- CareFirst (Baltimore, MD)
- … to support our Maryland Medicare enrollees. Under minimal supervision, the Care Manager researches and analyzes a member's medical and behavioral health needs ... and healthcare cost drivers. The Care Manager works closely with members and the interdisciplinary care team to ensure members have an effective plan of care and… more
- SitusAMC (Helena, MT)
- …emerging industry practices + Such other activities as may be assigned by your manager + Understands our pricing model and billing procedures + Assures project legal ... handle multiple tasks at the same time while maintaining attention to detail \#LI-AS1 #LI- Remote Note: This job description is not intended to be all inclusive or… more
- Highmark Health (Harrisburg, PA)
- …resource utilization, identification of opportunities for referral to a Health Coach/ case management, and identification and resolution of quality issues. Monitors ... with established industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable state, federal… more
- Adams County Government (Westminster, CO)
- Case Services Aide V Adult Protective Services-162354 Print (https://www.governmentjobs.com/careers/adams/jobs/newprint/5122587) Apply Case Services Aide V ... classification Hybrid -- Job duties and expectations allow for onsite and remote work scheduled every week. Employees in this classification are regularly scheduled… more
- Molina Healthcare (Columbus, OH)
- …directly with individuals with substance use disorders. Preferred Qualifications * Certified Case Manager (CCM). * Experience working with populations that ... resources to enhance continuity of care. * Assesses for medical necessity and authorizes all appropriate waiver services. *...resources and recommendations to peers as needed. * Care manager RNs may be assigned complex member cases and… more
- The Hershey Company (IN)
- …week (No Remote ) * Job Summary:* Reporting to the EHS manager , the Occupational Health Nurse will provide professional and comprehensive health, wellness, safety ... providers, including, but not limited to physical therapists, specialists, and/or Nurse Case Managers. * / Medical Surveillance/* * Oversight and participation in… more
- Molina Healthcare (Columbus, OH)
- …and ability to navigate online portals and databases. Preferred Qualifications * Certified Case Manager (CCM). To all current Molina employees: If you are ... resources and recommendations to peers as needed. * Care manager RNs may be assigned complex member cases and...care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of… more
- Molina Healthcare (Columbus, OH)
- …License must be active and unrestricted in state of practice. * Certified Case Manager (CCM), Certified Professional in Health Care Management certification ... care review, care management, utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), transition of care, health management, behavioral… more
- Molina Healthcare (Columbus, OH)
- …be required (dependent upon state/contractual requirements). Preferred Qualifications * Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed ... and community resources to enhance continuity of care. * Assesses for medical necessity and authorizes all appropriate waiver services. * Evaluates covered benefits… more
- Guardian Life (Harrisburg, PA)
- As the **Team Leader, LTD Claims Case Management** , you will be responsible for validating that all LTD claims are accurately and fairly adjudicated according to ... manner and in accordance to departmental policy + Assist manager with departmental budget and vendor expenses + Identify...**Travel and Office Model** + This is a fully remote role with possible minimal travel to other locations… more