• SE Primary Nurse

    Fallon Health (Springfield, MA)
    …health and inspiring hope, we strive to be the leading provider of government -sponsored health insurance programs -including Medicare, Medicaid , and PACE- in ... experience, service, and clinical quality. Fallon Health's Summit ElderCare(R) is a Program of All-Inclusive Care for the Elderly-PACE for short. PACE, an… more
    Fallon Health (12/13/25)
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  • Nurse Manager - Long Term Care

    First Atlantic Health Care (Saco, ME)
    …staff understand and follow their respective job descriptions. * Participate in state and federal surveys with authorized government agencies as requested ... Healthcare, part of the Atlantic Heights Community, is a fully-licensed Medicaid /Medicare-certified facility offering 105 beds. Under the ownership of First Atlantic… more
    First Atlantic Health Care (12/09/25)
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  • Outpatient Site Manager- SLP or OT

    BrightSpring Health Services (Henrico, VA)
    …Develops and maintains working knowledge of third-party payers, both government and commercial, for admissions. + Communicates established financial/billing ... Conducts chart audits to ensure that all federal and state law requirements and conditions of participation for Medicare...law requirements and conditions of participation for Medicare and Medicaid are met. + Gather data for assigned area(s)… more
    BrightSpring Health Services (12/09/25)
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  • RN, Field Care Manager(Maternal-Child Health)…

    Humana (New Castle, VA)
    …member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources ... + Ability to use a variety of electronic information applications/software programs including electronic medical records. + Excellent keyboard and web navigation… more
    Humana (12/07/25)
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  • RN - Nurse-Worcester - M- F , 8.30 AM - 5:00 PM

    Fallon Health (Worcester, MA)
    …health and inspiring hope, we strive to be the leading provider of government -sponsored health insurance programs -including Medicare, Medicaid , and PACE- in ... experience, service, and clinical quality. Fallon Health's Summit ElderCare(R) is a Program of All-Inclusive Care for the Elderly-PACE for short. PACE, an… more
    Fallon Health (11/12/25)
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  • LPN or RN - **High Pay - Part Time (24-32)…

    Fallon Health (Webster, MA)
    …strive to be the leading provider of government -sponsored health insurance programs , including Medicare, Medicaid , and PACE- in the region. **Brief Summary ... experience, service, and clinical quality. Fallon Health's Summit ElderCare(R) is a Program of All-Inclusive Care for the Elderly-PACE for short. PACE, an… more
    Fallon Health (10/17/25)
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  • Utilization Management Reviewer, RN (Multiple…

    Excellus BlueCross BlueShield (Rochester, NY)
    …+ Experience in interpreting managed care benefit plans and strong knowledge of government program contracts (Medicare and Medicaid ) and benefits, preferred. ... guidelines and medical policies and contractual benefits as well as State and Federal Mandates. May perform clinical review telephonically, electronically, or… more
    Excellus BlueCross BlueShield (10/07/25)
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  • RN Case Manager - United States Air Force

    Katmai (Usaf Academy, CO)
    …any US United States or jurisdiction, be able to practice using a nurse compact state license or Enhanced Nurse Licensure Compact (eNLC) or have a license from any ... United States jurisdiction. + Must maintain a current, valid, and unrestricted State nursing/social worker license in good standing. + Extensive knowledge of… more
    Katmai (12/07/25)
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  • Member Intake Admin - Worcester Office based…

    Fallon Health (Worcester, MA)
    …strive to be the leading provider of government -sponsored health insurance programs -including Medicare, Medicaid , and PACE ( Program of All-Inclusive Care ... all products, and in compliance with applicable NCQA standards and other state or federal regulatory requirements. Strict adherence to department turn-around time… more
    Fallon Health (11/20/25)
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  • Engage Clinical Care Specialist

    Elara Caring (Grand Rapids, MI)
    …Clinical Care Specialist is part of the ElaraConnect suite of patient engagement programs that aims to improve patient outcomes on-service. The Engage Clinical Care ... to our success in the following ways:** + Receives and maintains program referrals for assigned market (states or branch groups) identified by ElaraConnect… more
    Elara Caring (12/18/25)
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