• RN Care Manager - Rex Case…

    UNC Health Care (Raleigh, NC)
    …processing) to Care Management Assistant. Consult Social Worker and/or Utilization Manager per established departmental protocol. Maintain knowledge of ... the integrating and functions of case management , utilization review and discharge planning. The Care Manager...from CAPP as appropriate. As necessary meet with the Utilization Manager (UM) and SW after the… more
    UNC Health Care (07/24/25)
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  • RN Quality Review Nurse Home Health

    AdventHealth (Orlando, FL)
    …you'll contribute:** The Population Health Case Manager (PHCM) ensures effective utilization and case management oversight activities as defined by inter ... **Population Health Case Manager (RN) AdventHealth Home Health** **All the benefits...best practices, agency policies/processes. Ensures clear and appropriate visit utilization using evidence-based and best practice guidelines to achieve… more
    AdventHealth (08/07/25)
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  • Manager of Care Management - RN

    Community Health Systems (Birmingham, AL)
    …home health with excellent communication required + 2-4 years experience in case management or utilization management preferred **Knowledge, Skills and ... spending accounts + Life and disability insurance and more **Job Summary** The Manager of Care Management is responsible for the development, planning,… more
    Community Health Systems (08/09/25)
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  • RN Case Manager - Case Management

    Mayo Clinic (Jacksonville, FL)
    …by ensuring appropriate utilization management , care coordination, resource utilization , and clinical documentation. The RN Case Manager will function ... The RN Case Manager provides leadership through education on case management / utilization management concepts, committee work, research, and community… more
    Mayo Clinic (07/31/25)
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  • Hybrid Manager , Care Management

    CenterWell (Tampa, FL)
    **Become a part of our caring community and help us put health first** The Manager Care/Case Management in **Tampa area (** **_this is not a remote position_** ... for managing populations and coordinating care to reduce acute and post-acute care utilization . The Manager role is hybrid with travel requirements to preferred… more
    CenterWell (08/08/25)
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  • Manager Case Management Long-term…

    Highmark Health (Dover, DE)
    …accountable for the oversight development and maintenance of the department's case management processes. This includes utilization management , strategic ... **JOB SUMMARY** This job supervises a team of Case Manager Supervisors who are charged with promoting quality member...not limited to Medical Directors, Behavioral Health Teams, Disease Management , and Utilization Review. The incumbent is… more
    Highmark Health (06/27/25)
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  • Registered Nurse - Case Manager - Day

    WellSpan Health (Lebanon, PA)
    …**Duties and Responsibilities** + Reviews assigned patients for medical necessity, utilization management , and appropriateness of setting for continued ... quality and cost of care efforts. + Liaisons between utilization management team, third party payers, and... of resources to the attention of the appropriate manager (s). **Common Expectations:** + Demonstrates a commitment to patient,… more
    WellSpan Health (07/22/25)
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  • Case Manager RN - York Hospital - Days

    WellSpan Health (York, PA)
    …principles. **Essential Functions:** + Reviews assigned patients for medical necessity, utilization management , and appropriateness of setting for continued ... quality and cost of care efforts. + Liaisons between utilization management team, third party payers, and... of resources to the attention of the appropriate manager (s). **Common Expectations:** + Demonstrates a commitment to patient,… more
    WellSpan Health (07/22/25)
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  • Clinical Reimbursement Case Management

    Genesis Healthcare (York, PA)
    …while making a meaningful impact in the communities we serve. Responsibilities The Manager , Case Management is responsible for the clinical, administrative, and ... responding to the needs of its payor customers. The Manager will also perform the functions of the Case...of clinical nursing experience is required. Prior experience in utilization review, case management or discharge planning… more
    Genesis Healthcare (07/01/25)
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  • Supervisor Care Management - Remote

    Martin's Point Health Care (Portland, ME)
    …or delegates projects. + Works closely with the Manager Care Management , Director Health Management , Utilization Review managers/ supervisors, Quality ... Supervisor is responsible for day-to-day operations of the Care Management Teams within the Health Management Department...and issues, as necessary. + Works as a Care Manager in a back-up capacity as needed based on… more
    Martin's Point Health Care (08/08/25)
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