogetherCFSP **IDD Specialty Care Manager Lead** **$3,500 SIGN ON BONUS** _We are partnering with North Carolina DHHS to operationalize a ... services and supports, Unmet health-related resource needs, and Integrated care management . We envision a North Carolina...is granted as required by law. The **IDD Specialty Care Manager Lead** is responsible for coordinating… more
- Molina Healthcare (Yonkers, NY)
- …**Job Summary** The Care Manager (BH) provides support for care management / care coordination activities and collaborates with multidisciplinary team ... for members including behavioral health, long-term services and supports ( LTSS ), and home and community resources to enhance continuity... Manager (CCM). * Experience in behavioral health care management . * Field-based care … more
- Molina Healthcare (Philadelphia, MS)
- JOB DESCRIPTION Job Summary Provides support for care management / care coordination activities and collaborates with multidisciplinary team coordinating ... per regulated timelines and determines who may qualify for care management based on clinical judgment, changes...consultation, resources and recommendations to peers as needed. * Care manager RNs may be assigned complex… more
- Molina Healthcare (GA)
- …services functions: care management , utilization management , care transitions, long-term supports and services ( LTSS ), behavioral health, nurse ... of practice. * Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM), Certified Professional in Health Care … more
- Commonwealth Care Alliance (Boston, MA)
- …CCA's delegated partnerships programs, working with clinical community partners responsible for care management and utilization management across CCA's One ... providers, and supporting the implementation of CCA's model of care and strategic objectives. The Manager leads...Abilities & Language (nice to have): * Familiarity with care management and utilization management … more